Sentences with phrase «for obstetric unit»

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 ⇓).

Restriction of the analyses to low risk women without complicating conditions at the start of care in labour narrowed the cost differences between planned places of birth: total mean costs were # 1511 for an obstetric unit, # 1426 for an alongside midwifery unit, # 1405 for a free standing midwifery unit, and for # 1027 the home (table 2 ⇓).

(OU stands for Obstetric unit [hospital], AMU stands for along side maternity unit [in hospital birth center], and FMU for free - standing maternity unit [independent birth center].)

Not exact matches

Advise low ‑ risk nulliparous women that planning to give birth 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.

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.

Babies were significantly more likely to be breast fed at least once for planned births at home and at freestanding midwifery units compared with planned obstetric unit births.

In England, planned birth outside an obstetric unit remains uncommon, despite this being an available option for a number of years.

The grass roots organization Improving Birth coined the term «obstetric violence» - which is playing out in labor and delivery units in certain parts of the world; the World Health Organization called for increased scrutiny of these disrespectful childbirth care practices, as women treated in this way, feel assaulted and violated, and must be taken as seriously as rape.

Overall, there were no significant differences in the odds of the primary outcome for births planned in any of the non-obstetric unit settings compared with planned births in obstetric units (table 3 ⇑).

These are considered to increase risk for the woman or baby, and care in an obstetric unit would be expected to reduce this risk.8

For healthy nulliparous women with a low risk pregnancy, the risk of an adverse perinatal outcome seems to be higher for planned births at home, and the intrapartum transfer rate is high in all settings other than an obstetric uFor healthy nulliparous women with a low risk pregnancy, the risk of an adverse perinatal outcome seems to be higher for planned births at home, and the intrapartum transfer rate is high in all settings other than an obstetric ufor planned births at home, and the intrapartum transfer rate is high in all settings other than an obstetric unit

For the restricted sample of women without any complicating conditions at the start of care in labour, the odds of a primary outcome event were higher for births planned at home compared with planned obstetric unit births (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52) but there was no evidence of a difference for either freestanding or alongside midwifery units compared with obstetric uniFor the restricted sample of women without any complicating conditions at the start of care in labour, the odds of a primary outcome event were higher for births planned at home compared with planned obstetric unit births (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52) but there was no evidence of a difference for either freestanding or alongside midwifery units compared with obstetric unifor births planned at home compared with planned obstetric unit births (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52) but there was no evidence of a difference for either freestanding or alongside midwifery units compared with obstetric unifor either freestanding or alongside midwifery units compared with obstetric units.

For healthy multiparous women with a low risk pregnancy, there are no differences in adverse perinatal outcomes between planned births at home or in a midwifery unit compared with planned births in an obstetric unit

In the subgroup analysis stratified by parity, there was an increased incidence of the primary outcome for nulliparous women in the planned home birth group (weighted incidence 9.3 per 1000 births, 95 % confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3).

Overall, there were no significant differences in the adjusted odds of the primary outcome for any of the non-obstetric unit settings compared with obstetric units.

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 ⇓).

For many women, a traumatic primary experience in an obstetric led unit is one of the main reasons for choosing midwifery - led care or home birth in a subsequent pregnanFor many women, a traumatic primary experience in an obstetric led unit is one of the main reasons for choosing midwifery - led care or home birth in a subsequent pregnanfor choosing midwifery - led care or home birth in a subsequent pregnancy.

Yet we know from repeated high quality, robust research that midwifery - led care options (as opposed to midwife attended care in obstetric - led units) is the safest model of care for 85 % of women.

The majority of maternity units in Ireland are yet to implement these recommendations into their policy and many women report admission trace and electronic foetal monitoring is routine everyday practice for all women in obstetric led units.

Descriptive statistics were reported for maternal demographic, social, and obstetric characteristics by maternity unit Baby Friendly status with a comparison of percentages, weighted for design effect (F statistic27 significance P ≤ 0.05).

Incremental cost effectiveness ratios and net benefit statistics for normal birth outcome in women at low risk of complications according to planned place of birth: home, freestanding midwifery unit (FMU), or alongside midwifery unit (AMU) with obstetric unit (OU) as reference

Results Mothers delivering in accredited maternity units were more likely to start breastfeeding than those delivering in units with neither award [adjusted rate ratio: 1.10, 95 % confidence interval (CI) 1.05 — 1.15], but were not more likely to breastfeed at 1 month (0.96, 95 % CI 0.84 — 1.09), after adjustment for social, demographic, and obstetric factors.

After adjustment for country of residence and individual social, demographic, and obstetric characteristics, mothers who delivered in an accredited hospital were 10 % more likely to start breastfeeding: adjusted rate ratio [95 % confidence interval (CI): 1.10 (1.05 — 1.15)-RSB-, than those who delivered in a unit with neither award (Table 4).

The adjusted odds of the secondary maternal outcomes — namely, maternal morbidity avoided and «normal birth» — were significantly increased for planned births in all three non-obstetric unit settings compared with those planned in obstetric units.

For all low risk women, bootstrapped estimates showed that planned birth in settings other than an obstetric unit was associated with cost savings and considerable stochastic uncertainty surrounding adverse perinatal outcomes.

In further analyses restricted to women without complicating conditions at the start of care in labour, the adjusted odds of adverse perinatal outcomes were higher for births planned at home compared with those planned in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52).

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).

Fig 2 Cost effectiveness plane: planned birth at home compared with planned birth in obstetric units for nulliparous low risk women without complicating conditions at start of care in labour

For the purposes of this economic evaluation, the forms were initially used in a related study funded by the National Institute of Health Research (NIHR) research for patient benefit programme «assessing the impact of a new birth centre on choice and outcome of maternity care in an inner city area,» which will be reported in full elsewhere, comparing the costs of care in a free standing midwifery unit with care in an obstetric unit in the same trust.16 The data collected included details of staffing levels, treatments, surgeries, diagnostic imaging tests, scans, drugs, and other resource inputs associated with each stage of the pathway through intrapartum and after birth caFor the purposes of this economic evaluation, the forms were initially used in a related study funded by the National Institute of Health Research (NIHR) research for patient benefit programme «assessing the impact of a new birth centre on choice and outcome of maternity care in an inner city area,» which will be reported in full elsewhere, comparing the costs of care in a free standing midwifery unit with care in an obstetric unit in the same trust.16 The data collected included details of staffing levels, treatments, surgeries, diagnostic imaging tests, scans, drugs, and other resource inputs associated with each stage of the pathway through intrapartum and after birth cafor patient benefit programme «assessing the impact of a new birth centre on choice and outcome of maternity care in an inner city area,» which will be reported in full elsewhere, comparing the costs of care in a free standing midwifery unit with care in an obstetric unit in the same trust.16 The data collected included details of staffing levels, treatments, surgeries, diagnostic imaging tests, scans, drugs, and other resource inputs associated with each stage of the pathway through intrapartum and after birth care.

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 ⇓).

In this study of the cost effectiveness of alternative planned places of birth in England in women at low risk of complications before the onset of labour, we found that the cost of intrapartum and after birth care, and associated related complications, was less for births planned at home, in a free standing midwifery unit, or in an alongside midwifery unit compared with planned births in an obstetric unit.

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.

For reasons explained in the cohort study report, obstetric units contained more women in whom complicating conditions were an unexpected observation, which suggests that the risk profile of low risk women varied between the settings.

If admitted to the unit, women are cared for by the hospital's internationally renowned maternal - fetal medicine and obstetric medicine specialists.

Jane Sandall was and is principal investigator for two studies evaluating models of midwife - led continuity of care (Sandall 2001), and co-investigator on the «Birthplace in England Research Programme», an integrated programme of research designed to compare outcomes of births for women planned at home, in different types of midwifery units, and in hospital units with obstetric services.

Obstetric - led care has a very important place in Irish maternity services and should be available for women who want or need this type of maternity care, however, in failing to provide evidence based care options, valuable resources are being over-utilized as women have no option but birth in under - staffed and over-crowded consultant led units.»

The most recent U.K. data for planned place of birth shows no significant differences in negative outcomes between births at home, at birth centers, and obstetric units for mothers who have already had children.

Declan Devane is a co-author in one of the included trials in this review (Begley 2011) Jane Sandall was and is principal investigator for two studies evaluating models of midwife - led continuity of care (Sandall 2001), and co-investigator on the «Birthplace in England Research Programme», an integrated programme of research designed to compare outcomes of births for women planned at home, in different types of midwifery units, and in hospital units with obstetric services.

For women who are likely to give birth easily, being in a major obstetric unit may result in interventions that make their birth less straightforward.