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Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care

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Listed:
  • Jackson, D.J.
  • Lang, J.M.
  • Swartz, W.H.
  • Ganiats, T.G.
  • Fullerton, J.
  • Ecker, J.
  • Nguyen, U.

Abstract

Objective. We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based ca re. Methods. We studied 2957 low-risk, low-income women: 1808 receiving collaborative care and 1149 receiving traditional care. Results. Major antepartum (adjusted risk difference [RD]=-0.5%; 95% confidence interval [CI]=-2.5, 1.5), intrapartum (adjusted RD=0.8%; 95% CI=-2.4, 4.0), and neonatal (adjusted RD=-1.8%; 95% CI=-3.8, 0.1) complications were similar, as were neonatal intensive care unit admissions (adjusted RD=-1.3%; 95% CI=-3.8, 1.1). Collaborative care had a greater number of normal spontaneous vaginal deliveries (adjusted RD=14.9%; 95% CI=11.5, 18.3) and less use of epidural anesthesia (adjusted RD=-35.7%; 95% CI=-39.5, -31.8). Conclusions. For low-risk women, both scenarios result in safe outcomes for mothers and babies. However, fewer operative deliveries and medical resources were used in collaborative care.

Suggested Citation

  • Jackson, D.J. & Lang, J.M. & Swartz, W.H. & Ganiats, T.G. & Fullerton, J. & Ecker, J. & Nguyen, U., 2003. "Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care," American Journal of Public Health, American Public Health Association, vol. 93(6), pages 999-1006.
    • Handle: RePEc:aph:ajpbhl:2003:93:6:999-1006_4
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    Cited by:

    1. Markowitz, Sara & Adams, E. Kathleen & Lewitt, Mary Jane & Dunlop, Anne L., 2017. "Competitive effects of scope of practice restrictions: Public health or public harm?," Journal of Health Economics, Elsevier, vol. 55(C), pages 201-218.
    2. Goodman, Steffie, 2007. "Piercing the veil: The marginalization of midwives in the United States," Social Science & Medicine, Elsevier, vol. 65(3), pages 610-621, August.
    3. Edwin van Teijlingen & Sirpa Wrede & Cecilia Benoit & Jane Sandall & Raymond DeVries, 2009. "Born in the USA: Exceptionalism in Maternity Care Organisation among High-Income Countries," Sociological Research Online, , vol. 14(42), pages 52-11, January.

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