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Expert Group on Acute Maternity Services: Reference Report

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Expert Group on Acute Maternity Services: Reference Report

ANNEX D: Advantages of Birth Centres

Increased consumer satisfaction

Ernst 1986, Rooks et al, 1989; Spitzer 1995; Campbell R 1997; Gillis SL (1995); Hayes KE.(1996); Saunders et al 2000

High midwifery job satisfaction

Saunders et al, 2000

More appropriate use of midwifery skills, more autonomy

Saunders et al, 2000; Ernst 1986

Women/ families able to make own birth decisions

Kucera 1987

Women felt empowered

Spitzer 1995

Higher normal delivery rates

David et al, 1999; Saunders et al. 2000; Wladenstrom et al 1997; Durand, AM. (1992)

Lower forceps and Ventouse rates

David et al, 1999; Feldman & Hunt 1987; Durand, AM. 1992; Rosenblatt, Roger A et.al. 1997

Lower caesarean section rate

Feldman & Hunt 1987; Saunders et al. 2000, Durand AM. (1992); Rosenblatt, Roger A., et.al. 1997

Fewer inductions

Saunders et al. 2000

Lower augmentation rates

Scupholme et al. 1986; Feldman & Hunt 1987; Rooks et al. 1992; Law YY, Lam KY (1999)

Fewer epidurals

Rooks et al. 1992; Feldman & Hunt 1987; Saunders et al..2000; Rosenblatt, Roger A. et.al. 1997

Less pethidine

Rooks et al. 1992; Spitzer 1995; Saunders et al. 2000

Fewer episiotomies

David et al. 1999; Rooks et .1992; Campbell et al 1999; Saunders et al. 2000

Less electronic fetal monitoring

Rooks et al. 1992; Spitzer 1995

Fewer amniotomies

Rooks et al. 1992; Spitzer 1995

Fewer intravenous infusions

Rooks et al. 1992; Feldman & Hunt 1987

Fewer vaginal examinations

Rooks et al. 1992; Spitzer 1995

Lower incidence of shoulder dystocia

Scupholme et al. 1986

Shorter labours

Albers & Katz 1991; Saunders et al. 2000

More likely to eat during labour

Rooks et al. 1992

More use of hydrotherapy

Rooks et al. 1992

Less fetal distress

Fullerton & Severino 1992

Less difficulty establishing respiration

Fullerton & Severino 1992

Increased chance of successful breastfeeding

Ernst 1986; Albers & Katz 1991; Spitzer 1995; De Konincket al. (2001)

Cost effectiveness

Saunders et al. 2000; Reinharz et al. 2000; Spitzer 1995; Rosser 2001; American Public Health Association 2001; Anderson RE, Anderson, DA. (1999); Gabay M and Wolfe SM 1999

Source: Walsh, D. 2001, amended

Interventions not available in a Level I unit include amniotomy, caesarean section, electronic fetal monitoring, repeat analgesia and forceps delivery.

Definition of Birth Centre =A home-like facility, existing within a healthcare system with a programme of care in the wellness model of pregnancy and birth. These centres are guided by the principles of prevention, sensitivity, safety (appropriate medical intervention), and cost effectiveness. These units provide family centred acre for health women before, during and after normal pregnancy, labour and birth (National Association of Childbearing Centres, 1995) http://www.birthcenters.org

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