Skip to main content

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



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.


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%.


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.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Wagner M (2001) Fish can’t see water: the need to humanize birth. Int J Gynaecol Obstet 75:S25–S37

    PubMed  Article  Google Scholar 

  2. Department of Health. National Health Service Maternity Statistics, England 1998–99 to 2000–1. London: Department of Health, 2002

  3. Johanson R, Newburn M, Macfarlane A (2002) Has medicalisation of childbirth gone to far? BMJ 321:892–895

    Article  Google Scholar 

  4. Williams F, Florey C, Ogston S, Patel N, et al (1998) United Kingdom study of intrapartum care for low risk primigravidas: a survey of interventions. J Epidemiol Community Health 52:494–500

    PubMed  CAS  Article  Google Scholar 

  5. Saunders D, BoultonM, Chapple J, et al. Evaluation of the Edgware Birth Center. Middlesex, North Thames Perinatal Health, 2000

  6. Hundley V, Cruickshank F, Lang G, Glazener C (1994) Midwife managed delivery unit: a randomized controlled comparison with consultant led care. Br Med J 309:1400–1404

    CAS  Google Scholar 

  7. Rosser J (2001) Birth centers—the key to modernising the maternity services. Midirs 3(2):22–26

    Google Scholar 

  8. Rooks JP,Weatherby NL, Ernst EK, et al (1989) Outcomes of care in birth centers. The National Birth Center Study. N Engl J Med 321:1804–1811

    PubMed  CAS  Article  Google Scholar 

  9. Steward M, McCandlish R, Henderson J, Brocklehurst P. Report of a structured review of birth centre outcomes. The Maternity Research Group of the National Service Framework (NSF) for Children, Young People and Maternity Services. December 2004. NPEU

  10. Azonobi I, McBride-Richter H, Patrick L (2006) Late-onset postpartum eclampsia. J Midwifery Womens Health 51(1):51–53

    PubMed  Article  Google Scholar 

  11. Sikorski J, Wilson J, Clement S, Das S, Smeeton N (1996) A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project. BMJ 312(7030):546–553

    PubMed  CAS  Google Scholar 

  12. Tucker L, Hoff C, Peevy K, Brost B, Holland S, Calhoun BC (1995) The effects of antenatal steroid use in premature rupture of membranes. Aust N Z J Obstet Gynaecol 35(4):390–392

    PubMed  CAS  Google Scholar 

  13. Hodnett ED, Downe S, Edwards N, Walsh D. Home-like versus conventional institutional settings for birth. The Cochrane Database of Systematic Reviews 2005, Issue 4

  14. Eskes M, van Alten D, Treffers PE (1993) The Wormerveer study; perinatal mortality and non-optimal management in a practice of independent midwives. Eur J Obstet Gynecol Reprod Biol 51(2):91–95

    PubMed  Article  CAS  Google Scholar 

  15. Waldenstrom U, Turnbull D (1998) A systematic review comparing continuity of midwifery care with standard maternity services. Br J Obstet Gynaecol 105(11):1160–1170

    PubMed  CAS  Google Scholar 

  16. Turnbull D, Holmes A, Shields N, Cheyne H, Twaddle S, Gilmour WH, McGinley M, Reid M, Johnstone I, Geer I, McIlwaine G, Lunan CB (1996) Randomised, controlled trial of efficacy of midwife-managed care. Lancet 348(9022):213–218

    PubMed  Article  CAS  Google Scholar 

  17. Saporito M, Arsieri R, Pugliese A, Formisano V, Triassi M (2003) Increase of births by cesarean section in Campania in 2000. Epidemiol Prev 27(5):291–296

    PubMed  Google Scholar 

  18. Gottval K, Grunewald C, Waldenstrom U (2004) Safety of birth centre care: perinatal mortality over a 10-year period. BJOG 111:71–78

    Article  Google Scholar 

  19. Gould D, Lupton B, Marks M, Wales N (2004) Outcomes of an alongside birth centre in a tertiary referral centre. Midwives 7(6):252–256

    PubMed  Google Scholar 

  20. MacVicar J, Dobbie G, Owen-Johnstone L, Jagger C, Hopkins M, Kennedy J (1993) Simulated home delivery in hospital: a randomised controlled trial. Br J Obstet Gynecol 100:316–323

    CAS  Google Scholar 

  21. Homer C, Davis G, Petocz P, Barclay L, Matha D, Chapman M (2000) Birth centre or labour ward? A comparison of the clinical outcomes of low risk women in NSW hospital. Austral J Advanced Nursing 18(1):8–12

    CAS  Google Scholar 

  22. Mahmood ta (2003) Evaluation of an experimental midwife-led unit in Scontland. J Obstet Gynecol 23(2):121–129

    Google Scholar 

  23. Woodcock H, Baston H (1996) Midwife-led care: an audit of the home from home scheme at Darley Maternity Centre. MIDIRS Midwifery Digest 6(1):20–22

    Google Scholar 

  24. Donati S, Andreozzi S, Grandolfo ME. Istituto Superiore di Sanità. (2001) Evaluation of the support and the information activities offered to pregnant women: a national survey, 93p. Rapporti ISTISAN 01/5 (in Italian)

  25. Waldenstrom U, Nilsson CA, Winbladh B (1997) The Stockholm Birth Centre trial: maternal and infant outcome. Br J Obstet Gynecol 104:410–418

    CAS  Google Scholar 

Download references


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

Author information

Authors and Affiliations


Corresponding author

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.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


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