Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study.
Por:
Martín-Arribas A, Vila-Candel R, O'Connell R, Dillon M, Vila-Bellido I, Beneyto MÁ, De Molina-Fernández I, Rodríguez-Conesa N, González-Blázquez C and Escuriet R
Publicada:
13 nov 2020
Ahead of Print:
13 nov 2020
Resumen:
BACKGROUND: In Europe, the majority of healthy women give birth at conventional obstetric units with the assistance of registered midwives. This study examines the relationships between the intrapartum transfer of care (TOC) from midwife to obstetrician-led maternity care, obstetric unit size (OUS) with different degrees of midwifery autonomy, intrapartum interventions and birth outcomes. METHODS: A prospective, multicentre, cross-sectional study promoted by the COST Action IS1405 was carried out at eight public hospitals in Spain and Ireland between 2016-2019. The primary outcome was TOC. The secondary outcomes included type of onset of labour, oxytocin stimulation, epidural analgesia, type of birth, episiotomy/perineal injury, postpartum haemorrhage, early initiation of breastfeeding and early skin-to-skin contact. A logistic regression was performed to ascertain the effects of studied co-variables on the likelihood that participants had a TOC; Results: Out of a total of 2,126 low-risk women, those whose intrapartum care was initiated by a midwife (1772) were selected. There were statistically significant differences between TOC and OUS (S1 = 29.0%, S2 = 44.0%, S3 = 52.9%, S4 = 30.2%, p < 0.001). Statistically differences between OUS and onset of labour, oxytocin stimulation, type of birth and episiotomy or perineal injury were observed (p = 0.009, p < 0.001, p < 0.001, p < 0.001 respectively); Conclusions: Findings suggest that the model of care and OUS have a significant effect on the prevalence of intrapartum TOC and the birth outcomes. Future research should examine how models of care differ as a function of the OUS in a hospital, as well as the cost-effectiveness for the health care system.
Filiaciones:
Martín-Arribas A:
GHenderS Research Group, School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain
Faculty of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain
:
La Ribera Hospital Health Department, Carretera Corbera km 1, 46600 Valencia, Spain
Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
Faculty of Nursing and Podiatry, Universitat de València, Jaume Roig, s/n, 46010 Valencia, Spain
O'Connell R:
School of Nursing and Midwifery, University College Cork, T12 YN60 Cork, Ireland
Dillon M:
Cork University Maternity Hospital, Wilton, T12 YE02 Cork, Ireland
:
Verge dels Lliris Hospital, Poligon de Caramanxel s/n, 03804 Alcoi, Spain
Beneyto MÁ:
Verge dels Lliris Hospital, Poligon de Caramanxel s/n, 03804 Alcoi, Spain
De Molina-Fernández I:
Nursing Department, Universitat Rovira i Virgili, 43003 Tarragona, Spain
Rodríguez-Conesa N:
Rio Hortega Hospital, Calle Dulzaina, 2, 47012 Valladolid, Spain
González-Blázquez C:
Faculty of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain
Escuriet R:
GHenderS Research Group, School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain
Catalan Health Service, Government of Barcelona, 08028 Catalonia, Spain
Green Published, gold
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