Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121347

Jean Ewan, CNM, MPH¹, Julie Mottl-Santiago², Catherine Walker, CNM, MPH¹, and Suzanne Winder, BA¹. (1) Nurse-Midwifery Program, Boston Medical Center, 1 Boston Medical Center Place, Dowling 321 S, Boston, MA 02118, 617-414-5469, Jean.Ewan@bmc.org, (2) Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany Street, Ste 527W, Boston, MA 02118

Background: Lay labor support during childbirth has been shown in several randomized controlled trials to improve perinatal outcomes. The Birth SistersSM Program at Boston Medical Center offers multicultural prenatal, labor and postpartum support to all childbearing women. We conducted an evaluation to determine if Birth Sister Program outcomes are similar to those reported in the literature. Methodology: A retrospective cohort analysis compared outcomes for Birth Sister attended births with non-Birth Sister attended births through the program's first five years. 9818 live births were identified and analyzed from the hospital's previously existing computerized obstetrical database. Demographic profiles and obstetrical risk factors were analyzed for the two group's comparability. Outcome measures included primary and total cesarean delivery rates, epidural use, operative vaginal delivery, Apgar scores, breastfeeding intent and early breastfeeding initiation. Log binomial regression models were constructed to evaluate the relationship between variables and to control for confounders. Subgroup analyses were also performed for each provider service (midwifery and physician) and for primiparous and multiparous women. Results: For overall data (N=9818), significant differences in epidural use (p=.01), intent to breastfeed (p=.0001) and early breastfeeding initiation (p=.0001) were found for Birth Sister attended births compared with non-Birth Sister attended births. For breastfeeding outcomes, results were also true for subgroup analysis where sample size varies with regards to subgroups. Additionally, Birth Sister attended primiparous midwifery births had significantly lower rates of cesarean delivery (p=.006) and epidural use (.04)

Learning Objectives:

• 1. List 5 randomized controlled trials of lay social support during childbirth and discuss their results
• 2. List the goals of the Birth Sisters Model
• 3. State four childbirth outcomes that are improved by the Birth Sisters Program at Boston Medical Center.

Keywords: Midwifery, Access to Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.