{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:48:17Z","timestamp":1790628497357,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Midwife\u2010led units have been shown to be safer and reduce interventions for women at low risk of complications at birth. In 2017, the first alongside birth center was opened in Spain. The aim of this study was to compare outcomes for women with uncomplicated pregnancies giving birth in the Midwife\u2010led unit (MLU) and in the Obstetric unit (OU) of the same hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study comparing birth outcomes between low\u2010risk women, depending on their planned place of birth. Data were analyzed with an intention\u2010to\u2010treat approach for women that gave birth between January 2018 and December 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 878 women were included in the study, 255 women chose to give birth in the MLU and 623 in the OU. Findings showed that women in the MLU were more likely to have a vaginal birth (91.4%) than in the OU (83.8%) (aOR 2.98 [95%CI 1.62\u20135.47]), less likely to have an instrumental delivery, 3.9% versus 11.2% (0.25 [0.11\u20130.55]), to use epidural analgesia, 19.6% versus 77.9% (0.15 [0.04\u20130.17]) and to have an episiotomy, 7.4% versus 15.4% (0.27 [0.14\u20130.53]). There were no differences in rates of postpartum hemorrhage, retained placenta, or adverse neonatal outcomes. Intrapartum and postpartum transfer rates from the MLU to the OU were 21.1% and 2.4%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The high rate of obstetric interventions in Spain could be reduced by implementing midwife\u2010led units across the whole system, without an increase in maternal or neonatal complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.12749","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T11:48:34Z","timestamp":1692618514000},"page":"1057-1067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The first alongside midwifery unit in Spain: A retrospective cohort study of maternal and neonatal outcomes"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-3422","authenticated-orcid":false,"given":"Roser","family":"Palau\u2010Costafreda","sequence":"first","affiliation":[{"name":"Biomedicine Programme, Department of Experimental and Health Sciences Universitat Pompeu Fabra  Barcelona Spain"},{"name":"ESIMar (Mar Nursing School), Parc de Salut Mar Universitat Pompeu Fabra \u2010 affiliated  Barcelona Spain"},{"name":"SDHEd (Social Determinants and Health Education Research Group) IMIM (Hospital del Mar Medical Research Institute)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0360-7476","authenticated-orcid":false,"given":"Sara","family":"Garc\u00eda\u00a0Gumiel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fundaci\u00f3 Hospital Sant Joan de D\u00e9u de Martorell  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaranta","family":"Eles\u00a0Velasco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fundaci\u00f3 Hospital Sant Joan de D\u00e9u de Martorell  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8504-1618","authenticated-orcid":false,"given":"Anna","family":"Jansana\u2010Riera","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Evaluation Hospital del Mar Institute for Medical Research  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lluna","family":"Orus\u2010Covisa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fundaci\u00f3 Hospital Sant Joan de D\u00e9u de Martorell  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falia","family":"Hermida\u00a0Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fundaci\u00f3 Hospital Sant Joan de D\u00e9u de Martorell  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Algarra\u00a0Ramos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fundaci\u00f3 Hospital Sant Joan de D\u00e9u de Martorell  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-9345","authenticated-orcid":false,"given":"Olga","family":"Canet\u2010V\u00e9lez","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences Universitat Ramon Llull  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-2498","authenticated-orcid":false,"given":"Noem\u00ed","family":"Obreg\u00f3n\u00a0Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Parc Taul\u00ed University Hospital  Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-3331","authenticated-orcid":false,"given":"Ram\u00f3n","family":"Escuriet","sequence":"additional","affiliation":[{"name":"Directorate General of Health Planning Ministry of Health of the Government of\u00a0Catalonia  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000012.pub4"},{"key":"e_1_2_8_3_1","volume-title":"Midwifery Unit Standards","author":"Rocca\u2010Ihenacho L","year":"2018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2004.00309.x"},{"key":"e_1_2_8_5_1","volume-title":"Review of Evidence about Clinical, Psychosocial and Economic Outcomes for Women with Straightforward Pregnancies Who Plan to Give Birth in a Midwife\u2010Led Birth Centre, and Outcomes for their Babies. 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