NHS and Midwife Births Have Their Share of Problems

Clinical outcomes of both point to a need for review
By Jane Parry
HealthDay Reporter

FRIDAY, June 12 (HealthDay News) -- The outcomes of births in Great Britain's National Health Service (NHS) and those managed by an independent midwife point to a need for a review of both practices, according to a study published online June 11 in BMJ.

Andrew Symon, Ph.D., and colleagues at the University of Dundee in the United Kingdom compared the outcomes of births by 8,676 women, of whom 7,214 were NHS patients matched on a ratio of one to five with 1,462 women who employed an independent midwife.

While 96.6 percent of the women with independent midwives had spontaneous onset of labor, and 77.9 percent had an unassisted vertex delivery, the rates for NHS patients were only 74.5 and 54.3 percent, respectively, the investigators discovered. However, the stillbirth and neonatal death rate was higher in the independent midwife group at 1.7 percent versus 0.6 percent for the NHS patients. In addition, prematurity, low birth weight, and admission to neonatal intensive care units were higher in the NHS group.

"While clinical outcomes across a range of variables are much better for women using an independent midwife, the significantly higher perinatal mortality rate, particularly in higher risk women, indicates the need for a full review of case notes to identify possible causative factors," the authors write. "A full review of these cases could help to explain the higher perinatal mortality rate in higher risk women and thereby provide women with further evidence on which to base their decisions about pregnancy care and delivery."

One of the authors is an honorary member of the Independent Midwives' Association.

Abstract
Full Text
Editorial (subscription or payment may be required)

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events