{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:16:57Z","timestamp":1781605017377,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Healthy women with low risk singleton pregnancies are offered a midwife-led birth model at our department. Exclusion criteria for midwife-led births include a range of abnormalities in medical history and during the course of pregnancy. In case of complications before, during or after labor and birth, an obstetrician is involved. The purpose of this study was 1) to evaluate the frequency of and reasons for secondary obstetrician involvement in planned midwife-led births and 2) to assess the maternal and neonatal outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We analyzed a cohort of planned midwife-led births during a 14\u2009years period (2006-2019). Evaluation included a comparison between midwife-led births with or without secondary obstetrician involvement, regarding maternal characteristics, birth mode, and maternal and neonatal outcome. Statistical analysis was performed by unpaired t-tests and Chi-square tests.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, there were 532 intended midwife-led births between 2006 and 2019 (2.6% of all births during this time-period at the department). Among these, 302 (57%) women had spontaneous vaginal births as midwife-led births. In the remaining 230 (43%) births, obstetricians were involved: 62% of women with obstetrician involvement had spontaneous vaginal births, 25% instrumental vaginal births and 13% caesarean sections. Overall, the caesarean section rate was 5.6% in the whole cohort of women with intended midwife-led births. Reasons for obstetrician involvement primarily included necessity for labor induction, abnormal fetal heart rate monitoring, thick meconium-stained amniotic fluid, prolonged first or second stage of labor, desire for epidural analgesia, obstetrical anal sphincter injuries, retention of placenta and postpartum hemorrhage. There was a significantly higher rate of primiparous women in the group with obstetrician involvement. Arterial umbilical cord pH &lt;\u20097.10 occurred significantly more often in the group with obstetrician involvement, while 5\u2032 Apgar score\u2009&lt;\u20097 did not differ significantly. The overall transfer rate of newborns to neonatal intensive care unit was low (1.3%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>A midwife-led birth in our setting is a safe alternative to a primarily obstetrician-led birth, provided that selection criteria are being followed and prompt obstetrician involvement is available in case of abnormal course of labor and birth or postpartum complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12884-021-04209-2","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T09:02:54Z","timestamp":1635325374000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Obstetrician involvement in planned midwife-led births: a cohort study in an obstetric department of a University Hospital in Switzerland"],"prefix":"10.1186","volume":"21","author":[{"given":"Ann-Katrin","family":"Morr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Malah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Manuela","family":"Messer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annina","family":"Etter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Raio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Surbek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"4209_CR1","unstructured":"Bundesamt f\u00fcr Statistik. Geburten-Todesf\u00e4lle, Geburten. https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/bevoelkerung\/geburten-todesfaelle\/geburten.html. Accessed 2020."},{"key":"4209_CR2","unstructured":"Bundesamt f\u00fcr Statistik. Gesundheitsstatistik 2019. https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/gesundheit.assetdetail.10227275.html. Accessed 29 Oct 2019."},{"key":"4209_CR3","unstructured":"Schweizerischer Hebammenverband. Statistikbericht der frei praktizierenden Hebammen. https:\/\/www.hebamme.ch\/qualitaet\/statistikberichte-fph\/. Accessed Sept 2020."},{"key":"4209_CR4","unstructured":"Euro-Peristat project in collaboration SCPE, EUROCAT and EURONEOSTAT. European Perinatal Health Report 2004. https:\/\/www.europeristat.com\/index.php\/reports\/european-perinatal-health-report2004.html. Accessed 11 Dec 2008."},{"key":"4209_CR5","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1136\/jech.2009.087296","volume":"63","author":"J Zeitlin","year":"2009","unstructured":"Zeitlin J, Mohangoo A, Cuttini M, Alexander S, Barros H, EUROPERISTAT report writing committee, et al. The European perinatal health report: comparing the health and care of pregnant women and newborn babies in Europe. J Epidemiol Community Health. 2009;63:681\u20132.","journal-title":"J Epidemiol Community Health"},{"key":"4209_CR6","unstructured":"Euro-Peristat project with SCPE and Eurocat. European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010. https:\/\/www.europeristat.com\/index.php\/reports\/european-perinatal-health-report-2010.html. 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I confirm that all methods and procedures of the study were performed in accordance with the relevant guidelines and regulations.This study was approved by Ethics Committee of the University of Bern (Basec-No. 2016-00415).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"728"}}