Year of Publication

2021

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julie Marfell

Clinical Mentor

Dr. Jill Alliman

Committee Member

Dr. Debra Hampton

Committee Member

Victoria Burslem

Abstract

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of data from the records of 700 patients who have given birth with the University of Kentucky Healthcare Midwife Clinic (referred to throughout as UK Midwife Clinic) for the three fiscal years beginning July 1, 2017 and ending June 30, 2020.

Results: The results indicated that 33.2% of the patients who gave birth during the specified time frame would have been eligible for birth center care. This group had the lowest risk going into labor and had a vaginal birth rate of 96.54% and the cesarean birth rate was 3.03%.

Discussion: Although it is a hospital-based service, care provided by the midwives showed a higher vaginal birth rate and a lower cesarean section rate than what is discussed in the literature and is consistent with the model of care provided in birth centers.

Conclusion. Birth center program development may be a feasible endeavor for the patients at UK Midwife Clinic. Further research is recommended to determine consumer demand, acceptance by other medical providers and administration, and financial feasibility.

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