Factors Associated With Non-Normal Birth Outcomes for Low-Risk Women in an Inner-City Hospital

Authors

  • Anne M. McDermott CNM, MSN

    Corresponding author
    1. Certified Nurse-Midwife in full-scope practice with Norwalk Hospital Midwifery Service in Norwalk, CT.
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Address correspondence to Anne M. McDermott, CNM, MSN, 27 Topstone Rd., Ridgefield, CT 06877. E-mail: Anne.McDermott@NorwalkHealth.org

Abstract

Introduction: The purpose of this study was to examine factors associated with normal versus non-normal birth outcomes for low-risk women who were admitted for care in spontaneous labor.

Methods: The birth records of 93 women were reviewed.

Results: At the completion of the fourth stage of labor, 61% of births (n = 57) met the criteria for normal, while 39% of births (n = 36) had non-normal outcomes. On bivariate analysis, variables associated with non-normal outcomes included nulliparity (odds ratio [OR], 9.10; 95% confidence interval [CI], 3–28; P <.0001), lower average centimeters of dilation at admission (t-score 4.422; P <.001), use of pharmacologic pain relief, including narcotics and epidural anesthesia (OR, 5.03; 95% CI, 2–16; P = .005), and birth attended by a physician versus a certified nurse-midwife (OR, 3.60; 95% CI, 2–9; P = .004). In a multivariate analysis, nulliparity (OR, 6.07; 95% CI, 2–19; P = .002) and lower average centimeters of dilation at admission (OR, 0.63; 95% CI, 0.5–0.9; P = .005) were independently associated with non-normal outcome.

Discussion: The development of clinical guidelines aimed at reducing admissions of women in early labor may reduce non-normal outcomes, particularly for nulliparous women.

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