Impact of Structured Care on Birth Outcomes
Author Information
Author(s): Hodnett Ellen D, Stremler Robyn, Willan Andrew R, Weston Julie A, Lowe Nancy K, Simpson Kathleen R, Fraser William D, Gafni Amiram
Primary Institution: Lawrence S Bloomberg Faculty of Nursing, University of Toronto
Hypothesis
A complex nursing and midwifery intervention in hospital labour assessment units would increase the likelihood of spontaneous vaginal birth and improve other maternal and neonatal outcomes.
Conclusion
A structured approach to care in hospital labour assessment units increased satisfaction with care and was suggestive of a modest increase in the likelihood of spontaneous vaginal birth.
Supporting Evidence
- The rate of spontaneous vaginal birth was 64.0% in the structured care group compared to 61.3% in the usual care group.
- Women in the structured care group were less likely to report disappointment with the amount of attention received from staff.
- Fewer women in the structured care group rated staff helpfulness as less than very helpful.
Takeaway
This study looked at how a special way of caring for women in labor can help them have their babies more easily and feel better about their care.
Methodology
Multicentre, randomised controlled trial with prognostic stratification by hospital.
Potential Biases
Potential for contamination between groups due to the nature of care in the labour assessment units.
Limitations
Results did not reach conventional levels of statistical significance for most outcomes.
Participant Demographics
Participants were 5002 nulliparous women experiencing contractions but not in active labour, with a mean age of 26.7 years.
Statistical Information
P-Value
p<0.05 for primary outcome.
Confidence Interval
95% confidence interval 0.96 to 1.27 for spontaneous vaginal birth.
Digital Object Identifier (DOI)
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