Sentences with phrase «alongside birth settings»

Not exact matches

1.1.2 Explain to both multiparous and nulliparous women that they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice of setting wherever they choose to give birth: Advise low ‑ risk multiparous women that planning to give birth at home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate of interventions is lower and the outcome for the baby is no different compared with an obstetric unit.

The proportion of women with a «normal birth» (birth without induction of labour, epidural or spinal analgesia, general anaesthesia, forceps or ventouse delivery, caesarean section, or episiotomy9 10) varied from 58 % for planned obstetric unit births to 76 % in alongside midwifery units, 83 % in freestanding midwifery units, and 88 % for planned home births; the adjusted odds of having a «normal birth» were significantly higher in all three non-obstetric unit settings (table 5 ⇓).

Interventions Planned birth in four alternative settings: at home, in freestanding midwifery units, in alongside midwifery units, and in obstetric units.

The generalised linear model on costs showed that, even after adjustment for clinical and sociodemographic confounders, planned birth in settings other than obstetric units remained cost saving compared with the reference category of the obstetric unit: savings averaged # 134, # 130, and # 310 for planned births in alongside midwifery units, free standing midwifery units, and at home, respectively (P < 0.001)(see appendix 3 on bmj.com).

For low risk women without complicating conditions at the start of care in labour, the mean incremental cost effectiveness ratios associated with switches from planned birth in obstetric unit to non-obstetric unit settings fell in the south west quadrant of the cost effectiveness plane (representing, on average, reduced costs and worse outcomes).25 The mean incremental cost effectiveness ratios ranged from # 143382 (alongside midwifery units) to # 497595 (home)(table 4 ⇓).

The mean net monetary benefit associated with shifts to non-obstetric unit settings varied from # 2486 (# 2259 to # 2692)(alongside midwifery units) to # 4498 (# 4306 to # 4669)(home) at a # 20000 cost effectiveness threshold for avoiding a maternal morbidity (table 5 ⇓), and from # 3828 (# 3600 to # 4052)(alongside midwifery units) to # 6609 (# 6411 to # 6810)(home) at a # 20000 cost effectiveness threshold for achieving an additional normal birth (table 6 ⇓).

Setting 142 of 147 trusts providing home birth services, 53 of 56 freestanding midwifery units, 43 of 51 alongside midwifery units, and a random sample of 36 of 180 obstetric units, stratified by unit size and geographical region, in England, over varying periods of time within the study period 1 April 2008 to 30 April 2010.

Since the early 1990s, government policy on maternity care in England has moved towards policies designed to give women with straightforward pregnancies a choice of settings for birth.1 2 In this context, freestanding midwifery units, midwifery units located in the same building or on the same site as an obstetric unit (hereafter referred to as alongside midwifery units), and home birth services have increasingly become relevant to the configuration of maternity services under consideration in England.3 The relative benefits and risks of birth in these alternative settings have been widely debated in recent years.4 5 6 7 8 9 10 Lower rates of obstetric interventions and other positive maternal outcomes have been consistently found in planned births at home and in midwifery units, but clear conclusions regarding perinatal outcome have been lacking.

Profiles of resource use, and their associated unit costs, for each planned place of birth are reported in detail in appendices 1 and 2 on bmj.com.25 The total mean costs per low risk woman planning birth in the various settings at the start of care in labour were # 1631 ($ 1950, $ 2603) for an obstetric unit, # 1461 ($ 1747, $ 2332) for an alongside midwifery unit, # 1435 ($ 1715, $ 2290) for a free standing midwifery unit, and # 1067 ($ 1274, $ 1701) for the home (table 1 ⇓).

Firstly all women irrespective of where they live should have access to the three pathways of care; supported, assisted and specialised, in the three different settings outlined in the strategy; namely at home, at an alongside birth centre and at a specialised birth centre.

The study was carried out in Japan, where scientists observed birth ratios and set them alongside yearly temperatures from 1968 to 2012.