Nearly four million women give birth in the United States every year. The great majority of pregnant women are healthy and anticipate an uncomplicated birth. Nonetheless, federal statistics reveal that childbearing is procedure-intensive. This presentation will consider the appropriateness of patterns of care for low-risk childbearing women. The authors will first examine national trends in rates of use of obstetric interventions with low-risk women, and then will compare this profile to care that is indicated by the high-quality systematic reviews that are created by the Cochrane Collaboration's Pregnancy and Childbirth Group. Data from the National Center for Health Statistics will be used to examine trends and most current available rates of obstetric interventions. This analysis will focus on procedure-related data that are available on birth certificates and through the National Hospital Discharge Survey. It will use the definition of low-risk that the Public Health Service has recently established to set target Healthy People cesarean rates for 2010. Indicated care will primarily be identified through two related sources. First, the Guide to Effective Care in Pregnancy and Childbirth is a summary of the output of the Cochrane Collaboration's Pregnancy and Childbirth Group. The third edition of this overview (2000) provides current information and continues the tradition of earlier editions in assigning hundreds of specific forms of care to one of six lists of differing degrees of effectiveness and safety. Second, pertinent individual systematic reviews within the Cochrane Database of Systematic Reviews provide more detailed information about indicated maternity care.
Learning Objectives: Those who attend this presentation will be able to (1) describe the leading sources that are available to identify national trends in use of obstetric procedures and to clarify what constitutes evidence-based maternity care, (2) characterize national trends in the use of selected obstetric procedures with low-risk women, and (3) assess whether these trends are supported by the higher-quality evidence on the safety and effectiveness of maternity practices that is currently available
Keywords: Evidence Based Practice, Maternal Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: National Center for Health Statistics, Cochrane Collaboration, Maternity Center Association
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am assistant executive director of the Maternity Center Association.