Outcomes for the First Year of Ontario's Birth Center Demonstration Project. (10th September 2018)
- Record Type:
- Journal Article
- Title:
- Outcomes for the First Year of Ontario's Birth Center Demonstration Project. (10th September 2018)
- Main Title:
- Outcomes for the First Year of Ontario's Birth Center Demonstration Project
- Authors:
- Sprague, Ann E.
Sidney, Dana
Darling, Elizabeth K.
Van Wagner, Vicki
Soderstrom, Bobbi
Rogers, Judy
Graves, Erin
Coyle, Doug
Sumner, Amanda
Holmberg, Vivian
Khan, Bushra
Walker, Mark C. - Abstract:
- Abstract : Introduction: In 2014, Ontario opened 2 stand‐alone midwifery‐led birth centers. Using mixed methods, we evaluated the first year of operations for quality and safety, client experience, and integration into the maternity care community. This article reports on our study of safety and quality of care. Methods: This descriptive evaluation focused on women admitted to a birth center at the beginning of labor. For context, we matched this cohort (on a 1:4 basis) with similar low‐risk midwifery clients giving birth in a hospital. Data sources included Ontario's Better Outcomes Registry and Network (BORN) Information System, the Canadian Institute for Health Information, Ontario census data, and birth center records. Results: Of 495 women admitted to a birth center, 87.9% experienced a spontaneous vaginal birth, regardless of the eventual location of birth, and 7.7% had a cesarean birth. The transport rate to a hospital was 26.3%. When compared with midwifery clients with a planned hospital birth, rates of intervention (epidural analgesia, labor augmentation, assisted vaginal birth, and cesarean birth) were significantly lower in the planned birth center group, even when controlled for previous cesarean birth and body mass index. Markers of potential morbidity were identified in about 10% of birth center births; however, there were no short‐term health impacts up to discharge from midwifery care at 6 weeks postpartum. Care was low in intervention and safe (minimalAbstract : Introduction: In 2014, Ontario opened 2 stand‐alone midwifery‐led birth centers. Using mixed methods, we evaluated the first year of operations for quality and safety, client experience, and integration into the maternity care community. This article reports on our study of safety and quality of care. Methods: This descriptive evaluation focused on women admitted to a birth center at the beginning of labor. For context, we matched this cohort (on a 1:4 basis) with similar low‐risk midwifery clients giving birth in a hospital. Data sources included Ontario's Better Outcomes Registry and Network (BORN) Information System, the Canadian Institute for Health Information, Ontario census data, and birth center records. Results: Of 495 women admitted to a birth center, 87.9% experienced a spontaneous vaginal birth, regardless of the eventual location of birth, and 7.7% had a cesarean birth. The transport rate to a hospital was 26.3%. When compared with midwifery clients with a planned hospital birth, rates of intervention (epidural analgesia, labor augmentation, assisted vaginal birth, and cesarean birth) were significantly lower in the planned birth center group, even when controlled for previous cesarean birth and body mass index. Markers of potential morbidity were identified in about 10% of birth center births; however, there were no short‐term health impacts up to discharge from midwifery care at 6 weeks postpartum. Care was low in intervention and safe (minimal negative outcomes and transport rates comparable to the literature). Discussion: In the first year of operation, care was consistent with national guidelines, and morbidity and mortality rates and intervention rates were low for women with low‐risk pregnancies seeking a low‐intervention approach for labor and birth. Further evaluation to confirm these findings is required as the number of births grows. … (more)
- Is Part Of:
- Journal of midwifery & women's health. Volume 63:Number 5(2018)
- Journal:
- Journal of midwifery & women's health
- Issue:
- Volume 63:Number 5(2018)
- Issue Display:
- Volume 63, Issue 5 (2018)
- Year:
- 2018
- Volume:
- 63
- Issue:
- 5
- Issue Sort Value:
- 2018-0063-0005-0000
- Page Start:
- 532
- Page End:
- 540
- Publication Date:
- 2018-09-10
- Subjects:
- birthing center -- childbirth -- midwifery -- quality of health care
Midwives -- Periodicals
Obstetrics -- Periodicals
Women's health services -- Periodicals
618.2 - Journal URLs:
- http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1542-2011/issues ↗
http://www.sciencedirect.com/science/journal/15269523 ↗
http://onlinelibrary.wiley.com/ ↗ - DOI:
- 10.1111/jmwh.12884 ↗
- Languages:
- English
- ISSNs:
- 1526-9523
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 5019.935000
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 11286.xml