Local birthing services for rural women: Adaptation of a rural New South Wales maternity service.

Durst, M; Rolfe, M; Longman, J; Robin, S; Dhnaram, B; Mullany, K; Wright, I; Barclay, L

Local birthing services for rural women: Adaptation of a rural New South Wales maternity service.

Durst, M Rolfe, M Longman, J Robin, S Dhnaram, B Mullany, K Wright, I Barclay, L

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Aust J Rural Health, 2016, 24, (6), pp. 385-391
Issue Date:: 2016-12

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Field	Value	Language
dc.contributor.author	Durst, M
dc.contributor.author	Rolfe, M
dc.contributor.author	Longman, J
dc.contributor.author	Robin, S
dc.contributor.author	Dhnaram, B
dc.contributor.author	Mullany, K
dc.contributor.author	Wright, I
dc.contributor.author	Barclay, L https://orcid.org/0000-0002-9345-3468
dc.date.accessioned	2022-08-19T03:59:27Z
dc.date.available	2016-05-17
dc.date.available	2022-08-19T03:59:27Z
dc.date.issued	2016-12
dc.identifier.citation	Aust J Rural Health, 2016, 24, (6), pp. 385-391
dc.identifier.issn	1038-5282
dc.identifier.issn	1440-1584
dc.identifier.uri	http://hdl.handle.net/10453/160512
dc.description.abstract	OBJECTIVE: To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS). DESIGN: A retrospective descriptive study using quantitative methodology. SETTING: Maternity unit in a small public hospital in rural New South Wales, Australia. PARTICIPANTS: Data were extracted from the ward-based birth register for 1172 births at the service between July 2007 and June 2012. MAIN OUTCOME MEASURES: Birth numbers, maternal characteristics, labour, birthing and neonatal outcomes. RESULTS: There were 750 births over 29 months in GPO and 277 and 145 births over 31 months in MGP and PCS, respectively, totalling 422 births following the change in model of care. The GPO had 553 (73.7%) vaginal births and 197 (26.3%) caesarean section (CS) births (139 planned and 58 unplanned). There were almost universal normal vaginal births in MGP (>99% or 276). For normal vaginal births, more women in MGP had no analgesia (45.3% versus 25.1%) or non-invasive analgesia (47.9% versus 38.6%) and episiotomy was less common in MGP than GPO (1.9% versus 3.4%). Neonatal outcomes were similar for both groups with no difference between Apgar scores at 5 min, neonatal resuscitations or transfer to high-level special care nurseries. CONCLUSION: This study demonstrates how a rural maternity service maintained quality care outcomes for low-risk women following the adaptation from a GPO to an MGP service.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Aust J Rural Health
dc.relation.isbasedon	10.1111/ajr.12310
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences, 16 Studies in Human Society
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Hospitals, Rural
dc.subject.mesh	Humans
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Midwifery
dc.subject.mesh	New South Wales
dc.subject.mesh	Parturition
dc.subject.mesh	Pregnancy
dc.subject.mesh	Registries
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Registries
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Parturition
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Hospitals, Rural
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	New South Wales
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.title	Local birthing services for rural women: Adaptation of a rural New South Wales maternity service.
dc.type	Journal Article
utslib.citation.volume	24
utslib.location.activity	Australia
utslib.for	11 Medical and Health Sciences
utslib.for	16 Studies in Human Society
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2022-08-19T03:59:26Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	24
utslib.citation.issue	6

Abstract:

OBJECTIVE: To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS). DESIGN: A retrospective descriptive study using quantitative methodology. SETTING: Maternity unit in a small public hospital in rural New South Wales, Australia. PARTICIPANTS: Data were extracted from the ward-based birth register for 1172 births at the service between July 2007 and June 2012. MAIN OUTCOME MEASURES: Birth numbers, maternal characteristics, labour, birthing and neonatal outcomes. RESULTS: There were 750 births over 29 months in GPO and 277 and 145 births over 31 months in MGP and PCS, respectively, totalling 422 births following the change in model of care. The GPO had 553 (73.7%) vaginal births and 197 (26.3%) caesarean section (CS) births (139 planned and 58 unplanned). There were almost universal normal vaginal births in MGP (>99% or 276). For normal vaginal births, more women in MGP had no analgesia (45.3% versus 25.1%) or non-invasive analgesia (47.9% versus 38.6%) and episiotomy was less common in MGP than GPO (1.9% versus 3.4%). Neonatal outcomes were similar for both groups with no difference between Apgar scores at 5 min, neonatal resuscitations or transfer to high-level special care nurseries. CONCLUSION: This study demonstrates how a rural maternity service maintained quality care outcomes for low-risk women following the adaptation from a GPO to an MGP service.

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http://hdl.handle.net/10453/160512