title: Midwife-led care unit for 'low risk' pregnant women in a Japanese hospital.
abstract: OBJECTIVE
  To examine the obstetric outcomes of our 'low risk' pregnant women under the midwife-led delivery care compared with those under the obstetric shared care.
  
  
  METHODS
  A retrospective cohort study compared outcomes of labor under midwife 'primary' care with those under obstetric shared care. The factors examined were: maternal age, parity, gestational age at delivery, length of labor, augmentation of labor pains, delivery mode, episiotomy, perineal laceration, postpartum hemorrhage, neonatal birth weight, Apgar score, and umbilical artery pH. In this study, pregnant women were initially considered 'low risk' at admission when they had no history of medical, gynecological, or obstetric problems and no complications during the present pregnancy.
  
  
  RESULTS
  There were 1031 pregnant women initially considered 'low risk' at admission. At admission, 878 of them (85%) requested to give birth under midwife care; however 364 of these women (42%) were transferred to obstetric shared care during labor. The average length of labor under the midwife 'primary' care was significantly longer than that under the obstetric shared care. However, there were no significant differences in the rate of prolonged labor (≥24  h). There were no significant differences in other obstetric or neonatal outcomes between the two groups.
  
  
  CONCLUSIONS
  There was no evidence indicating that midwife 'primary' care is unsafe for 'low risk' pregnant women. Therefore, midwifery care is recommended for 'low risk' pregnant women.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan. czg83542@mopera.ne.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Hiraizumi
authors.forename: Misao
authors.initials: M
authors.lastname: Satomi
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Miyake
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007743:Labor, Obstetric; D008880:Midwifery; D061214:Patient Safety / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014041:Tokyo