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Outcomes of the first midwife-led birth centre in Italy: 5 years’ experience

Abstract

Objective

To assess the experience of the first 5 years of the first midwife-led birth centre (MLBC) in Italy.

Study design

Data were prospectively collected to analyse the first 5 years’ experience of the MLBC. MLBC is located alongside a University hospital maternity unit and it offers care to women with a straightforward pregnancy and midwives take primary professional responsibility for care. Women with maternal diseases, complicated obstetric history, height < 150 cm, maternal age > 45, or multiple pregnancy were excluded. Transfer was request in case of antenatal, intrapartum and postpartum pathological conditions.

Results

During the 5-year period (1 January 2001–31 December 2005), 1,438 low-risk women were admitted in labour to the MLBC. Of these, 203 (14.1%) were transferred during labour to consultant care (138 because of pathologies and 65 because of request of epidural analgesia). Among the transfers, the caesarean sections were 87, corresponding to 6.1% (87/1,438) of the total of women admitted to MLBC, while the operative vaginal deliveries were 14, corresponding to 1.0% (14/1,438) of the total of women admitted to MLBC. Among women who gave birth in the MLBC, episiotomy rate was 17.1%.

Conclusions

In Italy, in the passed 10 years, the caesarean section rate reached 60%, in some regions. According to our data, the first 5 years of activity of the first MLBC in Italy had been associated with a low rate of medical interventions during labour and birth, with high rates of spontaneous vaginal birth and without signs of complications. We hope that this experience could be taken as a model to improve the quality of maternity care in Italy.

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Acknowledgments

We thank the many midwives without whose help the first Italian midwife-led birth centre would not have been possible.

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Correspondence to Emanuela Mistrangelo.

Additional information

Condensation: The experience of the first midwife-led birth centre in Italy in reducing rates of perinatal medical interventions and in increasing rates of spontaneous vaginal birth.

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Morano, S., Cerutti, F., Mistrangelo, E. et al. Outcomes of the first midwife-led birth centre in Italy: 5 years’ experience. Arch Gynecol Obstet 276, 333–337 (2007). https://doi.org/10.1007/s00404-007-0358-9

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Keywords

  • Midwife-led birth centre
  • Midwives care unit
  • Straightforward pregnancy
  • Low-risk pregnancy