ArticleBirth (Berkeley, Calif.)2018
Association between provider type and cesarean birth in healthy nulliparous laboring women: A retrospective cohort study.
Article in Birth (Berkeley, Calif.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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.
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Who cites it
25 citing papers in PubMed, 50 citations in OpenAlex.
- Retrospective Cohort Study on Racial and Ethnic Disparities in Cesarean Birth in a Midwifery-Integrated Health System.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2026Article
- Impact of Increasing Midwifery-Led Prenatal Care on Birth Outcomes: An Application of the g-Formula and Target Trial Emulation.Paediatric and perinatal epidemiology · 2026Article
- Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery.Birth (Berkeley, Calif.) · 2025Article
- Midwifery Care in the United States: Increasing Access and Utilization to Improve Perinatal Health Outcomes.Obstetrical & gynecological survey · 2025Review
- Exploring the influence of medical staffing and birth volume on observed-to-expected cesarean deliveries: a panel data analysis of integrated obstetric and gynecological departments in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Midwife-Led Versus Obstetrician-Led Perinatal Care for Low-Risk Pregnancy: A Systematic Review and Meta-Analysis of 1.4 Million Pregnancies.Journal of clinical medicine · 2024Review
- Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans.Healthcare (Basel, Switzerland) · 2024Article
- Shared Decision Making in Perinatal Care.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2024Article
- Acculturation, Acculturative Stress, Experience of Discrimination, and Cesarean Birth in Mexican American Women.Hispanic health care international : the official journal of the National Association of Hispanic Nurses · 2023Article
- Disparities by race/ethnicity in unplanned cesarean birth among healthy nulliparas: a secondary analysis of the nuMoM2b dataset.BMC pregnancy and childbirth · 2023Article
- Inequalities in cesarean births between American Indian & Alaska Native people and White people.Health services research · 2023Article
- The Pathophysiology of Labor Dystocia: Theme with Variations.Reproductive sciences (Thousand Oaks, Calif.) · 2023Review
- Caesarean birth in public maternities in Argentina: a formative research study on the views of obstetricians, midwives and trainees.BMJ open · 2022Article
- Induction of labor or expectant management? Birth outcomes for nulliparous individuals choosing midwifery care.Birth (Berkeley, Calif.) · 2021Article
- The Role of Oxytocin in Primary Cesarean Birth Among Low-Risk Women.Journal of midwifery & women's health · 2021Article
- Effectiveness of Dinoprostone and Cook's Balloon for Labor Induction in Primipara Women at Term.Current medical science · 2020Article
- Factors Associated with Unplanned Primary Cesarean Birth: Secondary Analysis of the Listening to Mothers in California Survey.BMC pregnancy and childbirth · 2020Article
- Outcomes of trial of labor after cesarean birth by provider type in low-risk women.Birth (Berkeley, Calif.) · 2020Article
- 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
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundTerm nulliparous women have the greatest variation across hospitals and providers in cesarean rates and therefore present an opportunity to improve quality through optimal care. We evaluated associations between provider type and mode of birth, including examination of intrapartum management in healthy, laboring nulliparous women.
methodsRetrospective cohort study using prospectively collected perinatal data from a United States academic medical center (2005-2012). The sample included healthy nulliparous women with spontaneous labor onset and term, singleton, vertex fetus managed by either obstetricians or certified nurse-midwives. Univariate and multivariate logistic regression was used to compare labor interventions and mode of birth by provider type.
resultsA total of 1339 women received care by an obstetrician (n = 749) or nurse-midwife (n = 590). The cesarean rate was 13.4% (179/1339). Adjusting for maternal and pregnancy characteristics, care by obstetricians was associated with an increased risk of unplanned cesarean birth (adjusted odds ratio [aOR] 1.48 [95% confidence interval {CI} 1.04-2.12]) compared with care by midwives. Obstetricians more frequently used oxytocin augmentation (aOR 1.41 [95% CI 1.10-1.80]), neuraxial anesthesia (aOR 1.69 [95% CI 1.29-2.23]), and operative vaginal delivery with forceps or vacuum (aOR 2.79 [95% CI 1.75-4.44]). Adverse maternal or neonatal outcomes were not different by provider type across all modes of birth, but were more frequent in women with cesarean than vaginal births. DISCUSSION: In low-risk nulliparous laboring women, care by obstetricians compared with nurse-midwives was associated with increased risk of labor interventions and operative birth. Changes in labor management or increased use of nurse-midwives could decrease the rate of a first cesarean in low-risk laboring women.
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