{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:23:15Z","timestamp":1767993795619,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to compare maternal and neonatal outcomes of women with a low\u2010risk pregnancy attending the \u201cCocoon,\u201d an alongside midwifery\u2010led birth center and care pathway, with women with a low\u2010risk pregnancy attending the traditional care pathway in a tertiary care hospital in Belgium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of maternal and neonatal outcomes of women with a low\u2010risk pregnancy who chose to adhere to the Cocoon pathway of care (n\u00a0=\u00a0590) and women with a low\u2010risk pregnancy who chose the traditional pathway of care (n\u00a0=\u00a0394) from March 1, 2014, to February 29, 2016. We performed all analyses using an intention\u2010to\u2010treat approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this setting, the cesarean birth rate was 10.3% compared with 16.0% in the traditional care pathway (adjusted odds ratios [aOR] 0.42 [95% CI 0.25\u20100.69]), the induction rate was 16.3% compared with 30.5% (0.46 [0.30\u20100.69]), the epidural analgesia rate was 24.9% compared with 59.1% (0.15 [0.09\u20100.22]), and the episiotomy rate was 6.8% compared with 14.5% (0.31 [0.17\u20100.56]). There was no increase in adverse neonatal outcomes. Intrapartum and postpartum transfer rates to the traditional pathway of care were 21.1% and 7.1%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women planning their births in the midwifery\u2010led unit, the Cocoon, experienced fewer interventions with no increase in adverse neonatal outcomes. Our study gives initial support for the introduction of similar midwifery\u2010led care pathways in other hospitals in Belgium.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12466","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T02:19:15Z","timestamp":1574216355000},"page":"115-122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The \u201cCocoon,\u201d first alongside midwifery\u2010led unit within a Belgian hospital: Comparison of the maternal and neonatal outcomes with the standard obstetric unit over 2\u00a0years"],"prefix":"10.1111","volume":"47","author":[{"given":"Karine","family":"Welffens","sequence":"first","affiliation":[{"name":"Departement of Obstetrics and Gynecology Cliniques Universitaires de Bruxelles H\u00f4pital Erasme Brussels 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