Midwife-led, birth centre care

A recent study has found that women receiving care in midwifery-led birth centres in the US experience very low rates of intervention with an excellent safety record. Of 15,574 women who planned to give birth in a midwife-led birth centre, 84% actually gave birth at the birth centre. 4% were transferred after the birth, and 12% were transferred in labour after admission to the birth centre.  Regardless of where the women gave birth (ie, birth centre or hospital transfer), 93% of women had a normal birth, 1% an assisted vaginal birth, and 6% a cesarean.

This study is significant because in the US, as with Australia, intervention rates in labour and birth are increasing.  Rates of continuous monitoring, epidurals, induction and of course caesarean are increasing in both countries. The study suggests that if birth centre care was more widely available, we may be able to reduce the intervention rates.

In Australia, we don't have any birth centres that are separate to hospitals: all birth centres exist within hospital grounds.  In the US, this is not the case.  Regardless, I have often wondered if the model of care is more important than the place of birth.  The women who experienced birth centre care in the US accessed midwifery care.  Likewise, in Australia, midwifery care is available either privately (through a private midwife) or through the public hospital system (if a woman is low risk).  I think what is needed is the promotion of midwifery care as the norm for women; I am sure that intervention rates would drop one this occurred.  Nevertheless, it is great that we have this study to back-up midwifery care and birth centre care as safe and effective models of care for women and babies.

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