An intrapartum intervention scoring system for the comparison of maternity units' intrapartum care of nulliparous women suitable for midwifery-led care.
OBJECTIVE
To develop an intrapartum intervention scoring tool which could be used to define maternity units as either 'lower intrapartum intervention' or 'higher intrapartum intervention' units. This scoring tool was designed to form the basis of a comparison of the perception of risk by midwives working in either 'lower intrapartum intervention' or 'higher intrapartum intervention' units.


METHODS
Three aspects were included: (1) the systematic data reduction of the St. Mary's Maternity Information System database used by 11 maternity units to include Caucasian nulliparous women suitable for midwifery-led care; (2) the calculation and the ranking of frequency distributions for the following interventions/management: (a) the management of breech presentation and of one previous caesarean section, the choice of home birth; and (b) augmentation of labour, use of electronic fetal monitoring, use of epidural, method of delivery; (3) the sum of the individual intrapartum ranking marks made up the final intrapartum score for each unit.


RESULTS
Intrapartum interventions varied considerably between units. The scoring system enabled units to be described as either 'Lower intrapartum intervention' or 'Higher intrapartum intervention' units.


CONCLUSIONS
Routinely collected computerised data can be used to identify the outcomes of intrapartum care. This study suggests that the analysis of computerised data could provide a suitable basis for the audit and the comparison of intrapartum interventions for the care of women suitable for midwifery-led care.
Mead
Marianne M P
MM
Department of Midwifery and Child, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK.
Kornbrot
Diane
D
D000328:Adult; D003266:Continuity of Patient Care / Q000592:standards; D003696:Delivery Rooms / Q000592:standards*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000592:standards*; D008880:Midwifery / Q000592:standards*; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D010298:Parity; D018743:Perinatal Care / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control; D012107:Research Design; D006113:United Kingdom / Q000453:epidemiology