Maternal and neonatal outcomes of childbirth care in a Freestanding Birth Centre.
Nathalie Leister, Gisele Almeida Lopes, Caroline de Oliveira Ferreira Iguchi and 2 others
PMID 40736104WHAT IT FOUND
Primiparous women at this birth center had higher rates of interventions and transfers than multiparous women.
Despite this, overall maternal and neonatal outcomes remained positive, with low cesarean rates and good Apgar scores.
Key findings
01Primiparous women had significantly higher odds of intrapartum transfer, oxytocin use, amniotomy, second-degree perineal tear, episiotomy, postpartum hemorrhage, forceps-assisted birth, cesarean section, and neonatal NICU admission compared to multiparous women.
02Care practices at the birth center reflected limited use of interventions, high prevalence of perineal integrity or mild trauma, and a preference for upright birthing positions.
03Newborns had excellent vitality at birth, with 99.4% having an Apgar score of 7 or higher at 5 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relies on secondary data from institutional records, which may be subject to information bias. Data on key demographic variables like skin color, education, and income were missing for a significant portion of the sample (up to 23.5%). The cross-sectional design limits the ability to establish causality between parity and outcomes. The study did not follow up on women who transferred to the hospital, so outcomes for this group are incomplete.
Declared interests
The study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) in Brazil. No other conflicts of interest were declared.
The easy way to misread this
Do not conclude that birth centers are unsafe for first-time mothers. While primiparous women had higher rates of interventions and transfers, the overall maternal and neonatal outcomes remained positive and comparable to low-risk hospital births.