Intrapartum Quality of Care among Healthy Women: A Population-Based Cohort Study in an Italian Region

Simona Fumagalli, Antonella Nespoli, Maria Panzeri (), Edda Pellegrini, Michele Ercolanoni, Paul Stefan Vrabie, Olivia Leoni and Anna Locatelli
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Simona Fumagalli: School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
Antonella Nespoli: School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
Maria Panzeri: School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
Edda Pellegrini: Maternal and Child Committee, Lombardy Region, 20124 Milan, Italy
Michele Ercolanoni: ARIA, 20124 Milan, Italy
Paul Stefan Vrabie: ARIA, 20124 Milan, Italy
Olivia Leoni: Welfare Department, Epidemiologic Observatory, Lombardy Region, 20124 Milan, Italy
Anna Locatelli: School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy

IJERPH, 2024, vol. 21, issue 5, 1-12

Abstract: Although the quality of care during childbirth is a maternity service’s goal, less is known about the impact of the birth setting dimension on provision of care, defined as evidence-based intrapartum midwifery practices. This study’s aim was to investigate the impact of hospital birth volume (≥1000 vs. <1000 births/year) on intrapartum midwifery care and perinatal outcomes. We conducted a population-based cohort study on healthy pregnant women who gave birth between 2018 and 2022 in Lombardy, Italy. A total of 145,224 (41.14%) women were selected from nationally linked databases. To achieve the primary aim, log-binomial regression models were constructed. More than 70% of healthy pregnant women gave birth in hospitals (≥1000 births/year) where there was lower use of nonpharmacological coping strategies, higher likelihood of epidural analgesia, episiotomy, birth companion’s presence at birth, skin-to-skin contact, and first breastfeeding within 1 h ( p -value < 0.001). Midwives attended almost all the births regardless of birth volume (98.80%), while gynecologists and pediatricians were more frequently present in smaller hospitals. There were no significant differences in perinatal outcomes. Our findings highlighted the impact of the birth setting dimension on the provision of care to healthy pregnant women.

Keywords: midwifery care; birth volume; perinatal outcomes; best practice; intrapartum care; quality of care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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