Evidence map›Paper›PMID 37691323›Full record

Observational studyHealth services research2024

An alternative model of maternity care for low-risk birth: Maternal and neonatal outcomes utilizing the midwifery-based birth center model.

Jacqueline Wallace, Lauren Hoehn-Velasco, Ellen Tilden, Bryan E Dowd, Steve Calvin, Diana R Jolles, Jennifer Wright, Susan Stapleton

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jacqueline WallaceAmerican Association of Birth Centers Research Committee, Perkiomenville, Pennsylvania, USA.ORCID 0000-0002-7991-2808
Lauren Hoehn-VelascoDepartment of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia, USA.
Ellen TildenNurse-Midwifery Department, School of Nursing, Oregon Health and Science University, Portland, Oregon, USA.
Bryan E DowdDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0002-3384-5144
Steve CalvinDepartment of Obstetrics, Gynecology and Women's Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Diana R JollesClinical Faculty, Frontier Nursing University, Tucson, Arizona, USA.
Jennifer WrightAmerican Association of Birth Centers Research Committee, Perkiomenville, Pennsylvania, USA.
Susan StapletonAmerican Association of Birth Centers Research Committee, Perkiomenville, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess key birth outcomes in an alternative maternity care model, midwifery-based birth center care. DATA SOURCES: The American Association of Birth Centers Perinatal Data Registry and birth certificate files, using national data collected from 2009 to 2019. STUDY

designThis observational cohort study compared key clinical birth outcomes of women at low risk for perinatal complications, comparing those who received care in the midwifery-based birth center model versus hospital-based usual care. Linear regression analysis was used to assess key clinical outcomes in the midwifery-based group as compared with hospital-based usual care. The hospital-based group was selected using nearest neighbor matching, and the primary linear regressions were weighted using propensity score weights (PSWs). The key clinical outcomes considered were cesarean delivery, low birth weight, neonatal intensive care unit admission, breastfeeding, and neonatal death. We performed sensitivity analyses using inverse probability weights and entropy balancing weights. We also assessed the remaining role of omitted variable bias using a bounding methodology. DATA COLLECTION: Women aged 16-45 with low-risk pregnancies, defined as a singleton fetus and no record of hypertension or cesarean section, were included. The sample was selected for records that overlapped in each year and state. Counties were included if there were at least 50 midwifery-based birth center births and 300 total births. After matching, the sample size of the birth center cohort was 85,842 and the hospital-based cohort was 261,439. PRINCIPAL

findingsWomen receiving midwifery-based birth center care experienced lower rates of cesarean section (-12.2 percentage points, p < 0.001), low birth weight (-3.2 percentage points, p < 0.001), NICU admission (-5.5 percentage points, p < 0.001), neonatal death (-0.1 percentage points, p < 0.001), and higher rates of breastfeeding (9.3 percentage points, p < 0.001).

conclusionsThis analysis supports midwifery-based birth center care as a high-quality model that delivers optimal outcomes for low-risk maternal/newborn dyads.

Indexed as

Birthing CentersMaternal Health ServicesMidwiferyPerinatal DeathCesarean SectionFemaleHumansInfant, NewbornPregnancybirth centercommunity birthlow-risk birthmaternity care modelsmidwifery-led birth centerpropensity score weighting

Identifiers

PMID37691323
PMCPMC10771911

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.