title: [The access of independent midwives to maternity ward technical facilities: the experimentation of a level-1 department].
abstract: OBJECTIVE
  The first aim of this study was to evaluate the access of independent midwives to the technical facilities of a level-1 maternity hospital, with a follow-up of 2 years. The second aim was to evaluate the transfer of clinical responsibility, when a patient stops being managed by the independent midwife to be taken care of by the hospital team.
  
  
  METHODS
  A retrospective study including 51 patients. Analysis of maternal and perinatal data.
  
  
  RESULTS
  Of the 51 births, there were 42 vaginal deliveries without intervention (82.35%), 3 instrumental deliveries (5.88%), 6 caesarean sections (11.76%). The midwife-led care was completed in 70.59% of cases. The rate of transfer of clinical responsibility during labor was 25.49%. We conducted a neonatal transfer due to a respiratory distress syndrome.
  
  
  CONCLUSIONS
  The access to technical support appears as an opportunity for independent midwives to establish a special relationship with their patients. However, this device preserves the possibility of a traditional hospital care when needed. This way, access to the technical support is a safe alternative that has the consent of the users (patients and midwives) as well as of the entire hospital team. Moreover, such device allowed an increase of 5% per year of our obstetrical activity with an estimated increase of 10% per year.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France. Electronic address: enohuz@yahoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Nohuz
authors.affiliation: Service de pédiatrie, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: A
authors.initials: A
authors.lastname: Brunel
authors.affiliation: Cabinet de sages-femmes, 14, avenue Pierre-et-Marie-Curie, 63400 Chamalières, France.
authors.forename: E
authors.initials: E
authors.lastname: Tarraga
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Albaut
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: C
authors.initials: C
authors.lastname: Paganelli
authors.affiliation: Direction des soins, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: V
authors.initials: V
authors.lastname: Gillot
authors.affiliation: Service de pharmacie, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: G
authors.initials: G
authors.lastname: Julien
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: N
authors.initials: N
authors.lastname: Larregain
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: V
authors.initials: V
authors.lastname: Tarrit
authors.affiliation: Direction administrative, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: G
authors.initials: G
authors.lastname: Allegre
authors.affiliation: Service de santé publique, CHU Gabriel-Montpied, 7, place Henri-Dunant, 63000 Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Gerbaud
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D008504:Medical Staff Privileges; D008880:Midwifery; D009774:Obstetrics; D010564:Personnel, Hospital; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Accompagnement global; Accouchement; Childbirth; Global caring; Grossesse à bas risque; Independent midwife; Low-risk pregnancy; Maternity hospital; Maternité; Plateau technique; Sage-femme libérale; Technical support