Trial reportObstetrics and gynecology2015
The Association of Expanded Access to a Collaborative Midwifery and Laborist Model With Cesarean Delivery Rates.
Trial report in Obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Non-clinical interventions for reducing unnecessary caesarean section.The Cochrane database of systematic reviews · 2018Pooled it
- Trial
- Assessing Racial/Ethnic Variation and Trends in Vaginal Birth after Cesarean in California: A Retrospective Cohort Study Using Linked Birth Certificate and Hospital Discharge Records.American journal of perinatology · 2026Article
- Characteristics and outcomes associated with multiple triage visits among patients with suspected preterm labor or preterm premature rupture of membranes.AJOG global reports · 2025Article
- Midwifery Care in the United States: Increasing Access and Utilization to Improve Perinatal Health Outcomes.Obstetrical & gynecological survey · 2025Review
- Examining provider practice-level disparities in delivery outcomes among patients with a history of Cesarean Delivery.BMC pregnancy and childbirth · 2024Article
- Interventions targeting healthcare providers to optimise use of caesarean section: a qualitative comparative analysis to identify important intervention features.BMC health services research · 2022Article
- Advancing quality and safety of perinatal services in India: opportunities for effective midwifery integration.Health policy and planning · 2022Article
- Contrasting Birth Preferences to Practices in El Paso, Texas.Frontiers in global women's health · 2022Article
- Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study.BMC pregnancy and childbirth · 2021Article
- Women's experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia.BMC pregnancy and childbirth · 2020Article
- Non-Clinical Variables Influencing Cesarean Section Rate According to Robson Classification.Medicina (Kaunas, Lithuania) · 2020Observational
- Using the Robson 10-Group Classification System to Compare Cesarean Birth Utilization Between US Centers With and Without Midwives.Journal of midwifery & women's health · 2020Article
- Preventing Cesarean Birth in Women with Obesity: Influence of Unit-Level Midwifery Presence on Use of Cesarean among Women in the Consortium on Safe Labor Data Set.Journal of midwifery & women's health · 2020Article
- Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: A Consortium on Safe Labor study.Birth (Berkeley, Calif.) · 2019Observational
- Association between provider type and cesarean birth in healthy nulliparous laboring women: A retrospective cohort study.Birth (Berkeley, Calif.) · 2018Article
- Obstetrician call schedule and obstetric outcomes among women eligible for a trial of labor after cesarean.American journal of obstetrics and gynecology · 2017Article
- Variation in primary cesarean delivery rates by individual physician within a single-hospital laborist model.American journal of obstetrics and gynecology · 2016Article
- Comparison between continuing midwifery care and standard maternity care in vaginal birth after cesarean.Pakistan journal of medical sciencesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo examine the association between expanded access to collaborative midwifery and laborist services and cesarean delivery rates.
methodsThis was a prospective cohort study at a community hospital between 2005 and 2014. In 2011, privately insured women changed from a private practice model to one that included 24-hour midwifery and laborist coverage. Primary cesarean delivery rates among nulliparous, term, singleton, vertex women and vaginal birth after cesarean delivery (VBAC) rates among women with prior cesarean delivery were compared before and after the change. Multivariable logistic regression models estimated the effects of the change on the odds of primary cesarean delivery and VBAC; an interrupted time-series analysis estimated the annual rates before and after the expansion.
resultsThere were 3,560 nulliparous term singleton vertex deliveries and 1,324 deliveries with prior cesarean delivery during the study period; 45% were among privately insured women whose care model changed. The primary cesarean delivery rate among these privately insured women decreased after the change, from 31.7% to 25.0% (P=.005, adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.39-0.81). The interrupted time-series analysis estimated a 7% drop in the primary cesarean delivery rate in the year after the expansion and a decrease of 1.7% per year thereafter. The VBAC rate increased from 13.3% before to 22.4% afterward (adjusted OR 2.03, 95% CI 1.08-3.80).
conclusionThe change from a private practice to a collaborative midwifery-laborist model was associated with a decrease in primary cesarean rates and an increase in VBAC rates. LEVEL OF EVIDENCE: II.
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