{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:06:24Z","timestamp":1765609584426},"reference-count":11,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:00:00Z","timestamp":1382572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare obstetric morbidity of midwife\u2010performed instrumental vaginal deliveries with those performed by doctors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University Hospital, <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women undergoing an instrumental vaginal delivery of a singleton infant outside of the operating theater in Aberdeen Maternity Hospital, between June 2005 and June 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospectively entered data were obtained from the hospital data management system. Obstetric outcomes of deliveries by midwives were compared with those performed by any doctor and, in a secondary analysis, with those by junior doctors (fewer than two years at \u2018registrar\u2019 level). Sociodemographic characteristics and clinical outcomes were compared using the chi\u2010squared test, Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test and independent sample <jats:italic>t<\/jats:italic>\u2010test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Third\u2010 or fourth\u2010degree tears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 2540 women identified, 330 (13%) were delivered by midwives. Maternal and clinical characteristics were comparable in each group. Midwives were more likely to use ventouse as their instrument of choice. Women delivered by midwives were less likely to suffer a third\u2010 or fourth\u2010degree tears than those delivered by doctors and junior doctors. This difference did not reach statistical significance once adjusted for instrument used: odds ratio 0.6 (95% confidence interval: 0.3\u20131.2) and odds ratio 0.6 (95% confidence interval: 0.3\u20131.1), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Instrumental vaginal deliveries performed by trained midwives are associated with equivalent maternal morbidity to those performed by doctors once adjusted for midwives' preference for the ventouse. This study highlights the potential contribution of an advanced role for midwives in the labor ward.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12265","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T01:27:45Z","timestamp":1381541265000},"page":"1383-1387","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Instrumental vaginal deliveries; are midwives safer practitioners? A retrospective cohort study"],"prefix":"10.1111","volume":"92","author":[{"given":"Mairead","family":"Black","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Division of Applied Health Sciences University of Aberdeen Aberdeen Maternity Hospital Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Labour Ward Aberdeen Maternity Hospital Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Danielian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Division of Applied Health Sciences University of Aberdeen Aberdeen Maternity Hospital Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,24]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Clinical effectiveness Support Unit","author":"Royal College of Obstetricians and Gynaecologists","year":"2001"},{"key":"e_1_2_9_3_1","unstructured":"Information Services Division Scotland.Scottish Health Statistics. Births in Scotland report (Births 1981\u20132000).2002. Available online at:www.show.scot.nhs.uk\/isd\/sexual_health(accessed June 6 2012)."},{"key":"e_1_2_9_4_1","volume-title":"Greentop Guidelines No 26. Operative Vaginal Delivery","author":"Royal College of Obstetricians and Gynaecologists","year":"2007"},{"key":"e_1_2_9_5_1","first-page":"181","article-title":"The midwife ventouse: a safe practice: Ventouse deliveries by midwives: a review of the successes, failures and outcomes from a single NHS trust made up of seven community hospitals and a consultant\u2010led unit","volume":"16","author":"Aawala A","year":"2006","journal-title":"MIDIRS Midwifery Digest"},{"key":"e_1_2_9_6_1","volume-title":"Childbirth unmasked","author":"Jowitt M","year":"1993"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02646839308403222"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-2973-0"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2000.00104.x"},{"key":"e_1_2_9_10_1","volume-title":"Midwifery and the Medicalization of Childbirth: Comparative Perspectives","author":"Teijlingen E","year":"2000"},{"key":"e_1_2_9_11_1","volume-title":"The midwife\u2010mother relationship","author":"Kirkham M","year":"2000"},{"key":"e_1_2_9_12_1","volume-title":"The Future of Professional Practice: The Council's Strategy for Education and Practice Following Regsitration","author":"United Kingdom Central Council for Nursing, Midwifery and Health Visiting","year":"1994"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.12265","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.12265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T11:51:15Z","timestamp":1695556275000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.12265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,24]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1111\/aogs.12265"],"URL":"https:\/\/doi.org\/10.1111\/aogs.12265","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,24]]},"assertion":[{"value":"2013-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-10-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}