Type of deliveries supported by Dutch clinical midwives.

Autor: Harmsen van der Vliet-Torij HW; Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, Rotterdam 3015 EK, the Netherlands. Electronic address: h.w.torij@hr.nl., Bertens LCM; Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands., Ochoa LB; Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands., Gouman MJBM; Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, Rotterdam 3015 EK, the Netherlands., Posthumus AG; Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands., Steegers EAP; Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, PO Box 2040, Rotterdam 3000 CA, the Netherlands.
Jazyk: angličtina
Zdroj: Midwifery [Midwifery] 2023 Sep; Vol. 124, pp. 103744. Date of Electronic Publication: 2023 May 26.
DOI: 10.1016/j.midw.2023.103744
Abstrakt: Objective: The number of clinical midwives in the Netherlands has substantially increased over the last twenty years, but their role in obstetric care is not clearly defined. Our aim was to identify the type of deliveries that are usually supported by clinical midwives and whether these changed over time.
Design, Setting, and Participants: National data from the Netherlands Perinatal Registry from the years 2000 to 2016 (n = 2.999.411 deliveries) were used to divide all deliveries into classes using latent class analyses based on delivery characteristics. In the primary analyses, the identified classes, type of hospital, and year of cohort were used to predict deliveries supported by a clinical midwife. In secondary analyses, the same analyses were repeated where the classes were replaced by individual level characteristics of deliveries and stratified by referral during birth.
Measurements and Findings: The latent class analyses identified three classes: I. referral during birth; II. Induction of labour; and III. Planned caesarian section. The primary analyses indicated that women in both class I and II were frequently supported by clinical midwives and those in the third class almost never. Therefore, only data from deliveries assigned to class I and II were used in the secondary analyses. The secondary analyses showed that clinical midwives supported deliveries with a great variety in characteristics, such as pain relief and preterm birth. Although the frequency of clinical midwives being involved in the second stage of labour increased over the years, we did not find noticeable changes in their involvement.
Key Conclusion and Implications for Practice: Clinical midwives care for women with various types of deliveries with varying degrees of pathology and complexity during second stage of labour. Additional training, taking previously acquired skills and competences into account, is necessary to deal with this complexity for which clinical midwives are not always trained.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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