title: Perinatal and maternal outcomes in a midwife-led centre in Italy: a comparison with standard hospital assistance.
abstract: BACKGROUND
  In many countries midwives are the primary providers of care for childbearing women. The aim of the present study was to compare the outcomes of childbirth occurring in the birth benter (midwifery-lead) vs. the traditional delivery room organization (doctor-lead) of the Policlinico of Modena Hospital.
  
  
  METHODS
  A prospective observational study was conducted over four years. At 35-36th week, women with a single, uneventful pregnancy, being classified at low-risk according to The National Institute for Health and Care Excellence (NICE) guidelines on intrapartum care, were offered to deliver with standard care assistance (SC) in a doctors-led unit or in the Birth Centre (BC).
  
  
  RESULTS
  The number of women included was 3156. Overall emergency cesarean sections were lower in BC vs. SC group, and a significant decrease in the rate of augmentation of labor with intravenous oxytocin, in the use of episiotomy and operative deliveries in women of BC were recorded more than in the SC group. More women with intact perineum were present in BC group, while no significant differences in perineal tears was described between groups.
  
  
  CONCLUSIONS
  Our results suggest that midwifery care can result in a decrease of medical interventions during labor, namely a reduction of cesarean section and episiotomy rate. Also, the BC remains a valid option for women who satisfy low-risk criteria and wish to give birth in a hospital setting. In Italy the concern to education of all midwives, obstetricians and women at a global level is urgently required, with specific focus on ethics, communication and philosophy of care to enable normalization and humanization of birth.
authors.affiliation: Mother‑Infant Department, University of Modena and Reggio Emilia, Modena, Italy - giulia.dante@hotmail.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Dante
authors.forename: Isabella
authors.initials: I
authors.lastname: Neri
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
authors.forename: Chiara
authors.initials: C
authors.lastname: Salvioli
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchinetti
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy; D007743:Labor, Obstetric; D008880:Midwifery / Q000706:statistics & numerical data*; D010120:Oxytocics / Q000008:administration & dosage; D010121:Oxytocin / Q000008:administration & dosage; D036801:Parturition; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
chemical_list: D010120:Oxytocics; D010121:Oxytocin