The access of independent midwives to maternity ward technical facilities: the experimentation of a level-1 department

• Published in: Gynécologie, obstétrique & fertilité Vol. 43; no. 4; pp. 271 - 277
• Main Authors: Nohuz, E, Brunel, A, Tarraga, E, Albaut, M, Paganelli, C, Gillot, V, Julien, G, Larregain, N, Tarrit, V, Allegre, G, Gerbaud, L
• Format: Journal Article
• Language: French
• Published: France 01.04.2015
• Subjects: Adult; Cesarean Section; Delivery, Obstetric; Female; Hospitals, Maternity; Humans; Medical Staff Privileges; Midwifery; Obstetrics; Personnel, Hospital; Pregnancy; Retrospective Studies; Maternité; Low-risk pregnancy; Sage-femme libérale; Global caring; Accompagnement global; Independent midwife; Plateau technique; Grossesse à bas risque; Accouchement; Maternity hospital; Childbirth; Technical support
• ISSN: 1769-6682
• DOI: 10.1016/j.gyobfe.2015.02.005

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. A retrospective study including 51 patients. Analysis of maternal and perinatal data. 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. 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.