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Article

Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study

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GHenderS Research Group, School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain
2
Faculty of Medicine, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain
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La Ribera Hospital Health Department, Carretera Corbera km 1, 46600 Valencia, Spain
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Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
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Faculty of Nursing and Podiatry, Universitat de València, Jaume Roig, s/n, 46010 Valencia, Spain
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School of Nursing and Midwifery, University College Cork, T12 YN60 Cork, Ireland
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Cork University Maternity Hospital, Wilton, T12 YE02 Cork, Ireland
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Verge dels Lliris Hospital, Poligon de Caramanxel s/n, 03804 Alcoi, Spain
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Nursing Department, Universitat Rovira i Virgili, 43003 Tarragona, Spain
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Rio Hortega Hospital, Calle Dulzaina, 2, 47012 Valladolid, Spain
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Catalan Health Service, Government of Barcelona, 08028 Catalonia, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(22), 8394; https://doi.org/10.3390/ijerph17228394
Received: 17 October 2020 / Revised: 8 November 2020 / Accepted: 11 November 2020 / Published: 13 November 2020
(This article belongs to the Collection Women's Reproductive and Maternal Health)
Background: In Europe, the majority of healthy women give birth at conventional obstetric units with the assistance of registered midwives. This study examines the relationships between the intrapartum transfer of care (TOC) from midwife to obstetrician-led maternity care, obstetric unit size (OUS) with different degrees of midwifery autonomy, intrapartum interventions and birth outcomes. Methods: A prospective, multicentre, cross-sectional study promoted by the COST Action IS1405 was carried out at eight public hospitals in Spain and Ireland between 2016–2019. The primary outcome was TOC. The secondary outcomes included type of onset of labour, oxytocin stimulation, epidural analgesia, type of birth, episiotomy/perineal injury, postpartum haemorrhage, early initiation of breastfeeding and early skin-to-skin contact. A logistic regression was performed to ascertain the effects of studied co-variables on the likelihood that participants had a TOC; Results: Out of a total of 2,126 low-risk women, those whose intrapartum care was initiated by a midwife (1772) were selected. There were statistically significant differences between TOC and OUS (S1 = 29.0%, S2 = 44.0%, S3 = 52.9%, S4 = 30.2%, p < 0.001). Statistically differences between OUS and onset of labour, oxytocin stimulation, type of birth and episiotomy or perineal injury were observed (p = 0.009, p < 0.001, p < 0.001, p < 0.001 respectively); Conclusions: Findings suggest that the model of care and OUS have a significant effect on the prevalence of intrapartum TOC and the birth outcomes. Future research should examine how models of care differ as a function of the OUS in a hospital, as well as the cost-effectiveness for the health care system. View Full-Text
Keywords: midwife-led care; obstetrician-led care; continuity of care; transfer of care; maternal outcomes; neonatal outcomes midwife-led care; obstetrician-led care; continuity of care; transfer of care; maternal outcomes; neonatal outcomes
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MDPI and ACS Style

Martín-Arribas, A.; Vila-Candel, R.; O’Connell, R.; Dillon, M.; Vila-Bellido, I.; Beneyto, M.Á.; De Molina-Fernández, I.; Rodríguez-Conesa, N.; González-Blázquez, C.; Escuriet, R. Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study. Int. J. Environ. Res. Public Health 2020, 17, 8394. https://doi.org/10.3390/ijerph17228394

AMA Style

Martín-Arribas A, Vila-Candel R, O’Connell R, Dillon M, Vila-Bellido I, Beneyto MÁ, De Molina-Fernández I, Rodríguez-Conesa N, González-Blázquez C, Escuriet R. Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study. International Journal of Environmental Research and Public Health. 2020; 17(22):8394. https://doi.org/10.3390/ijerph17228394

Chicago/Turabian Style

Martín-Arribas, Anna, Rafael Vila-Candel, Rhona O’Connell, Martina Dillon, Inmaculada Vila-Bellido, M. Á. Beneyto, Inmaculada De Molina-Fernández, Nerea Rodríguez-Conesa, Cristina González-Blázquez, and Ramón Escuriet. 2020. "Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study" International Journal of Environmental Research and Public Health 17, no. 22: 8394. https://doi.org/10.3390/ijerph17228394

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