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Bibliographical entry (without author) : | Outcomes of free-standing, midwife-led birth centers: a structured review. Birth. 2004 Sep;31(3):222-9. |
Author(s) : | Walsh D, Downe SM. |
Year of publication : | 2004 |
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Résumé (français) : |
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Abstract (English) : | BACKGROUND: Over the last two decades, childbirth worldwide has been increasingly concentrated in large centralized hospitals, with a parallel trend toward more birth interventions. At the same time in several countries, interest in midwife-led care and free-standing birth centers has steadily increased. The objective of this review is to establish the current evidence base for free-standing, midwife-led birth centers. METHODS: A structured review, based on Cochrane guidelines, was conducted that included nonrandomized studies. The comparative outcomes measured were rates of normal vaginal birth; cesarean section; intact perineum; episiotomy; transfers; and babies remaining with their mothers. RESULTS: Of the 5 controlled studies that met the review criteria, all except one was a single site study. Since no study was randomized, meta-analysis was not performed. The included studies all raised quality concerns, and significant heterogeneity was observed among them. For the outcomes measured, every study reported a benefit for women intending to give birth in the free-standing, midwife-led unit. CONCLUSIONS: The benefits shown for women recruited into the included studies who intended to give birth in a free-standing, midwife-led unit suggest a question about the efficacy of consultant unit care for low-risk women. However, the findings cannot be generalized beyond the individual studies. Good quality controlled studies are needed to investigate these issues in the future. |
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Argument (français) : | Sécurité des maisons de naissance indépendantes, UK: très variable d’un lieu à un autre. |
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Keywords : | ➡ place of birth ; birthing center birthing centers ; evidence-based medicine/midwifery |
Author of this record : | Cécile Loup — 06 Dec 2005 |
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