THE NATIONAL BIRTH CENTER STUDY Part II—Intrapartum and Immediate Postpartum and Neonatal Care


  • Judith P. Rooks CNM, MS, MPH,

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    • Judith P. Rooks, CNM, MS, MPH, conducts research and assists a variety of national and international organizations to plan and evaluate projects and programs related to maternal and child health care and family planning services. She lives in Portland, Oregon.

  • Norman L. Weatherby PhD,

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    • Norman L. Weatherby, PhD, is a research associate professor in the Department of Epidemiology and Public Health and Associate Director of Health Services Research at the University of Miami School of Medicine. Miami, Florida.

  • Eunice K. M. Ernst CNM, MPH

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    • Eunice K. M. Ernst, CNM, MPH, is Executive Director of the National Association of Childbearing Centers, Perkiomenville, Pennsylvania.

Eunice K. M. Ernst, CNM, MPH, Director, National Association of Childbearing Centers, 3123 Gottschall Road, Perkiomenville, PA 18074.


Part II of a three-part report of the National Birth Center Study describes care provided to 11,814 women and their newborns during and after labor and delivery until they were transferred or discharged from the birth centers. There were few low birth weight or preterm or postterm births, but more macrosomic babies than among all U.S. births during the same time period. Certified nurse-midwives provided most of the intrapartum care, which is described in the context of medically recommended standards and data that describe care provided to low-risk women giving birth in U.S. hospitals. Birth center care deviated from typical hospital care in several ways. Birth center clients were much less likely to receive central nervous system depressants, anesthesia, continuous electronic fetal monitoring, induction and/or augmentation of labor, intravenous infusions, amniotomies, or episiotomies, and they had relatively few vaginal examinations. They were more likely to eat solid food during labor and to take showers and/or baths Nulliparity was strongly associated with longer first stage labors and longer labor was associated with more frequent use of many kinds of interventions. Infant birth weight, mother's position during delivery, and forceps- or vacuum-assisted deliveries are examined in relation to episiotomies and lacerations and tears.