Observational studyBirth (Berkeley, Calif.)2019
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: A Consortium on Safe Labor study.
Observational study in Birth (Berkeley, Calif.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Hospital Variation in Labor After Cesarean and Vaginal Birth After Cesarean in Massachusetts, 2012-2022.O&G open · 2026Article
- Midwifery Care in the United States: Increasing Access and Utilization to Improve Perinatal Health Outcomes.Obstetrical & gynecological survey · 2025Review
- Shared Decision Making in Perinatal Care.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2024Article
- An alternative model of maternity care for low-risk birth: Maternal and neonatal outcomes utilizing the midwifery-based birth center model.Health services research · 2024Observational
- "I was able to take it back": Seeking VBAC after experiencing dehumanizing maternity care in a primary cesarean.SSM. Qualitative research in health · 2023Article
- Addressing the National Crisis Facing Black and Latina Women, Birthing People, and Infants: The Maternal and Child Health Equity Summit.Obstetrics and gynecology · 2023Article
- Induction of labor or expectant management? Birth outcomes for nulliparous individuals choosing midwifery care.Birth (Berkeley, Calif.) · 2021Article
- A Tribute to Nancy C. Chescheir, MD.Obstetrics and gynecology · 2021Article
- The association between longer durations of the latent phase of labor and subsequent perinatal processes and outcomes among midwifery patients.Birth (Berkeley, Calif.) · 2020Article
- Geospatial variation in caesarean delivery.Nursing open · 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
- Intrapartum Care and Experiences of Women with Midwives Versus Obstetricians in the Listening to Mothers in California Survey.Journal of midwifery & women's health · 2020Article
- Safe Childbirth: A Call to Action.The Journal of perinatal education · 2019Article
- Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary.The Journal of perinatal education · 2019Article
- Challenges in the Triage Care of Low-Risk Laboring Patients: A Comparison of 2 Models of Practice.The Journal of perinatal & neonatal nursingArticle
- Outcomes for Labor Induction Compared With Expectant Management Among Women Receiving Hospital-Based, Midwifery-Led Care.Journal of midwifery & women's healthArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe presence of midwives in a health system may affect perinatal outcomes but has been inadequately described in United States settings. Our objective was to compare labor processes and outcomes for low-risk nulliparous women birthing in United States medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only).
methodsWe conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk nulliparous women who birthed in interprofessional (n = 7393) or noninterprofessional centers (n = 6982). Unadjusted, adjusted (age, race, health insurance type), propensity-adjusted, and propensity-matched logistic regression models were used to compare outcomes.
resultsThere was concordance across logistic regression models, the most restrictive and conservative of which were propensity-matched models. With this approach, women at interprofessional medical centers, compared with women at noninterprofessional centers, were 74% less likely to undergo labor induction (risk ratio [RR] 0.26; 95% CI 0.24-0.29) and 75% less likely to have oxytocin augmentation (RR 0.25; 95% CI 0.22-0.29). The cesarean birth rate was 12% lower at interprofessional centers (RR 0.88; 95% CI 0.79-0.98). Adverse neonatal outcomes occurred in only 0.3% of births and were thus too rare to be modeled.
conclusionsThe care processes and birth outcomes at interprofessional and noninterprofessional medical centers differed significantly. Nulliparous women receiving care at interprofessional centers were less likely to experience induction, oxytocin augmentation, and cesarean than women at noninterprofessional centers. Labor care and birth outcome differences between interprofessional and noninterprofessional centers may be the result of the presence of midwives and interprofessional collaboration, organizational culture, or both.
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