title: Outcomes of the first midwife-led birth centre in Italy: 5 years' experience.
abstract: OBJECTIVE
  To assess the experience of the first 5 years of the first midwife-led birth centre (MLBC) in Italy.
  
  
  METHODS
  Data were prospectively collected to analyse the first 5 years' experience of the MLBC. MLBC is located alongside a University hospital maternity unit and it offers care to women with a straightforward pregnancy and midwives take primary professional responsibility for care. Women with maternal diseases, complicated obstetric history, height < 150 cm, maternal age > 45, or multiple pregnancy were excluded. Transfer was request in case of antenatal, intrapartum and postpartum pathological conditions.
  
  
  RESULTS
  During the 5-year period (1 January 2001-31 December 2005), 1,438 low-risk women were admitted in labour to the MLBC. Of these, 203 (14.1%) were transferred during labour to consultant care (138 because of pathologies and 65 because of request of epidural analgesia). Among the transfers, the caesarean sections were 87, corresponding to 6.1% (87/1,438) of the total of women admitted to MLBC, while the operative vaginal deliveries were 14, corresponding to 1.0% (14/1,438) of the total of women admitted to MLBC. Among women who gave birth in the MLBC, episiotomy rate was 17.1%.
  
  
  CONCLUSIONS
  In Italy, in the passed 10 years, the caesarean section rate reached 60%, in some regions. According to our data, the first 5 years of activity of the first MLBC in Italy had been associated with a low rate of medical interventions during labour and birth, with high rates of spontaneous vaginal birth and without signs of complications. We hope that this experience could be taken as a model to improve the quality of maternity care in Italy.
authors.affiliation: Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genova, Padiglione 1, I piano - Largo R Benzi, 16100, Genova, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Morano
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Cerutti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Mistrangelo
authors.forename: Daniela
authors.initials: D
authors.lastname: Pastorino
authors.forename: Monica
authors.initials: M
authors.lastname: Benussi
authors.forename: Sergio
authors.initials: S
authors.lastname: Costantini
authors.forename: Nicola
authors.initials: N
authors.lastname: Ragni
mesh_terms: D016550:Birthing Centers / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy; D009721:Nurse Midwives; D010360:Patient Transfer / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D000078329:Workforce