Midwives Rule!
For those that are still skeptical!Midwife centres as safe as hospitals, says study
Babies born in midwife-run birth centres had significantly lower death rates than those born in hospitals, an Australian study of more than 1 million births has found.
Contradicting claims from doctors' groups that birth centres increased the risk of the baby dying, the study of all births in Australia from 1999 until 2002 confirmed the centres provide care that is as safe, if not safer, as standard maternity units.
"This study clearly shows that claims that Australian birth centres are dangerous are simply wrong," said Barbara Vernon, the executive officer of the Australian College of Midwives. "Governments should immediately expand women's access to primary midwifery-led care with medical back-up ... the safety and efficacy of birth centres is beyond doubt."
The birth centres in the study were located alongside or in hospitals, and were run by midwives but with medical back-up close by.
"In birth centres, women can labour normally, they can move around ... and they have more intensive support during pregnancy so they are more confident during labour," Dr Vernon said.
Yet in labour wards, medical interventions used to help women give birth, such as artificially starting or accelerating labour and the use of epidurals and anaesthesia, increased the risk to the baby, Dr Vernon said.
Sally Tracy, a professor of midwifery at the University of Technology, Sydney, and lead author of the study, said it showed babies were no more likely to die in a birth centre than in a labour ward.
"That has been what the Australian Medical Association and the National Association of Specialist Obstetricians and Gynaecologists have been saying - that women are stupid to give birth in the birth centre, their babies will die - and this study proves this is not the case."
Examining all peri-natal deaths over a four-year period, the study found the peri-natal death rate for babies born to first-time mothers in a birth centre was 1.4 per 1000 compared with 1.9 per 1000 for similar low-risk babies born in hospital labour wards.
For mothers of subsequent babies, the rates were 0.6 per 1000 for birth centre babies compared with 1.6 per 1000 for hospital-born babies, Professor Tracy said.
Of the more than 1 million births in Australia over those four years, 21,800 took place in birth centres next to or within hospitals. However, differences between the way states and territories recorded the transfer of a woman from a birth centre to a labour ward placed some limitations on the data, she said.
The findings should reassure women who have a normal pregnancy that they will have good outcomes whether they chose a birth centre or hospital-based care, said Andrew Pesce, the chairman of the National Association of Specialist Obstetricians and Gynaecologists.
However Dr Pesce said Professor Tracy's study was limited by "a failure to know how many women with problems had been transferred out of the birth centre and to a labour ward to give birth". He called on midwives and obstetricians to work together, rejecting the idea of segregating midwife-only care from what he described as "the more conventional model".
Petra Smedley had both her children - three-week-old Romy and three-year-old
Tristan - in the birth centre at Royal Prince Alfred Hospital. So positive was her experience that she is encouraging her friends to do the same. "I always felt very safe [at the centre]," Mrs Smedley, 38, said.
Ruth Pollard
Sydney Morning Herald
3 September 2007
Babies born in midwife-run birth centres had significantly lower death rates than those born in hospitals, an Australian study of more than 1 million births has found.
Contradicting claims from doctors' groups that birth centres increased the risk of the baby dying, the study of all births in Australia from 1999 until 2002 confirmed the centres provide care that is as safe, if not safer, as standard maternity units.
"This study clearly shows that claims that Australian birth centres are dangerous are simply wrong," said Barbara Vernon, the executive officer of the Australian College of Midwives. "Governments should immediately expand women's access to primary midwifery-led care with medical back-up ... the safety and efficacy of birth centres is beyond doubt."
The birth centres in the study were located alongside or in hospitals, and were run by midwives but with medical back-up close by.
"In birth centres, women can labour normally, they can move around ... and they have more intensive support during pregnancy so they are more confident during labour," Dr Vernon said.
Yet in labour wards, medical interventions used to help women give birth, such as artificially starting or accelerating labour and the use of epidurals and anaesthesia, increased the risk to the baby, Dr Vernon said.
Sally Tracy, a professor of midwifery at the University of Technology, Sydney, and lead author of the study, said it showed babies were no more likely to die in a birth centre than in a labour ward.
"That has been what the Australian Medical Association and the National Association of Specialist Obstetricians and Gynaecologists have been saying - that women are stupid to give birth in the birth centre, their babies will die - and this study proves this is not the case."
Examining all peri-natal deaths over a four-year period, the study found the peri-natal death rate for babies born to first-time mothers in a birth centre was 1.4 per 1000 compared with 1.9 per 1000 for similar low-risk babies born in hospital labour wards.
For mothers of subsequent babies, the rates were 0.6 per 1000 for birth centre babies compared with 1.6 per 1000 for hospital-born babies, Professor Tracy said.
Of the more than 1 million births in Australia over those four years, 21,800 took place in birth centres next to or within hospitals. However, differences between the way states and territories recorded the transfer of a woman from a birth centre to a labour ward placed some limitations on the data, she said.
The findings should reassure women who have a normal pregnancy that they will have good outcomes whether they chose a birth centre or hospital-based care, said Andrew Pesce, the chairman of the National Association of Specialist Obstetricians and Gynaecologists.
However Dr Pesce said Professor Tracy's study was limited by "a failure to know how many women with problems had been transferred out of the birth centre and to a labour ward to give birth". He called on midwives and obstetricians to work together, rejecting the idea of segregating midwife-only care from what he described as "the more conventional model".
Petra Smedley had both her children - three-week-old Romy and three-year-old
Tristan - in the birth centre at Royal Prince Alfred Hospital. So positive was her experience that she is encouraging her friends to do the same. "I always felt very safe [at the centre]," Mrs Smedley, 38, said.
Ruth Pollard
Sydney Morning Herald
3 September 2007