Access and outcomes of general practitioner obstetrician (rural generalist)-supported birthing units in Queensland.
Debra Tennett, Lauren Kearney, Mary Kynn
PMID 31903661WHAT IT FOUND
Queensland rural maternity units had more term births, spontaneous labour and vaginal births than state averages, with similar newborn outcomes, despite mothers having more high-risk characteristics.
Key findings
01In 2017, 3116 babies were born to 3111 mothers across 21 rural GP-obstetrician supported maternity units.
02Rural mothers were more likely to have term birth, spontaneous labour and vaginal birth, and less likely to have cardiotocography or pharmacological analgesia, than Queensland averages.
03Newborn outcomes were comparable between rural units and state averages, but precipitate births and uterine inertia were more common in rural units than Queensland overall.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is descriptive and compared rural units with statewide averages without adjusting for individual maternal risk profiles. It used existing 2017 data from one Australian state, so it describes only that time and place. Included units were not necessarily open for the whole year, and one unit was excluded because of heavy locum reliance. Complication counts cannot be added together because more than one complication might have been recorded for a birth. Vaginal birth after caesarean findings are limited by low numbers: 200 women had a second birth after a first caesarean and 23 had a vaginal birth.
Declared interests
The paper reports that Dr Tennett received a $5000 research grant from the Rural Generalist Pathway (Queensland Health), and the authors state they have no conflicts of interest to declare.
The easy way to misread this
Do not treat these results as proof that rural GP-obstetrician support causes safer births. The study compared existing 2017 data from 21 Queensland units with state averages, did not adjust for individual risk profiles, and found more precipitate births and uterine inertia.