Impact of the absence of hospital staff obstetricians on method of delivery, severe maternal and perinatal morbidity in a type 2 maternity ward.

Background: The presence of locum obstetricians in the delivery room raises concerns of increased maternal or perinatal morbidities.

Objectives: To examine the method of delivery, maternal and perinatal morbidities depending on whether the delivery doctor is a member of hospital staff or a locum doctor.

Materials And Methods: The study took place in a type 2 maternity ward marked by the departure of all hospital staff obstetricians in 2018. We compared the characteristics of the deliveries carried out in 2017 by a team of hospital staff obstetricians to those carried out by locums in 2019. The same was done for severe maternal and perinatal morbidities. The only exclusion criteria were medical terminations of pregnancy and births before 22 weeks of gestation.

Results: A total of 1,323 deliveries in 2017, and 1,463 in 2019 were included. We found no significant difference in the overall rate of Caesarean sections between 2017 (19.6%) and 2019 (20.5%). However, we noted a significant increase in forceps-assisted deliveries (8.5% in 2017 versus 21.4% in 2019) (p<0.001). Regarding severe maternal morbidity, we found no significant difference in 2019 (3.2%) compared to 2017 (2.7%). Severe perinatal morbidity was not significantly different (4.3% morbidity in 2017 versus 5.1% in 2019).

Conclusion: The presence of locum obstetricians does not appear to impact either the method of delivery or maternal and perinatal morbidities.