title: Feasibility of pulse oximetry for assessment of infants born in community based midwifery care.
abstract: OBJECTIVE
  to evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care.
  
  
  METHODS
  a prospective, observational study of infants born after midwifery supervised (home) births.
  
  
  METHODS
  27 midwives from seven practices providing primary care in (home) births used PO at birth or the early puerperal period over a ten-month period. Data were obtained on the effect of PO on outcome, interventions and decision-making. Midwives were surveyed about applicability and usefulness of PO.
  
  
  METHODS
  153 infants born in primary midwifery care.
  
  
  RESULTS
  all births were uncomplicated except for one infant receiving supplemental oxygen and another was mask ventilated. In 138/153 (90%) infants PO was successfully used and 88% of midwives found PO easy to use. In 148/153 (97%) infants PO did not influence midwives' clinical judgment and referral policy. In 5/153 (3%) infants, midwives were uncertain of the infant's condition, but PO measurements were reassuring. In case of suboptimal neonatal condition or resuscitation, 100% of midwives declared they would use PO again.
  
  
  CONCLUSIONS
  it is feasible to use PO in community based midwifery care, but not considered an important contribution to routine evaluation of infants. Midwives would like to have PO available during suboptimal neonatal condition or when resuscitation is required.
  
  
  CONCLUSIONS
  PO can be applied in community based midwifery care; it does not lead to insecurity or extra referral. Further research on a larger group of infants must show the effect of PO on neonatal outcomes.
authors.affiliation: Department of Obstetrics, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands. Electronic address: m.smit.verlos@lumc.nl.
authors.forename: Marrit
authors.initials: M
authors.lastname: Smit
authors.affiliation: Department of Obstetrics, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
authors.forename: Angelina
authors.initials: A
authors.lastname: Ganzeboom
authors.affiliation: Neonatal Services, The Royal Women's Hospital, Newborn Research - 7th Floor, Parkville Victoria, Melbourne, Australia. Electronic address: jennifer.dawson@thewomens.org.au.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dawson
authors.affiliation: Department of Paediatrics, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands. Electronic address: F.J.Walther@lumc.nl.
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.affiliation: PLATO, Centre for Research and Development in Education and Training, Faculty of Social Sciences, Pieter de la Courtgebouw, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bustraan
authors.affiliation: Department of Obstetrics, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands; Department of Medical Humanities, EMGO Institute VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: J.J.M.van_Roosmalen@lumc.nl.
authors.forename: Jos J M
authors.initials: JJ
authors.lastname: van Roosmalen
authors.affiliation: Department of Paediatrics, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands. Electronic address: A.B.te_Pas@lumc.nl.
authors.forename: Arjan B
authors.initials: AB
authors.lastname: te Pas
mesh_terms: D003153:Community Health Services / Q000379:methods*; D005260:Female; D006700:Home Childbirth / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000379:methods*; D009730:Nursing Assessment / Q000379:methods*; D010092:Oximetry / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies
keywords: Birth; Midwifery; Primary care; Pulse oximetry