PMID: 11903212Mar 21, 2002Paper

Epidural analgesia use as a marker for physician approach to birth: implications for maternal and newborn outcomes

Birth
Michael C KleinJ Kaczorowski

Abstract

Understanding the association between caregiver belief systems and practice patterns is an emerging area of research. We hypothesized an association between a maternity caregiver's belief system and his or her behavior. The study objective was to determine if a family physician's overall approach to maternity care, as measured by average use of epidural analgesia, was associated with maternal and fetal outcomes. Retrospective analysis was conducted of the births of three cohorts of 1992 nulliparous, low-risk women attended by 96 family physicians within an 18-month period in the department of family practice at the largest maternity hospital in Canada. Cohorts were based on the physicians' mean use of epidural analgesia for the women. Family physicians attending fewer than 5 births were excluded. The main outcome measures, by physician epidural utilization cohort, were maternal/newborn morbidity, procedure rates, consultation rates, and length of stay. Family physicians were separated into cohorts based on their mean use of epidural analgesia at rates of: low, 0-30 percent (15 physicians, 263 births); medium, 31-50 percent (55 physicians, 1323 births); and high, 51-100 percent (26 physicians, 406 births). After adjustment for m...Continue Reading

References

Sep 1, 1989·American Journal of Obstetrics and Gynecology·J A ThorpD A Johnston
Jan 1, 1989·European Journal of Obstetrics, Gynecology, and Reproductive Biology·T Philipsen, N H Jensen
Nov 1, 1995·Obstetrics and Gynecology·S M RaminK J Leveno
Nov 1, 1994·Obstetrics and Gynecology·H J Heyman, N Hatoum
Sep 1, 1994·American Journal of Obstetrics and Gynecology·M C KleinM S Guralnick
Jun 1, 1994·Obstetrics and Gynecology·S C MortonK L Kahn
May 20, 2000·American Journal of Obstetrics and Gynecology·J D TraynorA Shadron

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Citations

Aug 1, 2007·Annals of Family Medicine·Michael C Klein
Feb 28, 2006·Birth·Michael C Klein
Dec 7, 2013·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Amie SteelJane Frawley
May 24, 2011·Birth·Michael C KleinUNKNOWN Maternity Care Research Group
Jul 22, 2014·Paediatric and Perinatal Epidemiology·Melanie Bannister-TyrrellChristine L Roberts

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