Hospital PracticeIS OBSTETRICS SAFE IN SMALL HOSPITALS?: Evidence from New Zealand's Regionalised Perinatal System
References (25)
A review of perinatal mortality in Colorado, 1971 to 1978, and its relationship to the regionalization of perinatal services
Am J Obstet Gynecol
(1981)- et al.
The numbers game, or is small beautiful?
N Engl J Med
(1981) - et al.
Regionalization of operations
N Engl J Med
(1979) Evaluation of a rural perinatal care system
Pediatrics
(1980)The regionalization of perinatal care
Am J Public Health
(1981)- et al.
Impact of a regional infant dispatch center on neonatal mortality
Am J Public Health
(1981) - et al.
Analysis of interrupted time series mortality trends: An example to evaluate regionalized perinatal care
Am J Public Health
(1981) Volume, quality, and the regionalization of health care services
Med Care
(1984)Perinatal referral: A time for decisions
Br Med J
(1982)Regional variations in perinatal mortality in New Zealand and their significance
Aust NZ J Obstet Gynaecol
(1969)
Maternity Services in New Zealand, Maternity Services Committee
Special Care Services for the Newborn in New Zealand
Cited by (82)
Confidence: Fundamental to midwives providing labour care in freestanding midwifery-led units
2018, MidwiferyCitation Excerpt :Small maternity units have existed since the early 1900s in New Zealand, featuring in both urban and rural localities. While regionalisation of maternity services resulted in a decline in births in these units from 28% in 1982 to 10% in 2015 (Ministry of Health, 2017; Rosenblatt et al., 1985), the remaining freestanding midwifery-led units provide a unique space for the process of normal labour and birth to unfold (Smythe et al., 2016). Epidural analgesia assisted birth and caesarean operations are not available in these units.
A retrospective, descriptive study of maternal and neonatal transfers, and clinical outcomes of a Primary Maternity Unit in rural Queensland, 2009-2011
2015, Women and BirthCitation Excerpt :Current evidence demonstrates PMUs provide safe care for women classified as low-risk8,35–41 when compared to standard maternity care with no differences in perinatal mortality35,42; no difference or improved outcomes for perinatal morbidity35,36,42; improved outcomes for maternal morbidity36; less birth interventions including caesarean section8,35,36,40,42 and improved neonatal outcomes.40,41 While PMUs are uncommon in rural and remote Australia,2 in countries with comparable health systems (New Zealand, Canada) PMUs offer equitable and safe maternity care to rural women.43–45 New Zealand supports 58 primary units with 51 located in rural or remote settings, and 31 over an hour from tertiary services.46
Effect of patient risk on the volume-outcome relationship in obstetric delivery services
2014, Health PolicyCitation Excerpt :Some studies have found that hospitals with more deliveries had higher levels of perinatal care [12], lower maternal complication rates [13], and less mortality and morbidity compared with lower-volume hospitals [5]. However, a larger number of studies have found no such volume–outcome relationship in hospitals [14–20]. Volume–outcome theory implies that the volume of hospital deliveries is positively associated patient outcomes.
Perinatal health inequalities and accessibility of maternity services in a rural French region: Closing maternity units in Burgundy
2013, Health and PlaceCitation Excerpt :However, data from the literature about the relation between volume and results in obstetrics are far from concordant. Research in numerous countries including Finland (Hemminki et al., 2011), Australia (Tracy et al., 2006), and New Zealand (Rosenblatt et al., 1985), has concluded that risk does not rise in small maternity units. In Germany, an increase in the risk of per-partum and neonatal mortality was observed in maternity units with fewer than 500 deliveries (Heller et al., 2002).
The association between hospital obstetrical volume and maternal postpartum complications
2012, American Journal of Obstetrics and GynecologyCitation Excerpt :Previous studies that evaluated the volume-outcome relationship in obstetrics have been limited to studies from single state populations, to data that are now >1 decade old, and to conflicting results about the volume-outcome relationship.15-19 In addition, many previous obstetrics volume-outcome studies focused exclusively on neonatal outcomes without investigating maternal complications.27-33 Our study provides important new evidence of higher maternal complication rates at very low-volume hospitals.
The geography of belonging: The experience of birthing at home for First Nations women
2010, Health and Place