+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Perineal injury in nulliparous women giving birth at a community hospital: reduced risk in births attended by certified nurse-midwives



Perineal injury in nulliparous women giving birth at a community hospital: reduced risk in births attended by certified nurse-midwives



Journal of Midwifery and Women's Health 55(3): 243-249



Our objective was to determine if there is a difference in rates of perineal injury sustained by nulliparous women attended by obstetricians compared with certified nurse-midwives (CNMs) at a US community hospital. We analyzed retrospective data for 2819 women who spontaneously gave birth to singleton, vertex, term, live infants between 2000 and 2005. The independent variable was attendant type (obstetrician or CNM). The main outcome variables were intact perineum, episiotomy, and spontaneous perineal lacerations. Multivariate logistic regression was used to adjust for six potential confounders: macrosomia, maternal age, epidural anesthesia, oxytocin administration, medical insurance status, and ethnicity. The odds ratios (ORs) for obstetrician-attended births versus CNM-attended births were significant for a spontaneous minor perineal laceration versus intact perineum (OR = 1.82; 95% confidence interval [CI], 1.33-2.48), spontaneous major laceration versus intact perineum (OR = 2.29; 95% CI, 1.13-4.66), and episiotomy use versus no perineal injury, with or without extension (OR = 2.94; 95% CI, 2.01-4.29). We found that the prevalence and severity of perineal injury, both spontaneous and from episiotomy use, were significantly lower in CNM-attended births.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054931922

Download citation: RISBibTeXText

PMID: 20434084

DOI: 10.1016/j.jmwh.2009.11.006


Related references

No reduction in instrumental vaginal births and no increased risk for adverse perineal outcome in nulliparous women giving birth on a birth seat: results of a Swedish randomized controlled trial. Bmc Pregnancy and Childbirth 11: 22, 2011

Births attended by certified nurse-midwives in the United States in 2005. Journal of Midwifery and Women's Health 54(1): 95-96, 2009

2002 North Carolina live births attended by certified nurse midwives. North Carolina Medical Journal 65(2): 118-119, 2004

Outcomes of 11,788 planned home births attended by certified nurse-midwives. A retrospective descriptive study. Journal of Nurse-Midwifery 40(6): 483-492, 1995

Outcomes of planned home births attended by certified nurse-midwives in southeastern Pennsylvania, 1983-2008. Journal of Midwifery and Women's Health 58(2): 145-149, 2013

Births attended by certified nurse-midwives in the United States reach an all-time high: trends from 1989 to 2006. Journal of Midwifery and Women's Health 54(3): 263-265, 2009

Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births. Journal of Midwifery and Women's Health 59(2): 153-159, 2015

Reduced risk of low weight births among indigent women receiving care from nurse-midwives. Journal of Epidemiology and Community Health 54(3): 233-238, 2000

Reduced Risk of Low Weight Births among Indigent Women Receiving Care from Nurse-Midwives. Journal of Epidemiology and Community Health (1979-) 54(3): 233-238, 2000

Twelve years and more than 30,000 nurse-midwife-attended births: the Los Angeles County + University of Southern California women's hospital birth center experience. Journal of Nurse-Midwifery 39(4): 185-196, 1994

Outcomes Associated With Planned Home and Planned Hospital Births in Low-risk Women Attended by Midwives in Ontario, Canada, 2003 to 2006: A Retrospective Cohort Study. Obstetric Anesthesia Digest 30(3): 176-177, 2010

Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth 36(3): 180-189, 2009

Vaginal birth after cesarean in a hospital-based birth center staffed by certified nurse-midwives. Journal of Nurse-Midwifery 42(4): 304-307, 1997

The midwife option. Health plans and certified nurse midwives are offering women choices in how they give birth. Healthplan 37(3): 100-106, 1996

Certified nurse midwife-attended births: trends in Washington State, 1995-2004. Journal of Midwifery and Women's Health 52(5): 444-450, 2007