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The influence of group versus individual prenatal care on phase of labor at hospital admission
Tilden, Ellen L. Emeis, Cathy L. Caughey, Aaron B. Weinstein, Sarah R. Futernick, Sarah B. Lee, Christopher S.
Tilden, Ellen L.
Emeis, Cathy L.
Caughey, Aaron B.
Weinstein, Sarah R.
Futernick, Sarah B.
Lee, Christopher S.
Abstract
Introduction
Group prenatal care, an alternate model of prenatal care delivery, has been associated with various improved perinatal outcomes in comparison to standard, individual prenatal care. One important maternity care process measure that has not been explored among women who receive group prenatal care versus standard prenatal care is the phase of labor (latent vs active) at hospital admission.
Methods
A retrospective case-control study was conducted comparing 150 women who selected group prenatal care with certified nurse-midwives (CNMs) versus 225 women who chose standard prenatal care with CNMs. Analyses performed included descriptive statistics to compare groups and multivariate regression to evaluate the contribution of key covariates potentially influencing outcomes. Propensity scores were calculated and included in regression models.
Results
Women within this sample who received group prenatal care were more likely to be in active labor (≥ 4 cm of cervical dilatation) at hospital admission (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.03-2.99; P = .049) and were admitted to the hospital with significantly greater cervical dilatation (mean [standard deviation, SD] 5.7 [2.5] cm vs. 5.1 [2.3] cm, P = .005) compared with women who received standard prenatal care, controlling for potential confounding variables and propensity for group versus individual care selection.
Discussion
Group prenatal care may be an effective and safe intervention for decreasing latent labor hospital admission among low-risk women. Neither group prenatal care nor active labor hospital admission was associated with increased morbidity.
Keywords
antepartum care, centeringpregnancy/group care, cesarean birth, intrapartum care, first stage of labor
Date
2016
Type
Journal article
Journal
Journal of Midwifery & Womens Health
Book
Volume
61
Issue
4
Page Range
427-434
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled