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Midwifery Care at a Freestanding Birth Center: A Safe and Effective Alternative to Conventional Maternity Care
Author(s) -
Benatar Sarah,
Garrett A. Bowen,
Howell Embry,
Palmer Ashley
Publication year - 2013
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12061
Subject(s) - birth certificate , medicine , prenatal care , obstetrics , propensity score matching , maternity care , pregnancy , population , environmental health , biology , genetics
Objective To estimate the effect of a midwifery model of care delivered in a freestanding birth center on maternal and infant outcomes when compared with conventional care. Data Sources/Study Setting Birth certificate data for women who gave birth in W ashington D.C. and D.C. residents who gave birth in other jurisdictions. Study Design Using propensity score modeling and instrumental variable analysis, we compare maternal and infant outcomes among women who receive prenatal care from birth center midwives and women who receive usual care. We match on observable characteristics available on the birth certificate, and we use distance to the birth center as an instrument. Data Collection/Extraction Methods Birth certificate data from 2005 to 2008. Principal Findings Women who receive birth center care are less likely to have a C‐section, more likely to carry to term, and are more likely to deliver on a weekend, suggesting less intervention overall. While less consistent, findings also suggest improved infant outcomes. Conclusions For women without medical complications who are able to be served in either setting, our findings suggest that midwife‐directed prenatal and labor care results in equal or improved maternal and infant outcomes.