Midwife managed delivery unit: A randomised controlled comparison with consultant led care

This source preferred by Vanora Hundley

Authors: Hundley, V., Cruickshank, F.M., Lang, G., Glazener, C.M., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ : British Medical Journal (Clinical Research edition).)

Volume: 309

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour.

This data was imported from PubMed:

Authors: Hundley, V.A., Cruickshank, F.M., Lang, G.D., Glazener, C.M., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ

Volume: 309

Issue: 6966

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

OBJECTIVE: To examine whether intrapartum care and delivery of low risk women in a midwife managed delivery unit differs from that in a consultant led labour ward. DESIGN: Pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives unit and the labour ward. SETTING: Aberdeen Maternity Hospital, Grampian. SUBJECTS: 2844 low risk women, as defined by existing booking criteria for general practitioner units in Grampian. 1900 women were randomised to the midwives unit and 944 to the labour ward. MAIN OUTCOME MEASURES: Maternal and perinatal morbidity. RESULTS: Of the women randomised to the midwives unit, 647 (34%) were transferred to the labour ward antepartum, 303 (16%) were transferred intrapartum, and 80 (4%) were lost to follow up. 870 women (46%) were delivered in the midwives unit. Primigravid women (255/596, 43%) were significantly more likely to be transferred intrapartum than multi-gravid women (48/577, 8%). Significant differences between the midwives unit and labour ward were found in monitoring, fetal distress, analgesia, mobility, and use of episiotomy. There were no significant differences in mode of delivery or fetal outcome. CONCLUSIONS: Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour.

This data was imported from Scopus:

Authors: Hundley, V.A., Cruickshank, F.M., Lang, G.D., Glazener, C.M.A., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ

Volume: 309

Issue: 6966

Pages: 1400

eISSN: 1468-5833

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Objective: To examine whether intrapartum care and delivery of low risk women in a midwife managed delivery unit differs from that in a consultant led labour ward. Design: Pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives unit and the labour ward. Setting: Aberdeen Maternity Hospital, Grampian. Subjects—2844 low risk women, as defined by existing booking criteria for general practitioner units in Grampian. 1900 women were randomised to the midwives unit and 944 to the labour ward. Main outcome measures: Maternal and perinatal morbidity. Results: Of the women randomised to the midwives unit, 647 (34%) were transferred to the labour ward antepartum, 303 (16%) were transferred intrapartum, and 80 (4%) were lost to follow up. 870 women (46%) were delivered in the midwives unit. Primigravid women (255/596, 43%) were significantly more likely to be transferred intrapartum than multigravid women (48/577, 8%). Significant differences between the midwives unit and labour ward were found in monitoring, fetal distress, analgesia, mobility, and use of episiotomy. There were no significant differences in mode of delivery or fetal outcome. Conclusions: Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour. © 1994, BMJ Publishing Group Ltd. All rights reserved.

This data was imported from Web of Science (Lite):

Authors: HUNDLEY, V.A., CRUICKSHANK, F.M., LANG, G.D., GLAZENER, C.M.A., MILNE, J.M., TURNER, M., BLYTH, D., MOLLISON, J. and DONALDSON, C.

Journal: BRITISH MEDICAL JOURNAL

Volume: 309

Issue: 6966

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

The data on this page was last updated at 05:10 on February 17, 2020.