title: Type of attending obstetrician call schedule and changes in labor management and outcome.
abstract: OBJECTIVE
  To estimate whether a night-float call schedule for attending obstetricians is associated with different labor management or obstetric outcomes compared with a traditional call schedule.
  
  
  METHODS
  A chart review was performed for all women admitted for labor and delivery during two 3-month periods. One period occurred immediately before a single group of generalist obstetricians changed from a traditional call schedule to a night-float call schedule, whereas the second 3-month period occurred immediately after this change. A control group of women who were managed during the same 6-month time period by a group of generalist obstetricians at the same institution who did not alter their traditional call schedule was also identified. Data on labor management and perinatal outcomes were collected.
  
  
  RESULTS
  Change to a night-float call schedule was associated with a decreased use of induction of labor (30% to 16.7%, P=.02). Physicians also were more likely to use oxytocin augmentation (57.5% to 75.0%, P=.01) and less likely to manually extract the placenta (5.0% to 0%, P=.02) or perform an episiotomy (10.1% to 2.6%, P=.04). There were fewer observed third-degree and fourth-degree lacerations (10.3% to 3.3%, P=.045) and fewer neonates born with an umbilical artery pH less than 7.10 (9.3% to 2.2%, P=.03).
  
  
  CONCLUSIONS
  A night-float call schedule was associated with both a reduction in obstetric interventions, such as labor induction and episiotomy, and improvement of particular obstetric outcomes, such as the frequency of perineal lacerations.
  
  
  METHODS
  II.
authors: From the Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology and Division of Maternal Fetal Medicine, Chicago, Illinois.
authors: Emma L
authors: EL
authors: Barber
authors: David L
authors: DL
authors: Eisenberg
authors: William A
authors: WA
authors: Grobman
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009551:Night Care / Q000706:statistics & numerical data*; D061214:Patient Safety; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D016896:Treatment Outcome; D014940:Work Schedule Tolerance