Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study

Cien Saude Colet. 2022 Jul;27(7):2741-2752. doi: 10.1590/1413-81232022277.20632021. Epub 2022 Jan 2.

Abstract

Collaborative models (CM) focused on intrapartum care shared between both midwives and obstetricians have been proposed as a strategy to reduce these rates. Our aim was to compare use of evidence-based practices, obstetric interventions and c-section rates in two settings: a maternity hospital that applies a CM of care (MRJ) and data from a pool of maternity hospitals included in the Birth in Brazil Survey (NB) that do not adopt a CM. Data was abstracted from medical and administrative records in MRJ and from medical records and face-to-face interviews in NB. Differences were compared using chi-square test, with significance level set at p<0.05. MRJ showed a higher frequency of labour companionship, labour care provided by nurse midwives, non-pharmacological pain relief methods, food intake during labour, and less use of oxytocin, analgesia and amniotomy. More women also had second stage assisted by a nurse midwife and in a vertical position, as well as lower use of episiotomies and vacuum-extractor/forceps. The c-section rate was lower at MRJ. Shared care between midwives and obstetricians can be an effective strategy to improve quality of intrapartum care.

Publication types

  • Observational Study

MeSH terms

  • Delivery, Obstetric / methods
  • Female
  • Hospitals, Maternity
  • Humans
  • Labor, Obstetric*
  • Midwifery*
  • Nurse Midwives*
  • Parturition
  • Pregnancy