title: [Delivery by midwife in full autonomy. Literature review and analysis of 80 months of activity at the University Hospital Erasme].
abstract: BACKGROUND
  The last century focused all its attention on the care of the pathological pregnancies with remarkable results, at the price of fatal overmedicalisation in normal pregnancies. Efforts centered on the pregnant patients at low risk are being developped.
  
  
  OBJECTIVE
  To compare obstetric and neonatal outcomes obtained by independent midwives (IM) to a group control of pregnant women at low risk at Hospital Erasme.
  
  
  METHODS
  Retrospective constitution of a multivariated cohort case-witnesses 1:2 of patients at low risk including 128 followed in antenatal and delivered by the IM and 256 followed in antenatal and delivered by the group control Erasme (E) RESULTS: The rate of spontaneous vaginal delivery is significantly higher in the group IM (88,28 % versus 77,7 % in the group E). The rates of epidurals (66,79 % versus 37,50 %) and episiotomies (24,61 % versus 8,60 %) are significantly higher in the group E. Transfers to the neonatal unit are more frequent in the group E.
  
  
  CONCLUSIONS
  The obstetrics attitudes are less interventionist in the IM group. The reasons can be linked to bias selection or to different obstetrics practices in both groups. Positive effects in terms of maternal and neonatal outcomes are quite positive.
authors.forename: P
authors.initials: P
authors.lastname: Gironi
authors.forename: C
authors.initials: C
authors.lastname: Kirkpatrick
authors.forename: C
authors.initials: C
authors.lastname: Baeyens
authors.forename: Y
authors.initials: Y
authors.lastname: Englert
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000451:nursing* / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008880:Midwifery / Q000458:organization & administration / Q000706:statistics & numerical data; D009721:Nurse Midwives; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D017009:Professional Autonomy; D012189:Retrospective Studies; D055815:Young Adult