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Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study

Author

Listed:
  • Anna Martín-Arribas

    (GHenderS Research Group, School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain
    Faculty of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain)

  • Rafael Vila-Candel

    (La Ribera Hospital Health Department, Carretera Corbera km 1, 46600 Valencia, Spain
    Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
    Faculty of Nursing and Podiatry, Universitat de València, Jaume Roig, s/n, 46010 Valencia, Spain)

  • Rhona O’Connell

    (School of Nursing and Midwifery, University College Cork, T12 YN60 Cork, Ireland)

  • Martina Dillon

    (Cork University Maternity Hospital, Wilton, T12 YE02 Cork, Ireland)

  • Inmaculada Vila-Bellido

    (Verge dels Lliris Hospital, Poligon de Caramanxel s/n, 03804 Alcoi, Spain)

  • M. Ángeles Beneyto

    (Verge dels Lliris Hospital, Poligon de Caramanxel s/n, 03804 Alcoi, Spain)

  • Inmaculada De Molina-Fernández

    (Nursing Department, Universitat Rovira i Virgili, 43003 Tarragona, Spain)

  • Nerea Rodríguez-Conesa

    (Rio Hortega Hospital, Calle Dulzaina, 2, 47012 Valladolid, Spain)

  • Cristina González-Blázquez

    (Faculty of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain)

  • Ramón Escuriet

    (GHenderS Research Group, School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain
    Catalan Health Service, Government of Barcelona, 08028 Catalonia, Spain)

Abstract

Background: In Europe, the majority of healthy women give birth at conventional obstetric units with the assistance of registered midwives. This study examines the relationships between the intrapartum transfer of care (TOC) from midwife to obstetrician-led maternity care, obstetric unit size (OUS) with different degrees of midwifery autonomy, intrapartum interventions and birth outcomes. Methods: A prospective, multicentre, cross-sectional study promoted by the COST Action IS1405 was carried out at eight public hospitals in Spain and Ireland between 2016–2019. The primary outcome was TOC. The secondary outcomes included type of onset of labour, oxytocin stimulation, epidural analgesia, type of birth, episiotomy/perineal injury, postpartum haemorrhage, early initiation of breastfeeding and early skin-to-skin contact. A logistic regression was performed to ascertain the effects of studied co-variables on the likelihood that participants had a TOC; Results: Out of a total of 2,126 low-risk women, those whose intrapartum care was initiated by a midwife (1772) were selected. There were statistically significant differences between TOC and OUS (S1 = 29.0%, S2 = 44.0%, S3 = 52.9%, S4 = 30.2%, p < 0.001). Statistically differences between OUS and onset of labour, oxytocin stimulation, type of birth and episiotomy or perineal injury were observed ( p = 0.009, p < 0.001, p < 0.001, p < 0.001 respectively); Conclusions: Findings suggest that the model of care and OUS have a significant effect on the prevalence of intrapartum TOC and the birth outcomes. Future research should examine how models of care differ as a function of the OUS in a hospital, as well as the cost-effectiveness for the health care system.

Suggested Citation

  • Anna Martín-Arribas & Rafael Vila-Candel & Rhona O’Connell & Martina Dillon & Inmaculada Vila-Bellido & M. Ángeles Beneyto & Inmaculada De Molina-Fernández & Nerea Rodríguez-Conesa & Cristina González, 2020. "Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study," IJERPH, MDPI, vol. 17(22), pages 1-15, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8394-:d:444301
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    References listed on IDEAS

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    1. Rafael Vila-Candel & Anna Martín & Ramón Escuriet & Enrique Castro-Sánchez & Francisco Javier Soriano-Vidal, 2020. "Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain," IJERPH, MDPI, vol. 17(5), pages 1-12, February.
    2. de Jong, Judith D. & Groenewegen, Peter P. & Westert, Gert P., 2003. "Mutual influences of general practitioners in partnerships," Social Science & Medicine, Elsevier, vol. 57(8), pages 1515-1524, October.
    3. Sunita Panda & Cecily Begley & Deirdre Daly, 2018. "Clinicians’ views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-27, July.
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    1. Ernesto González-Mesa & Jesús Jiménez-López & Marta Blasco-Alonso & Daniel Lubián-López, 2021. "Obstetricians’ Attitude towards Childbirth," IJERPH, MDPI, vol. 18(20), pages 1-11, October.

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