This project was supported by a financial contribution from the Health Transition Fund, Health Canada, Ottawa, Ontario, Canada. The views expressed do not necessarily represent the official policy of federal, territorial, or provincial governments.
Outcomes of Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia
Version of Record online: 29 MAY 2007
2007, Blackwell Publishing, Inc.
Volume 34, Issue 2, pages 140–147, June 2007
How to Cite
Janssen, P. A., Ryan, E. M., Etches, D. J., Klein, M. C. and Reime, B. (2007), Outcomes of Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia. Birth, 34: 140–147. doi: 10.1111/j.1523-536X.2007.00160.x
- Issue online: 29 MAY 2007
- Version of Record online: 29 MAY 2007
- Accepted November 21, 2006
- pregnancy outcomes
ABSTRACT: Background: The impact of midwifery versus physician care on perinatal outcomes in a population of women planning birth in hospital has not yet been explored. We compared maternal and newborn outcomes between women planning hospital birth attended by a midwife versus a physician in British Columbia, Canada. Methods: All women planning a hospital birth attended by a midwife during the 2-year study period who were of sufficiently low-risk status to meet eligibility requirements for home birth as defined by the British Columbia College of Midwives were included in the study group (n =488). The comparison group included women meeting the same eligibility requirements but planning a physician-attended birth in hospitals where midwives also practiced (n =572). Outcomes were ascertained from the British Columbia Reproductive Care Program Perinatal Registry to which all hospitals in the province submit data. Results: Adjusted odds ratios for women planning hospital birth attended by a midwife versus a physician were significantly reduced for exposure to cesarean section (OR 0.58, 95% CI 0.39–0.86), narcotic analgesia (OR 0.26, 95% CI 0.18–0.37), electronic fetal monitoring (OR 0.22, 95% CI 0.16–0.30), amniotomy (OR 0.74, 95% CI 0.56–0.98), and episiotomy (OR 0.62, 95% CI 0.42–0.93). The odds of adverse neonatal outcomes were not different between groups, with the exception of reduced use of drugs for resuscitation at birth (OR 0.19, 95% CI 0.04–0.83) in the midwifery group. Conclusions: A shift toward greater proportions of midwife-attended births in hospitals could result in reduced rates of obstetric interventions, with similar rates of neonatal morbidity. (BIRTH 34:2 June 2007)