Maternity care program cut C-sections, hospital time
Pregnant women in B.C. who participated in a special care program had fewer cesarean sections, shorter average hospital stays and higher breast-feeding rates than women who had standard care, researchers have found.
In the South Community Birth Program, family doctors, midwives, public health nurses and doulas work together collaboratively to care for an ethnically diverse, low-income population.
In Monday's issue of the Canadian Medical Association Journal, researchers compared 1,238 women who received care under the program to the same number of women of similar age and previous births who were treated by either a doctor or a midwife.
Women in the birth program had a 25 per cent lower risk of caesarean delivery, Dr. Patricia Janssen, of the school of population and public health at the University of British Columbia and her co-authors found.
The finding was true both for first-time mothers and those who'd given birth before.
Length of hospital stays were also shorter for those in the program compared with those in regular care, both for mothers (average of 50.6 hours compared with 72.7 hours) and newborns (47.5 hours versus 70.6 hours), the researchers reported.
Twice as many women in the program breast fed exclusively when they were discharged from hospital.
However, more newborns in the program group were large for gestational age compared with the others.
Fewer maternity care providers
The lack of randomization in the study was one of the drawbacks.
The researchers weren't able to tell which components of the birth program might be responsible for the differences they observed.
Clinicians working in the program said the close working relationship they had, including the ability to discuss patient care and immediately access electronic medical records remotely, fosters an environment of support and learning.
"These findings have important implications given the decreasing numbers of maternity care providers in Canada," the study's authors concluded.
"Our findings should encourage the implementation and evaluation of this interdisciplinary approach in other settings."
But they cautioned the program was offered in an area that had been underserved and it’s unclear whether the results would apply to areas that are well supplied with maternity care providers.
The study was funded by the Canadian Federal Primary Health Care Transition Fund and the Provincial Health Services and Vancouver Coastal Health Authorities in British Columbia.