It's one of the reasons that NICE in the UK are recommending
midwife led settings for first births — to cut the primary c - section rate.
Not exact matches
This new
set of NICE guidelines concluded that healthy women with straightforward pregnancies are safer to give birth at home, or in a
midwife -
led birth centre, than at a hospital with the care of an obstetrician.
Setting England: all NHS trusts providing intrapartum care at home, all freestanding midwifery units, all alongside midwifery units (
midwife led units on a hospital site with an obstetric unit), and a stratified random sample of obstetric units.
It is possible that practice
settings such as
midwife -
led units can be a confounding influence on outcomes of
midwife -
led continuity of care (Brocklehurst 2011), although home birth was not offered in any of the trials.
The review includes trials that compared
midwife -
led continuity of care given both during the antepartum and the intrapartum period with other models of care, which included obstetricians or family physicians, or both, collaborating with nurses and
midwives in a variety of organisational
settings.
Four studies offered intrapartum care in home - like
settings, either to all women in the trial (Waldenstrom 2001), or to women receiving
midwife -
led continuity of care only (Begley 2011; MacVicar 1993; Turnbull 1996).
Four studies offered intrapartum care in homelike
settings, either to all women in the trial (Waldenstrom 2001), or to women receiving
midwife -
led continuity of care only (Begley 2011; MacVicar 1993; Turnbull 1996).
Thus,
midwife -
led continuity models of care aim to provide care in either community or hospital
settings, normally to healthy women with uncomplicated or «low - risk» pregnancies.
Other models of care include a) where the physician / obstetrician is the
lead professional, and
midwives and / or nurses provide intrapartum care and in - hospital postpartum care under medical supervision; b) shared care, where the
lead professional changes depending on whether the woman is pregnant, in labour or has given birth, and on whether the care is given in the hospital, birth centre (free standing or integrated) or in community
setting (s); and c) where the majority of care is provided by physicians or obstetricians.
But following an in - depth study of the safety of different maternity
settings which investigated 65,000 births across England,
midwife -
led care was found to be as safe as doctor -
led hospital care.