Related Experiment Video
Updated: Sep 10, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Infant Emergency Department Use After Midwifery- Versus Obstetrician-Led Perinatal Care: A Population-Based Cohort
Joel G Ray1,2,3, Sho Podolsky1, Carla Sorbara4
1ICES, Toronto, Ontario, Canada.
Objective:
To assess whether infant emergency department (ED) use differs between a midwifery-based and obstetrics-based model of care.
Design:
Retrospective population-based cohort study.
Setting:
Province of Ontario, Canada.
Population:
Infants born to low-risk primiparous women in a hospital, 2012-2021.
Methods:
Modified Poisson regression compared ED use between women with midwifery and obstetrics-model care, weighting by propensity-based overlap weights.
Main Outcome Measures:
Any unscheduled infant ED visit after the birth hospitalisation discharge date up to 27 days thereafter.
Results:
Included were 36 949 livebirths to women receiving care by a midwife and 120 463 to women receiving care by an obstetrician. Median gestational age at birth was 39 weeks; 11.8% and 13.3% were admitted to the NICU, and the median newborn hospital length of stay was 1.3 and 1.8 days, respectively. Midwifery-care mother-child pairs received a median of 6.9 postpartum visits by a midwife. An infant ED visit ≤ 27 days occurred among 1789 (4.8%) midwife-led care patients versus 11 886 (9.9%) obstetrician-led care recipients (relative risk [RR] 0.51, 95% CI 0.49 to 0.54; absolute risk difference -4.6%, 95% CI -4.9 to -4.3). The corresponding RR was 0.42 (95% CI 0.39 to 0.46) for infant ED visit ≤ 7 days and 0.87 (95% CI 0.86 to 0.89) for infant ED visit ≤ 365 days.
Conclusions:
Among infants born to low-risk primiparous women, midwifery-model care was associated with less ED use after birth than an obstetrics model of care. Among similar populations, enhanced access to midwifery care might reduce postnatal newborn resource use.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...