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I'd love to see some papers on that. I remember being in our pre-natal class and the instructor talking about hospitals etc. People in the class were talking
by giarc 9y ago
I'd love to see some papers on that.
I remember being in our pre-natal class and the instructor talking about hospitals etc. People in the class were talking about how they wanted to deliver at X hospital because they heard that Y hospital had double the amount of C-sections etc.
I had the benefit of being an epidemiologist that worked in Y hospital and knew a few things that others didn't. One, we don't publicly report c-section rates at a hospital level and two, hospital Y is a tertiary care centre with a level 3 NICU where all risk mothers are sent. So of course we are going to have a higher c-section and complication rate. We just don't send high risk mothers to other hospitals.
So even though you said outcome is better even after adjusting for risk, I'd still like to see the data. I assume there aren't a ton of matched cohort studies that looked at birthing centres vs hospital deliveries.
- Consultant32452 9y agoHere was the first result from a google search for a paper showing birthing centers provide better results. https://www.sciencedaily.com/releases/2013/05/130508213107.htm https://www.sciencedaily.com/releases/2013/05/130508213107.h...
- giarc 9y agoYou read it right? >However, Virginia R. Lupo, M.D., chair of the department of obstetrics and gynecology at Hennepin County Medical Center in Minneapolis, said the problem with these types of studies is that they "compare apples and oranges." "Women who have no risk factors do better, no matter where they are," Lupo explained. This is a retrospective study where the authors had no control of who went where. What's needed is an RCT.
- Consultant32452 9y agoYes, I did. >For women without medical complications who can be served in either setting, the study concluded that midwife-directed prenatal and labor care results in equal or better outcomes for the mother and newborn. Women with medical complications don't start at the birthing center to begin with. That's of course part of what I stated in the beginning that the data is corrected for at-risk patients. You compare the healthy people who choose birthing centers against the healthy people who go to hospitals. Unhealthy people only go to the hospitals, but they aren't counted against.
- giarc 9y agoI stand corrected. That paper is pretty good, however it is only a single centre in DC. I went searching for others and did find some similar papers finding similar results.