[The access of independent midwives to maternity ward technical facilities: the experimentation of a level-1 department].

Gynecol Obstet Fertil

Service de santé publique, CHU Gabriel-Montpied, 7, place Henri-Dunant, 63000 Clermont-Ferrand, France.

Published: April 2015

Objectives: The first aim of this study was to evaluate the access of independent midwives to the technical facilities of a level-1 maternity hospital, with a follow-up of 2 years. The second aim was to evaluate the transfer of clinical responsibility, when a patient stops being managed by the independent midwife to be taken care of by the hospital team.

Patients And Methods: A retrospective study including 51 patients. Analysis of maternal and perinatal data.

Results: Of the 51 births, there were 42 vaginal deliveries without intervention (82.35%), 3 instrumental deliveries (5.88%), 6 caesarean sections (11.76%). The midwife-led care was completed in 70.59% of cases. The rate of transfer of clinical responsibility during labor was 25.49%. We conducted a neonatal transfer due to a respiratory distress syndrome.

Discussion And Conclusion: The access to technical support appears as an opportunity for independent midwives to establish a special relationship with their patients. However, this device preserves the possibility of a traditional hospital care when needed. This way, access to the technical support is a safe alternative that has the consent of the users (patients and midwives) as well as of the entire hospital team. Moreover, such device allowed an increase of 5% per year of our obstetrical activity with an estimated increase of 10% per year.

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http://dx.doi.org/10.1016/j.gyobfe.2015.02.005DOI Listing

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