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Hoxha I, Grezda K, Udutha A, Taganoviq B, Agahi R, Brajshori N, Rising SS. Systematic review and meta-analysis examining the effects of midwife care on cesarean birth. Birth 2024; 51:264-274. [PMID: 38037256 DOI: 10.1111/birt.12801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND The increasing number of unnecessary cesarean births is a cause for concern and may be addressed by increasing access to midwifery care. The objective of this review was to assess the effect of midwifery care on the likelihood of cesarean births. METHODS We searched five databases from the beginning of records through May 2020. We included observational studies that reported odds ratios or data allowing the calculation of odds ratios of cesarean birth for births with and without midwife involvement in care or presence at the institution. Standard inverse-variance random-effects meta-analysis was used to generate overall odds ratios (ORs). RESULTS We observed a significantly lower likelihood of cesarean birth in midwife-led care, midwife-attended births, among those who received instruction pre-birth from midwives, and within institutions with a midwifery presence. CONCLUSIONS Care from midwives reduces the likelihood of cesarean birth in all the analyses, perhaps due to their greater preference and skill for physiologic births. Increased use of midwives in maternal care can reduce cesarean births and should be further researched and implemented broadly, potentially as the default modality in maternal care.
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Affiliation(s)
- Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Kolegji Heimerer, Prishtina, Kosovo
- Evidence Synthesis Group, Prishtina, Kosovo
| | | | - Anirudh Udutha
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
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Millatt A, Trout KK, Ledyard R, Brunk SE, Ruggieri DG, Bates L, Mullin AM, Burris HH. Giving Birth With a Midwife in Attendance: Associations of Race and Insurance Status With Continuity of Midwifery Care in Philadelphia. J Midwifery Womens Health 2024. [PMID: 38183620 DOI: 10.1111/jmwh.13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/23/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION From 2013 to 2019, Black women comprised 73% of pregnancy-related deaths in Philadelphia. There is currently a dearth of research on the continuity of midwifery care from initiation of prenatal care through birth in relation to characteristics such as race/ethnicity and income. The aim of this study was to investigate whether race/ethnicity and insurance status were associated with the likelihood of a pregnant person who begins prenatal care with a midwife to remain in midwifery care for birth attendance. METHODS This was a retrospective cohort study of a diverse population of pregnant patients who gave birth in a large tertiary care hospital and had their first prenatal visit with a certified nurse-midwife (CNM) between June 2, 2009, and June 30, 2020 (n = 5121). We used multivariable, log-binomial regression models to calculate risk ratios of transferring to physician care (vs remaining within CNM care), adjusted for age, race/ethnicity, prepregnancy body mass index, insurance type, and comorbidities. RESULTS After adjusting for pregnancy-related risk factors, non-Hispanic Black patients (adjusted relative risk [aRR], 1.14; 95% CI, 1.04-1.24) and publicly insured patients (aRR, 1.11; 95% CI, 1.01-1.22) were at higher risk of being transferred to physician care compared with non-Hispanic White and privately insured patients. Secondary analysis revealed that non-Hispanic Black patients had higher risk of transferring and having an operative birth (aRR, 1.35; 95% CI, 1.18-1.55), whereas publicly insured patients were at higher risk of being transferred for reasons other than operative births (aRR, 1.35; 95% CI, 1.18-1.54). DISCUSSION These findings indicate that Black and publicly insured patients were more likely than White and privately insured patients to transfer to physician care even after adjustment for comorbid conditions. Thus, further research is needed to identify the factors that contribute to racial and economic disparity in continuity of midwifery care.
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Affiliation(s)
- Amanda Millatt
- Communicable Disease Investigation, Long Beach Department of Health and Human Services, Long Beach, California
| | - Kimberly K Trout
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania
- Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Rachel Ledyard
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Susan E Brunk
- Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Dominique G Ruggieri
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lesley Bates
- Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Anne M Mullin
- Tufts University School of Medicine, Boston, Massachusetts
| | - Heather H Burris
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Jolles DR, Niemczyk N, Hoehn Velasco L, Wallace J, Wright J, Stapleton S, Flynn C, Pelletier-Butler P, Versace A, Marcelle E, Thornton P, Bauer K. The birth center model of care: Staffing, business characteristics, and core clinical outcomes. Birth 2023; 50:1045-1056. [PMID: 37574794 DOI: 10.1111/birt.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 02/28/2023] [Accepted: 06/24/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Interest in expanding access to the birth center model is growing. The purpose of this research is to describe birth center staffing models and business characteristics and explore relationships to perinatal outcomes. METHODS This descriptive analysis includes a convenience sample of all 84 birth center sites that participated in the AABC Site Survey and AABC Perinatal Data Registry between 2012 and 2020. Selected independent variables include staffing model (CNM/CM or CPM/LM), legal entity status, birth volume/year, and hours of midwifery call/week. Perinatal outcomes include rates of induction of labor, cesarean birth, exclusive breastfeeding, birthweight in pounds, low APGAR scores, and neonatal intensive care admission. RESULTS The birth center model of care is demonstrated to be safe and effective, across a variety of staffing and business models. Outcomes for both CNM/CM and CPM/LM models of care exceed national benchmarks for perinatal quality with low induction, cesarean, NICU admission, and high rates of breastfeeding. Within the sample of medically low-risk multiparas, variations in clinical outcomes were correlated with business characteristics of the birth center, specifically annual birth volume. Increased induction of labor and cesarean birth, with decreased success breastfeeding, were present within practices characterized as high volume (>200 births/year). The research demonstrates decreased access to the birth center model of care for Black and Hispanic populations. CONCLUSIONS FOR PRACTICE Between 2012 and 2020, 84 birth centers across the United States engaged in 90,580 episodes of perinatal care. Continued policy development is necessary to provide risk-appropriate care for populations of healthy, medically low-risk consumers.
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Affiliation(s)
- Diana R Jolles
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
- Clinical Faculty, Frontier Nursing University, Hyden, Kentucky, USA
| | - Nancy Niemczyk
- Nurse-Midwife Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Jacqueline Wallace
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Susan Stapleton
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Cynthia Flynn
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | | | | | - Ebony Marcelle
- Community of Hope, Washington, District of Columbia, USA
| | | | - Kate Bauer
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
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Li T, Zeng Y, Fan X, Yang J, Yang C, Xiong Q, Liu P. A Bibliometric Analysis of Research Articles on Midwifery Based on the Web of Science. J Multidiscip Healthc 2023; 16:677-692. [PMID: 36938484 PMCID: PMC10015947 DOI: 10.2147/jmdh.s398218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/17/2023] [Indexed: 03/13/2023] Open
Abstract
Objective This study aimed to bibliometrically analyse the main features of the 100 top-cited articles on the midwifery index on the Web of Science. Methods Academic articles on midwifery' research published from 1985 to 2020 were included. VOSviewer 1.6.15, SPSS 22.0 software and a homemade applet were used to identify, analyse and visualise the citation ranking, publication year, journal, country and organisation of origin, authorship, journal impact factor and keywords along with the total link strength of countries, organisations and keywords. Results Among the 100 top-cited articles, the highest number of citations of the retrieved articles was 484. The median number of citations per year was 5.16 (interquartile range: 3.74-8.38). Almost two-thirds of the included articles (n = 61) centred on nursing and obstetrics/gynaecology. The top-cited articles were published in 38 different journals, the highest number of which was published by Midwifery (15%). Australia was the most productive country (24%). According to the total link strength, the sequence ran from the United States (28) to England (28) to Australia (19). The University of Technology Sydney and La Trobe University in Australia topped the list with four papers each. Hunter B was the most productive author (n = 4), and the average citations were positively related to the number of authors (r = 0.336, p < 0.05). Conclusion This study identified the most influential articles on midwifery and documented the core journals and the most productive countries, organisations and authors along with future research hotspots for this field; the findings may be beneficial to researchers in their publication and scientific cooperation endeavours.
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Affiliation(s)
- Tingting Li
- Department of Science and Education, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Yilan Zeng
- Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xianrong Fan
- Department of Hospital Office, The Maternal and Child Health Hospital of Yongchuan, Chongqing, People’s Republic of China
| | - Jing Yang
- Department of Obstetrics and Gynecology, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Chengying Yang
- Department of Obstetrics and Gynecology, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Qingyun Xiong
- Department of Ultrasonography, Changsha Hospital of Traditional Chinese Medicine, Changsha, Hunan Province, People’s Republic of China
- Qingyun Xiong, Department of Ultrasonography, Changsha Hospital of Traditional Chinese Medicine, No. 22, Xingsha Avenue, Changsha County, Changsha City, Hunan Province, 410100, People’s Republic of China, Tel +86 731-85259000, Email
| | - Ping Liu
- Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, Changsha, Hunan Province, People’s Republic of China
- Correspondence: Ping Liu, Department of Respiratory and Critical Care Medicine, Changsha Hospital Affiliated to Xiangya Medical College, Central South University, 311 Yingpan Road, Kaifu District, Changsha, Hunan Province, 410005, People’s Republic of China, Tel +86 15973136512, Email
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Pfeifer LS, Schmitz J, Papadatou-Pastou M, Peterburs J, Paracchini S, Ocklenburg S. Handedness in twins: meta-analyses. BMC Psychol 2022; 10:11. [PMID: 35033205 PMCID: PMC8760823 DOI: 10.1186/s40359-021-00695-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/24/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In the general population, 10.6% of people favor their left hand over the right for motor tasks. Previous research suggests higher prevalence of atypical (left-, mixed-, or non-right-) handedness in (i) twins compared to singletons, and in (ii) monozygotic compared to dizygotic twins. Moreover, (iii) studies have shown a higher rate of handedness concordance in monozygotic compared to dizygotic twins, in line with genetic factors playing a role for handedness. METHODS By means of a systematic review, we identified 59 studies from previous literature and performed three sets of random effects meta-analyses on (i) twin-to-singleton Odds Ratios (21 studies, n = 189,422 individuals) and (ii) monozygotic-to-dizygotic twin Odds Ratios (48 studies, n = 63,295 individuals), both times for prevalence of left-, mixed-, and non-right-handedness. For monozygotic and dizygotic twin pairs we compared (iii) handedness concordance Odds Ratios (44 studies, n = 36,217 twin pairs). We also tested for potential effects of moderating variables, such as sex, age, the method used to assess handedness, and the twins' zygosity. RESULTS We found (i) evidence for higher prevalence of left- (Odds Ratio = 1.40, 95% Confidence Interval = [1.26, 1.57]) and non-right- (Odds Ratio = 1.36, 95% Confidence Interval = [1.22, 1.52]), but not mixed-handedness (Odds Ratio = 1.08, 95% Confidence Interval = [0.52, 2.27]) among twins compared to singletons. We further showed a decrease in Odds Ratios in more recent studies (post-1975: Odds Ratio = 1.30, 95% Confidence Interval = [1.17, 1.45]) compared to earlier studies (pre-1975: Odds Ratio = 1.90, 95% Confidence Interval = [1.59-2.27]). While there was (ii) no difference between monozygotic and dizygotic twins regarding prevalence of left- (Odds Ratio = 0.98, 95% Confidence Interval = [0.89, 1.07]), mixed- (Odds Ratio = 0.96, 95% Confidence Interval = [0.46, 1.99]), or non-right-handedness (Odds Ratio = 1.01, 95% Confidence Interval = [0.91, 1.12]), we found that (iii) handedness concordance was elevated among monozygotic compared to dizygotic twin pairs (Odds Ratio = 1.11, 95% Confidence Interval = [1.06, 1.18]). By means of moderator analyses, we did not find evidence for effects of potentially confounding variables. CONCLUSION We provide the largest and most comprehensive meta-analysis on handedness in twins. Although a raw, unadjusted analysis found a higher prevalence of left- and non-right-, but not mixed-handedness among twins compared to singletons, left-handedness was substantially more prevalent in earlier than in more recent studies. The single large, recent study which included birth weight, Apgar score and gestational age as covariates found no twin-singleton difference in handedness rate, but these covariates could not be included in the present meta-analysis. Together, the secular shift and the influence of covariates probably make it unsafe to conclude that twinning has a genuine relationship to handedness.
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Affiliation(s)
- Lena Sophie Pfeifer
- Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Universitätsstraße 150, 44780, Bochum, Germany.
| | - Judith Schmitz
- School of Medicine, University of St Andrews, St Andrews, Scotland
| | - Marietta Papadatou-Pastou
- School of Education, Department of Primary Education, National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Jutta Peterburs
- Institute of Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Using the Ecological Systems Theory to Understand Black/White Disparities in Maternal Morbidity and Mortality in the United States. J Racial Ethn Health Disparities 2020; 8:661-669. [DOI: 10.1007/s40615-020-00825-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 12/16/2022]
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Declercq ER, Belanoff C, Sakala C. Intrapartum Care and Experiences of Women with Midwives Versus Obstetricians in the Listening to Mothers in California Survey. J Midwifery Womens Health 2019; 65:45-55. [PMID: 31448884 PMCID: PMC7028014 DOI: 10.1111/jmwh.13027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/07/2019] [Accepted: 06/15/2019] [Indexed: 11/30/2022]
Abstract
Introduction Many studies based on hospital records or vital statistics have found that childbearing women experience benefits of lower rates of intervention with midwifery care versus obstetric care during labor and birth. Surveys of women's views and experiences can provide a richer analysis when comparing intrapartum care of midwives and obstetricians.
Methods This study was a secondary analysis of data from the population‐based Listening to Mothers in California survey. The sample, which was representative of 2016 California hospital births, was drawn from birth certificate files and oversampled midwife‐attended births. Women responded to the survey in English or Spanish on any device or with a telephone interviewer. The present analysis is based on 1421 of the 2539 participants who identified a midwife or obstetrician as their attendant at a vaginal birth. A bivariate analysis of demographic, attitudinal, and intrapartum variables was conducted. A multivariable model included sociodemographic and attitudinal variables as covariates. Results Bivariate analyses found significant socioeconomic differences by type of intrapartum care provider, with women in California attended by midwives more likely to be well educated and privately insured than women attended by obstetricians. Women with midwife birth attendants were less likely to report experiencing various intrapartum medical interventions, less likely to experience pressure to have epidural analgesia, and more likely to report that staff encouraged the woman's decision making. Adjusted odds ratios found that women with midwives were less likely to experience medical interventions, including attempted labor induction; labor augmentation; and use of pain medications, epidural analgesia, and intravenous fluids; and less likely to report pressure to have labor induction or epidural analgesia. Women cared for by midwives were more likely to experience any nonpharmacologic pain relief measures and nitrous oxide and to agree that hospital staff encouraged their decision making. Discussion Using women's own reports of their care experiences and adjusting for possible differences in women's attitudes and case mix, we found that midwifery care of women who had vaginal births was associated with reduced use of medical interventions and increased women's decisional latitude during labor and birth.
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Affiliation(s)
- Eugene R Declercq
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Candice Belanoff
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Carol Sakala
- National Partnership for Women & Families, Washington, District of Columbia
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Stitt C, Vang K. Midwife and Doula Information on the Web: An Analysis of Websites that Provide Information About Pregnancy and Childbirth. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2019. [DOI: 10.1080/15398285.2019.1574203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Carmen Stitt
- Department of Communication Studies, California State University, Sacramento, Sacramento, CA, USA
| | - Karen Vang
- Cultural Studies, University of California, Davis, Davis, CA, USA
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Thomson L. The Evolution of Hypnosis in the Profession of Nursing: We've Come a Long Way, Baby, and Still Have a Long Way to Go. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2019; 61:370-393. [PMID: 31017544 DOI: 10.1080/00029157.2018.1500879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Registered nurses (RNs) are the largest, most diverse, and most respected of all healthcare professions in the United States, numbering over 3.5 million (Gallup poll, 2017). Nurses have evolved from being the handmaidens of physicians and bedpan handlers to highly trained and educated clinicians who have assumed an important, integral, and indispensable role in the healthcare system. The capabilities of nurses to expand the excellent care they can provide has historically been thwarted by others in the healthcare field, including in the area of hypnosis. This article begins with a historical perspective on the education, training, and ever-expanding profession of nursing. The multiplicity of settings where nurses have the opportunity to incorporate clinical hypnosis into the care of their patients is discussed.
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Affiliation(s)
- Linda Thomson
- Springfield Medical Care Systems, Springfield, Vermont, USA
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Ali Y, Khan MW, Mumtaz U, Salman A, Muhammad N, Sabir M. Identification of factors influencing the rise of cesarean sections rates in Pakistan, using MCDM. Int J Health Care Qual Assur 2019; 31:1058-1069. [PMID: 30415618 DOI: 10.1108/ijhcqa-04-2018-0087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The rate of cesarean sections has been rapidly increased in the last few decades in all the developing as well as developed countries. The rate of cesarean sections determined by the World Health Organization has been crossed by many countries, like Brazil, India, China, USA, Australia, etc. Similarly, this rate has also increased in Pakistan. The purpose of this paper is to explore and identify the factors that are responsible for the rising rate of cesarean sections in Pakistan. DESIGN/METHODOLOGY/APPROACH These factors are categorized under medical and non-medical factors. The medical factors include the obesity of mother, age of mother, weight of the baby, umbilical cord prolapse, fetal distress, abnormal presentation, dystocia and failure to progress. The non-medical factors include financial incentives of doctors, time convenience for doctors, high tolerance to surgery, patient's preference toward cesarean section, private hospitals, public hospitals, income status of patients, rural areas, urban areas and the education of patients. To identify the critical factors, data have been collected and a multi-criteria decision-making technique, called Decision Making Trial and Evaluation Laboratory, is used. FINDINGS The result shows that the medical factors that are responsible for the rise in the rate of cesarean sections are umbilical cord prolapse, age of mother and obesity of mother. On the other hand, the non-medical factors that are the reasons for the increase in cesarean sections are the large number of private hospitals and the unethical acts of the doctors in these hospitals, preference of patients, and either the unavailability of doctors or poor conditions of hospitals in rural areas. ORIGINALITY/VALUE Cesarean section is an important surgical intervention and is considered to be very essential in the cases of existing as well as potential medical problems to the mother or the baby. Cesarean section is also performed for non-medical reasons. In Pakistan, the number of private hospitals has increased and these hospitals provide good health care. However, these hospitals do not work under the rules and regulations set by the government. The doctors in private hospitals perform unnecessary cesarean sections in order to fulfill the demands of private hospital's owners. In addition to this, it is also found that, nowadays, most women prefer to give birth through cesarean section in order to eliminate the pain of normal vaginal delivery.
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Affiliation(s)
- Yousaf Ali
- Department of Management Science and Humanities, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
| | - Muhammad Waseem Khan
- Department of Management Science and Humanities, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
| | - UbaidUllah Mumtaz
- Department of Management Science and Humanities, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
| | - Aneel Salman
- Department of Management Science COMSATS, Institute of Information Technology, Islamabad, Pakistan
| | - Noor Muhammad
- Department of Management Science, GIK Institute of Engineering Sciences and Technology, Topi, Pakistan
| | - Muhammad Sabir
- Department of Management Science and Humanities, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan
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Loewenberg Weisband Y, Klebanoff M, Gallo MF, Shoben A, Norris AH. Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care. J Midwifery Womens Health 2018; 63:399-409. [DOI: 10.1111/jmwh.12750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 01/05/2018] [Accepted: 01/10/2018] [Indexed: 11/30/2022]
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12
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Markowitz S, Adams EK, Lewitt MJ, Dunlop AL. Competitive effects of scope of practice restrictions: Public health or public harm? JOURNAL OF HEALTH ECONOMICS 2017; 55:201-218. [PMID: 28778349 DOI: 10.1016/j.jhealeco.2017.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
The demand for healthcare professionals is predicted to grow significantly over the next decade. Securing an adequate workforce is of primary importance to ensure the health and wellbeing of the population in an efficient manner. Occupational licensing laws and related restrictions on scope of practice (SOP) are features of the market for healthcare professionals and are also controversial. At issue is a balance between protecting the public health and removing anticompetitive barriers to entry and practice. In this paper, we examine the case of SOP restrictions for certified nurse midwives (CNMs) and evaluate the effects of changes in states' SOP laws on markets for CNMs and on maternal and infant outcomes. We find that SOP laws are neither helpful nor harmful in regards to health outcomes but states that have no SOP-based barriers have lower rates of induced labor and Cesarean section births. We discuss the implications for state policy.
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Thornton P. Characteristics of Spontaneous Births Attended by Midwives and Physicians in US Hospitals in 2014. J Midwifery Womens Health 2017; 62:531-537. [PMID: 28806489 DOI: 10.1111/jmwh.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/06/2017] [Accepted: 04/13/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study compares characteristics and birth outcomes of women attended by certified nurse-midwives/certified midwives (midwives) and physicians in US hospitals in 2014. METHODS Data reported in 2014 on the 2003 version of the US birth certificate were examined. Spontaneous vaginal births attributed to midwives and physicians and occurring in hospitals were included. Demographic and risk profiles and adjusted odds ratios for maternal and newborn outcomes were compared by provider type. RESULTS Midwives attended 294,604 (12.21%) and physicians attended 2,117,376 (87.79%) of all spontaneous vaginal births occurring in 47 states. Small but statistically significant differences (P < .05) were evident in most characteristics. Substantively, profiles were remarkably similar along all demographic and many medical risk variables. Age, race, and insurance status varied by less than 2 percentage points; education status and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation varied by less than one percentage point. Parity, body mass index, maternal weight gain, tobacco use, trimester care began, and average number of prenatal visits also varied by less than one to 2 percentage points. Midwives attended women with hypertension, diabetes, and infections in proportions similar to physicians. Physicians attended more women with preterm birth and multiple gestation. Midwives attended more women beyond 41 weeks' gestation. There were no differences in 5-minute Apgar scores, neonatal seizures, anomalous neonates, or those no longer living at the time of data collection. Third- or fourth-degree lacerations (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.78-0.84), labor induction (OR, 0.76; 95% CI, 0.76-0.77), and epidural analgesia use (OR, 0.54; 95% CI, 0.53-0.54) were less likely in midwife-attended births. Birth at greater than 42 weeks' gestation was more likely (OR, 2.07; 95% CI, 1.97-2.17) among midwife-attended births. DISCUSSION In 2014, midwives practicing in US hospitals attended women with a range of risks similar to those of women attended by physicians. Small but statistically significant differences were noted in most characteristics and should be controlled in comparative studies. This contrasts with earlier reports of midwives caring for disproportionately disadvantaged women compared to physicians.
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Hall R, Coffin C, Cyr D, Persutte W, Roberts D, Spitz JL, Waggoner A. The Ultrasound Practitioner: A Proposal. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/875647939901500402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Alan Waggoner
- Society of Diagnostic Medical Sonographers, Dallas, Texas
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Thiessen K, Nickel N, Prior HJ, Banerjee A, Morris M, Robinson K. Maternity Outcomes in Manitoba Women: A Comparison between Midwifery-led Care and Physician-led Care at Birth. Birth 2016; 43:108-15. [PMID: 26889889 DOI: 10.1111/birt.12225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Registered midwives, obstetricians/gynecologists, and general or family practice physicians (GPs) provide maternity care across Canada. Few North American studies have assessed whether maternity outcomes differ across these three groups. This study compared maternal and neonatal outcomes of low-risk pregnant women whose birth was attended by registered midwives, obstetricians/gynecologists, and family practice physicians in Winnipeg, Manitoba from 2001/02 to 2012/13. METHODS Descriptive statistics and logistic regression were used to examine differences in types of intervention, mode of delivery, and outcomes by provider type among low-risk women. Logistic regression models controlled for socio-demographic and birth-related covariates. RESULTS Low-risk births comprised 83,774 (48.7%) of total births (n = 171,910). The adjusted odds ratio (aOR), (95% confidence interval) for midwife vs OB/GYN showed women who had a midwife attend the birth had reduced odds of having an episiotomy 0.47 (0.40-0.54), epidural 0.25 (0.23-0.27), and cesarean delivery 0.13 (0.10-0.16) and their infants had less Neonatal Intensive Care Unit admissions 0.28 (0.18-0.43). The aOR for GP versus OB/GYN showed women who had a GP had reduced odds of having an epidural/spinal 0.83 (0.79-0.88) and cesarean delivery 0.44 (0.40-0.48). CONCLUSIONS The effectiveness of Manitoba maternity services can be improved with increased use of integrated midwifery services. Future research should examine how midwifery and physician-led models of care differ, and the influence of these differences on birth outcomes and cost-effectiveness to the health care system. Improvement of data tracking systems is also needed.
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Affiliation(s)
- Kellie Thiessen
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nathan Nickel
- Manitoba Centre for Health Policy, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Heather J Prior
- Manitoba Centre for Health Policy, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Margaret Morris
- Department of Obstetrics, Gynecology and Reproductive Sciences GFT, University of Manitoba, Winnipeg, Canada.,Women's Health Program, WRHA, Notre Dame Avenue, Winnipeg, Canada.,Department of Obstetrics Gynecology, Reproductive Sciences University of Manitoba, Notre Dame Avenue, Winnipeg, Canada
| | - Kristine Robinson
- Winnipeg Regional Health Authority, Tache Avenue, Winnipeg, MB, Canada
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Making a Case to Reduce Legal Impediments to Midwifery Practice in the United States. Womens Health Issues 2015; 25:314-7. [DOI: 10.1016/j.whi.2015.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 11/17/2022]
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17
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King TL, Pinger W. Evidence‐Based Practice for Intrapartum Care: The Pearls of Midwifery. J Midwifery Womens Health 2014; 59:572-585. [DOI: 10.1111/jmwh.12261] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Cockerham AZ, King TL. One hundred years of progress in nurse-midwifery: with women, then and now. J Midwifery Womens Health 2014; 59:3-7. [PMID: 24400818 DOI: 10.1111/jmwh.12161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cheng YW, Snowden JM, King TL, Caughey AB. Selected perinatal outcomes associated with planned home births in the United States. Am J Obstet Gynecol 2013; 209:325.e1-8. [PMID: 23791564 DOI: 10.1016/j.ajog.2013.06.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 05/15/2013] [Accepted: 06/12/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE More women are planning home birth in the United States, although safety remains unclear. We examined outcomes that were associated with planned home compared with hospital births. STUDY DESIGN We conducted a retrospective cohort study of term singleton live births in 2008 in the United States. Deliveries were categorized by location: hospitals or intended home births. Neonatal outcomes were compared with the use of the χ(2) test and multivariable logistic regression. RESULTS There were 2,081,753 births that met the study criteria. Of these, 12,039 births (0.58%) were planned home births. More planned home births had 5-minute Apgar score <4 (0.37%) compared with hospital births (0.24%; adjusted odds ratio, 1.87; 95% confidence interval, 1.36-2.58) and neonatal seizure (0.06% vs 0.02%, respectively; adjusted odds ratio, 3.08; 95% confidence interval, 1.44-6.58). Women with planned home birth had fewer interventions, including operative vaginal delivery and labor induction/augmentation. CONCLUSION Planned home births were associated with increased neonatal complications but fewer obstetric interventions. The trade-off between maternal preferences and neonatal outcomes should be weighed thoughtfully.
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Affiliation(s)
- Yvonne W Cheng
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA
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McCool WF, Guidera M, Janis J. 'The Best Health Care Delivery System in the World'? Women's health and maternity/newborn care trends in Philadelphia, PA, United States-1997-2011: a case report. Midwifery 2013; 29:1158-65. [PMID: 23911078 DOI: 10.1016/j.midw.2013.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 11/29/2022]
Abstract
Despite being ranked number one globally in terms of health care cost per capita, the United States (US) has ranked as low as 37th in the world in terms of health care system performance. This poor performance for one of the most developed nations in the world has been reflected in the underachieved attempts of the multiple US health care systems at improving maternal and newborn health, according to the goals set in 2000 by the United Nations with Millennium Development Goals (MDG's) 5: Improve Maternal Health, and 4: Reduce Child Mortality. This paper will examine the progress, or lack thereof, over a period of 15 years of the fifth largest urban area in the US - Philadelphia, Pennsylvania - in its delivery of health care to pregnant women and their newborns. Using data collected from national, state, and city health agencies, trends concerning pregnancy care will be presented and compared to the target goals of MDG-5 and MDG-4, as well as Healthy People 2020, a US government-based initiative to improve health care of all Americans. Findings will demonstrate that urban areas such as Philadelphia are on a path of not reaching goals that have been set by the United Nations and the US government, and by some indicators are moving away in a negative direction from these goals.
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Affiliation(s)
- William F McCool
- Midwifery Graduate Program, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
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21
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Pewitt AT. The experience of perinatal care at a birthing center: a qualitative pilot study. J Perinat Educ 2013; 17:42-50. [PMID: 19436419 DOI: 10.1624/105812408x329593] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this qualitative descriptive pilot study was to describe women's experiences of care and satisfaction at a freestanding birth center. Data were collected through semistructured interviews with seven women who had given birth within 12 months of participant selection. Using qualitative content analysis, three themes emerged: (1) Empowerment, (2) Sense of Motherhood, and (3) Establishing and Strengthening Relationships. Data revealed that women value caring providers, that caring providers may affect positive outcomes, and that those outcomes may lead to a satisfactory experience.
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Affiliation(s)
- Amber T Pewitt
- AMBER PEWITT graduated from the University of the South in Sewanee, Tennessee, with a Bachelor of Arts degree in anthropology and, subsequently, earned a Bachelor of Science in Nursing degree from East Tennessee State University. She has worked as a registered nurse in newborn nursery, postpartum, and labor and delivery
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Stapleton SR, Osborne C, Illuzzi J. Outcomes of Care in Birth Centers: Demonstration of a Durable Model. J Midwifery Womens Health 2013; 58:3-14. [DOI: 10.1111/jmwh.12003] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chang Pecci C, Mottl-Santiago J, Culpepper L, Heffner L, McMahan T, Lee-Parritz A. The Birth of a Collaborative Model. Obstet Gynecol Clin North Am 2012; 39:323-34. [DOI: 10.1016/j.ogc.2012.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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King TL, Laros RK, Parer JT. Interprofessional collaborative practice in obstetrics and midwifery. Obstet Gynecol Clin North Am 2012; 39:411-22. [PMID: 22963700 DOI: 10.1016/j.ogc.2012.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
As the health care system transforms to accommodate an increased need for primary care services and more patients, new models of health care delivery are needed that can provide quality health care services efficiently. An integrated collaborative practice of certified nurse-midwives, obstetrician-gynecologists, and perinatologists is best suited to meet the rapidly changing needs of the maternity health care delivery system. This article reviews the literature on interprofessional collaborative practice and describes the structure, function, and essential elements of successful collaboration in health care.
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Affiliation(s)
- Tekoa L King
- Journal of Midwifery & Women's Health, Oakland, CA 94602, USA.
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25
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Lee EJ, Park YS. Meaning of 'Natural Childbirth' and Experiences of Women Giving Birth using Midwifery: A Feminist Approach. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2012; 18:135-148. [PMID: 37697521 DOI: 10.4069/kjwhn.2012.18.2.135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
PURPOSE The purpose of this study was to explore the meanings of 'Natural childbirth' from experiences of Korean women who gave birth to a baby in the midwifery using a feminist approach. METHODS This paper is a qualitative research study and applies a feminist epistemology and methodology to the experiences of women who gave birth in midwifery. The data were collected by individual in-depth interviews with eleven participants. RESULTS Two main themes emerged from the feminist content analyses and each main theme had three sub themes. A. transformation of control and knowledge on childbirth and the body 1) refusing coercive medicalization and building a new normality, 2) specific expectations about biological health and maternity rather than a return to nature, 3) the subject of pregnancy and childbirth, B. 'natural childbirth' practice as a new embodied discipline 1) helpers to support mothers, midwives, 2) helping the body to do 'natural childbirth', 3) from isolated labor to cooperative reproduction. CONCLUSION These results indicate that women desired to practice being a subject, consultation with professionals, self-discipline and named actors except for women as 'other subjects' in childbirth.
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Affiliation(s)
- Eun Ju Lee
- College of Nursing, Seoul National University, Seoul, Korea
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26
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Comparison of Labor and Delivery Care Provided by Certified Nurse-Midwives and Physicians: A Systematic Review, 1990 to 2008. Womens Health Issues 2012; 22:e73-81. [DOI: 10.1016/j.whi.2011.06.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 06/14/2011] [Accepted: 06/15/2011] [Indexed: 02/06/2023]
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Wilson BL, Gance-Cleveland B, Locus TL. Ethnicity and newborn outcomes: the case of African American women. J Nurs Scholarsh 2011; 43:359-67. [PMID: 21981628 DOI: 10.1111/j.1547-5069.2011.01416.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Although previous studies have confirmed the relationship between socioeconomic status, ethnicity, education, and occupation on birth outcomes, less is known about the relationship of providers influence or hospital characteristics on birth outcomes for minority women. It is not well understood whether hospital or physician characteristics exert an equal or greater affect compared with maternal sociodemographic factors, particularly for Black childbearing women known to be at particular risk for adverse birth outcomes. DESIGN This retrospective descriptive study sought to determine whether variation in neonatal birth outcomes for Black women was attributable to hospital characteristics, physician influence, or patient sociodemographics. METHODS Fixed and random effects were conducted to empirically determine the relative importance of hospital, physician, and patient characteristics (partitioning the variation of differences in birth outcome to each component) using a large administrative dataset. FINDINGS Considerable variability existed among hospitals over and above hospital ownership or number of hospital beds. CONCLUSIONS Ethnicity was a statistically significant predictor of adverse outcomes, as was the number of prenatal visits and maternal education. There is a significant relationship between adverse newborn outcomes and ethnicity after controlling for hospital and physician characteristics. CLINICAL RELEVANCE Ongoing birth disparities in African American childbearing women are a significant public policy issue with important research and clinical implications. This research adds to nursing knowledge by helping eliminate some factors previously thought to have contributed to the high incidence of perinatal complications for African American women and their newborns.
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Affiliation(s)
- Barbara L Wilson
- Arizona State University College of Nursing and Health Innovation, Center for Improving Health Outcomesin Children, Teens, and Families, Phoenix, AZ 85004, USA.
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28
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Hans JD, Kimberly C. An Educational Intervention to Change Planned Behavior Concerning Midwife‐Assisted Out‐of‐Hospital Childbirth. J Midwifery Womens Health 2011; 56:371-375. [DOI: 10.1111/j.1542-2011.2011.00036.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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King TL. Can a vaginal birth after cesarean delivery be a normal labor and birth? Lessons from midwifery applied to trial of labor after a previous cesarean delivery. Clin Perinatol 2011; 38:247-63. [PMID: 21645793 DOI: 10.1016/j.clp.2011.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Women who undergo a trial of labor after a previous cesarean delivery (TOLAC) have special needs prenatally and during the intrapartum period. Counseling about the choice of TOLAC versus an elective repeat cesarean delivery involves complex statistical concepts. Prenatal counseling that is patient centered, individualized, and presented in a way that addresses the health literacy and health numeracy of the recipient encompasses best practices that support patient decision making. Evidence-based practices during labor that support vaginal birth and increase patient satisfaction are of special value for this population.
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Affiliation(s)
- Tekoa L King
- Department of Obstetrics, Gynecology and Reproductive Medicine, University of California San Francisco, CA, USA.
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30
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Sonenberg A. Medicaid and state regulation of nurse-midwives: the challenge of data retrieval. Policy Polit Nurs Pract 2011; 11:253-9. [PMID: 21531961 DOI: 10.1177/1527154411398137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article discusses one of four findings of a larger descriptive correlational health policy study, the purpose of which was to investigate relationships among state regulation of nurse-midwifery practice, utilization of certified nurse-midwives (CNM) for Medicaid funded prenatal care, and maternal newborn outcomes. The larger study showed that use of accurate data about CNM practice and subsequent health care outcomes creates a challenge for researchers because of the paucity of data related to services provided by CNMs. Barriers to adequate data collection related to CNM services, specifically those funded by Medicaid, preclude legitimate conclusions about subsequent health care policy. Methods of workforce data collection need to be addressed by health care and health policy groups to facilitate further investigation of the relationships among state regulation of CNM practice, utilization of CNMs for Medicaid-funded prenatal care and maternal newborn outcomes as they affect access to care for vulnerable populations.
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Affiliation(s)
- Andrea Sonenberg
- Pace University, Lienhard School of Nursing, 861 Bedford Road, Pleasantville, NY 10570, USA.
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31
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Catling-Paull C, Johnston R, Ryan C, Foureur MJ, Homer CS. Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review. J Adv Nurs 2011; 67:1662-76. [DOI: 10.1111/j.1365-2648.2011.05662.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Catling-Paull C, Johnston R, Ryan C, Foureur MJ, Homer CSE. Clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review. J Adv Nurs 2011; 67:1646-61. [DOI: 10.1111/j.1365-2648.2011.05635.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Advanced practice nurses, including midwives, are well positioned to conduct, participate, or both in both basic and translational research to improve the outcomes and processes of perinatal care. This article contains suggestions for future research by perinatal advanced practice nurses, conceptualized around a scale to promote balance in outcomes. More research is needed in a number of areas, examples include collaborative practice, normal birth, and translation of the evidence concerning skin-to-skin practice. Health disparities; maternal, neonatal, and infant morbidity and mortality; formula feeding; and other vulnerabilities need more research to decrease these problematic outcomes. Advanced practice nurses are encouraged to be actively involved in perinatal research, to help confront and reduce health disparities, and to apply evidence in practice, broadly promoting wellness for women and their families.
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Abstract
A systematic literature review of research on midwifery care of poor and vulnerable women from 1925 to 2003, which included topics studied, research methods used, and special issues and implications for future research, was performed; 44 studies published between 1955 and 2003 were identified. The majority were retrospective, descriptive studies. Outcomes examined included prenatal care visits, vaginal versus operative births, labor interventions, maternal and neonatal mortality and morbidity, birth weight, and cost-effectiveness. Studies showed that midwives predominantly serve vulnerable women who are young, poor, immigrants, or members of racial and ethnic minorities. Preterm birth prevention is emerging as a midwifery research focus. Health system changes are making it more difficult to provide effective care and counseling to disadvantaged women, especially in managed care settings. Extensive evidence documents excellent outcomes of midwifery care for the poor in urban and rural settings over the past three quarters of a century. Future research should include more intervention studies and use both qualitative and quantitative methods to investigate midwifery processes of care and the process-outcome connection. The research focus should broaden beyond childbirth to include gynecology, family planning, and primary care issues. Health disparities, cultural studies, obstetric interventions, and poor women's experiences of childbirth and midwifery care are important topics for future research.
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Affiliation(s)
- Jeanne Raisler
- University of Michigan School of Nursing, Ann Arbor, MI 48109, USA.
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McDermott AM. Factors Associated With Non‐Normal Birth Outcomes for Low‐Risk Women in an Inner‐City Hospital. J Midwifery Womens Health 2010; 55:101-6. [DOI: 10.1016/j.jmwh.2009.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 03/31/2009] [Accepted: 07/07/2009] [Indexed: 10/19/2022]
Affiliation(s)
- Anne M. McDermott
- Certified Nurse‐Midwife in full‐scope practice with Norwalk Hospital Midwifery Service in Norwalk, CT
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36
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Bussey CG, Bell JF, Lydon-Rochelle MT. Certified Nurse Midwife-Attended Births: Trends in Washington State, 1995-2004. J Midwifery Womens Health 2010; 52:444-50. [PMID: 17826706 DOI: 10.1016/j.jmwh.2007.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Nationwide, the proportion of certified nurse-midwife (CNM)-attended births has increased steadily. We examined trends in CNM-attended singleton spontaneous vaginal births between 1995 and 2004 in Washington State by site of birth, payer source, and hospital birth volume. CNMs were more likely than other providers to care for women at risk for adverse outcomes based on several sociodemographic indicators. The increased rate of CNM-attended births occurred primarily in hospitals and among both Medicaid- and privately-funded births. The rate of CNM-attended births doubled in hospitals with high birth volumes. We recommend future research designed to understand these trends.
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Kennedy HP, Shannon MT, Chuahorm U, Kravetz MK. The Landscape of Caring for Women: A Narrative Study of Midwifery Practice. J Midwifery Womens Health 2010. [DOI: 10.1111/j.1542-2011.2004.tb04403.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Collins‐Fulea C. Models of Organizational Structure of Midwifery Practices Located in Institutions With Residency Programs. J Midwifery Womens Health 2010; 54:287-93. [DOI: 10.1016/j.jmwh.2009.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 03/23/2009] [Accepted: 03/23/2009] [Indexed: 10/20/2022]
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Jordan R, Farley CL. The Confidence to Practice Midwifery: Preceptor Influence on Student Self-Efficacy. J Midwifery Womens Health 2010; 53:413-20. [DOI: 10.1016/j.jmwh.2008.05.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 04/13/2008] [Accepted: 05/12/2008] [Indexed: 11/27/2022]
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Abstract
The American Association of Colleges of Nursing recently published a policy statement calling for the requirement of the Doctor of Nursing Practice for entry into practice as an Advanced Practice Nurse by the year 2015. Certified nurse-midwives, defined as those educated in both nursing and midwifery, are commonly included in the definition of Advanced Practice Nurses, along with nurse practitioners, nurse anesthetists, and clinical nurse specialists. This paper explores issues related to the practice doctorate as an entry requirement for midwifery practice in the United States. The results of a brief survey of midwifery students indicate mixed interest in a clinical doctorate. At the present time, evidence points to the fact that current education requirements produce safe, knowledgeable, competent midwives. Because data are lacking regarding the potential impact of the proposed Doctor of Nursing Practice on the cost of education to both the institution and the student, on the applicant pool, and on the health care system, the Directors of Midwifery Education endorse a statement affirming support for multiple routes of midwifery education based on the ACNM Core Competencies, and does not endorse a mandatory requirement for the clinical doctorate for entry into practice at this time.
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Affiliation(s)
- Melissa D Avery
- University of Minnesota, 5-160 Weaver Densford Hall, 308 Harvard St. SE, Minneapolis, MN 55455, USA.
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Fagerlund K, Germano E. The Costs and Benefits of Nurse-Midwifery Education: Model and Application. J Midwifery Womens Health 2010; 54:341-350. [DOI: 10.1016/j.jmwh.2009.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 12/12/2008] [Accepted: 04/14/2009] [Indexed: 10/20/2022]
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Birthplace: a model of collaborative care at Baystate Franklin Medical Center. Am J Nurs 2010; 110:38-41. [PMID: 21107063 DOI: 10.1097/01.naj.0000391238.45392.bf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Nurse midwives, nurses, and physicians at this facility have lowered rates of medical interventions while giving patients greater say.
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Bloch JR, Dawley K, Suplee PD. Application of the Kessner and Kotelchuck prenatal care adequacy indices in a preterm birth population. Public Health Nurs 2009; 26:449-59. [PMID: 19706128 DOI: 10.1111/j.1525-1446.2009.00803.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Healthy People 2010 goals to eliminate racial and ethnic health disparities that persist in the utilization of prenatal care (PNC) highlight the importance of measuring PNC as a variable in maternal and infant health outcomes research. These disparities are significantly correlated to adverse infant outcomes in preterm birth (PTB), a leading cause of infant mortality and life-long morbidity. Currently the most extensively used PNC adequacy indices (Kessner and Kotelchuck) were developed to measure outcomes in populations consisting mostly of full-term births. It is unclear whether these PNC adequacy indices are reliable when pregnancy is truncated due to PTB (<37 weeks). This paper compares and demonstrates how they can be applied in a specific PTB cohort. DESIGN AND SAMPLE This secondary analysis of a nested case-control study compares Kessner and Kotelchuck adequacy scores of 367 mothers of PTB infants. RESULTS There were significant differences in the rating of PNC inadequacy ( p<.001) depending on the PNC adequacy index used. CONCLUSION Critical evaluation is warranted before using these PNC adequacy indices in future public health nursing and PTB research.
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Affiliation(s)
- Joan Rosen Bloch
- College of Nursing & Health Professions, Drexel University, 245 N.15th Street, MS 1030, Philadelphia, PA 19102, USA.
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45
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Treatment patterns and outcomes in a low-risk nurse-midwifery practice. Appl Nurs Res 2009; 22:10-7. [PMID: 19171290 DOI: 10.1016/j.apnr.2007.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 02/12/2007] [Accepted: 02/16/2007] [Indexed: 11/23/2022]
Abstract
Childbirth, which represents more than 20% of all hospitalizations for women, is often accompanied by technical intervention, and identifying best practices is crucial. This study analyzed data entered into the Nurse-Midwifery Clinical Data Set (ACNM, 1990) to ascertain treatment patterns and associated outcomes, using Kane's Model of Treatment and Outcomes (Kane, R. L. [1997]. Understanding health care outcomes research. Gaithersburg, MD: Aspen Publishers, Inc.). Low-risk women (N = 510) received prenatal care from nurse-midwives and delivered at a university facility. Significant relationships were found between patient characteristics (age) and clinical factors (parity, body mass index, number of prenatal visits, comorbidities) and between treatment interventions (activity, intake, invasive monitoring) and outcomes (infant Apgar scores, complications).
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Kennedy HP, Lyndon A. Tensions and Teamwork in Nursing and Midwifery Relationships. J Obstet Gynecol Neonatal Nurs 2008; 37:426-35. [DOI: 10.1111/j.1552-6909.2008.00256.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Rooks JP, Ernst EKM, Norsigian J, Guran LA. Marginalization of midwives in the United States: new responses to an old story. Birth 2008; 35:158-61. [PMID: 18507588 DOI: 10.1111/j.1523-536x.2008.00231.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This column addresses issues raised by an intensive study of the circumstances and actions that resulted in the closure of two long-standing, successful nurse-midwifery services in a large United States city in 2003. Dr. Steffie Goodman of the School of Nursing, University of Colorado Health Science Center in Denver, USA, conducted 52 in-depth interviews with midwives, nurses, administrators, childbirth educators, policymakers, and physicians in an effort to understand how and why these two services were closed and what their closures revealed about the general underutilization of midwives in contemporary U.S. health care. Goodman concluded that economics, power, and authority converge in a way that allows persons in positions of institutional power and authority to make self-serving decisions that diminish access to midwifery services and that they can do so without any public accountability for their actions.
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Hastings-Tolsma M, Tasaka Y, Burton A, Goodman S, Emeis CL, Patterson E, Bennett P, Koschoreck K, Ruyak S, Tanner T, Vaughn T, Williams A. A Profile of Colorado Nurse—Midwives. West J Nurs Res 2008; 31:24-43. [DOI: 10.1177/0193945908319989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nurse—midwives provide significant health care to underserved and vulnerable women, yet there is limited information about the nature of nurse—midwifery practices and compensation for services. This study reports the results of a Colorado statewide survey of nurse—midwives ( N = 217). Electronic survey was utilized to detail practice in seven areas: demographics, type of practice, compensation, leadership, legislativep riorities,teaching involvement, and practice satisfaction. Responses( N = 114) were analyzed using SPSS 13.0. Results found wide variation in compensation and practice types. Respondents largely worked in urban settings, cared for low to moderate risk patients, and were generally older and White. Restriction from medical staffm membership, prescriptive authority constraints, and liability issues were practice limitations. While teaching a wide variety of learners, nurse—midwives do limited mentoring of nurse—midwifery students, a finding which is concerning given the decreasing numbers of nurse—midwives. Findings are compared to known national data, with implications for the provision of health care services detailed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tanya Tanner
- University of Colorado-Denver Denver Health Medical Center
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Barclay L. Woman and midwives: position, problems and potential. Midwifery 2008; 24:13-21. [PMID: 17126965 DOI: 10.1016/j.midw.2006.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 06/23/2006] [Accepted: 07/18/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVE to describe and analyse birthing models in a number of countries, particularly Samoa and China, that have been the focus of my recent research; to discuss how cultural frameworks, colonisation and ideas of what is 'modern' influence the nature, place of birth and its attendant. IMPLICATIONS FOR PRACTICE midwives need to reflect on their practice and consider broader health policy and how it affects health systems. They also need to understand the social, economic, historical and cultural context of practice, including the influence of gender inequality and attitudes to women and themselves as midwives.
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Affiliation(s)
- Lesley Barclay
- Institute of Advanced Studies, Charles Darwin University, Darwin, NT 0909, Australia.
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Xu X, Lori JR, Siefert KA, Jacobson PD, Ransom SB. Malpractice liability burden in midwifery: a survey of Michigan certified nurse-midwives. J Midwifery Womens Health 2008; 53:19-27. [PMID: 18164430 DOI: 10.1016/j.jmwh.2007.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A statewide survey was conducted among 282 nurse-midwives in Michigan to examine the extent of their current medical liability burden. Two hundred ten responses were received for an adjusted response rate of 76.9%. Data from 145 certified nurse-midwives (CNMs) who were currently engaged in clinical practice in Michigan were used for this analysis. Sixty-nine percent of CNMs reported that liability concerns had a negative impact on their clinical decision making. Most CNMs (88.1%) acquired malpractice insurance coverage through an employer, whereas 4.9% were practicing "bare" due to difficulty in obtaining coverage. Thirty-five percent of the respondents had been named in a malpractice claim at least once in their career, and 15.5% had at least one malpractice payment of $30,000 or more made on their behalf. CNMs who purchased malpractice insurance coverage themselves or were going bare were significantly less likely to include obstetrics in their practice than their counterparts covered through an employer (70.6% versus 87.2%; P = .04). These findings among Michigan CNMs call for further investigation into the consequences of the current malpractice situation surrounding nurse-midwifery practice and its influence on obstetric care, particularly among women from disadvantaged populations.
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Affiliation(s)
- Xiao Xu
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.
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