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Midwifery, 1977.

T F Dillon, B A Brennan, J F Dwyer

    American Journal of Obstetrics and Gynecology
    |April 15, 1978
    PubMed
    Summary
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    An autonomous midwifery service offering empathetic care and expert obstetric support demonstrated similar outcomes to physician-led care. While low-risk groups can be identified, no population is entirely without risk.

    Area of Science:

    • Obstetrics and Gynecology
    • Midwifery
    • Healthcare Services Research

    Background:

    • An autonomous midwifery service was established at Roosevelt Hospital in 1974 for private patients.
    • This model integrated midwife-led care with readily available physician expertise.
    • The service aimed to combine consumer-preferred empathy with modern obstetric practice.

    Purpose of the Study:

    • To evaluate the outcomes of an autonomous midwifery service compared to traditional obstetric care.
    • To assess the safety and efficacy of midwife-managed obstetric care for private patients.

    Main Methods:

    • A comparative study design was employed.
    • Outcomes of 454 patients managed by midwives were compared to 500 patients managed by attending obstetricians.

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  • Data on delivery methods and complication rates were analyzed.

    • Main Results:

    • Overall outcomes showed striking similarity between the midwifery and obstetrician groups.
    • Operative delivery rates were higher in the private patient group (managed by obstetricians).
    • The midwifery group experienced a low incidence of complications, but acute complications necessitated immediate operating room availability.

    Conclusions:

    • Autonomous midwifery services can provide modern obstetric care comparable to physician-led care.
    • While low-risk patients can be identified, predicting a 'no risk' population is not feasible.
    • The integration of midwifery with physician support offers a viable model for obstetric care.