Women at low risk for developing complications have more “natural” deliveries if they use nurse-midwives, a University of Washington study has found.
Compared with women who use physicians, those attended by nurse-midwives have fewer Caesarean sections, less anesthesia, fewer episiotomies (surgical opening of the vagina) and lower costs, the study shows. Overall, however, the babies did very well regardless of whether a midwife, family physician or obstetrician was used.
“One of the implications of this is to look at what can we learn from midwives,” said Roger Rosenblatt, UW professor of family medicine and director of the study. The analysis of 1,322 randomly selected hospital-birth records statewide is reported in the current edition of the American Journal of Public Health.
Rosenblatt, vice chairman of the UW Department of Family Medicine, said nurse midwives seem to achieve a special relationship with their patients, which leads to excellent deliveries while using less technology and surgery. He said the study included both women who sought out midwives and those who went to some state-sponsored clinics where midwives were regularly assigned to perform deliveries.
“It was fairly dramatic to see the differences in the styles of practice for deliveries,” he said.
The UW study found that patients of nurse-midwives were less likely to have induced labor, epidural anesthesia or continuous fetal monitoring through electronic devices.
The Caesarean-section rate for patients of nurse midwives was 8.8 percent, compared with 13.6 percent for obstetricians and 15.1 percent for family physicians. (Midwives aren’t allowed to perform C-sections, but were counted if they referred them to physicians.) Overall, midwives’ patients used 12 percent fewer interventions than physicians’ patients.
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