The first alongside midwifery unit in Spain: A retrospective cohort study of maternal and neonatal outcomes.

BACKGROUND: Midwife-led units have been shown to be safer and reduce interventions for women at low risk of complications at birth. In 2017, the first alongside birth center was opened in Spain. The aim of this study was to compare outcomes for women with uncomplicated pregnancies giving birth in the Midwife-led unit (MLU) and in the Obstetric unit (OU) of the same hospital. METHODS: Retrospective cohort study comparing birth outcomes between low-risk women, depending on their planned place of birth. Data were analyzed with an intention-to-treat approach for women that gave birth between January 2018 and December 2020. RESULTS: A total of 878 women were included in the study, 255 women chose to give birth in the MLU and 623 in the OU. Findings showed that women in the MLU were more likely to have a vaginal birth (91.4%) than in the OU (83.8%) (aOR 2.98 [95%CI 1.62-5.47]), less likely to have an instrumental delivery, 3.9% versus 11.2% (0.25 [0.11-0.55]), to use epidural analgesia, 19.6% versus 77.9% (0.15 [0.04-0.17]) and to have an episiotomy, 7.4% versus 15.4% (0.27 [0.14-0.53]). There were no differences in rates of postpartum hemorrhage, retained placenta, or adverse neonatal outcomes. Intrapartum and postpartum transfer rates from the MLU to the OU were 21.1% and 2.4%, respectively. CONCLUSIONS: The high rate of obstetric interventions in Spain could be reduced by implementing midwife-led units across the whole system, without an increase in maternal or neonatal complications.

Level of Job Burnout among Midwives Working in Labour Rooms in Barcelona Region: A Cross-Sectional Study.

BACKGROUND: Nowadays, burnout syndrome (BS) symptoms appear to have increased in healthcare workers, specifically midwives, but there are no studies on burnout among midwives in Catalonia. The present study aimed to assess and describe the prevalence of BS in midwives working in labour rooms. METHODS: A cross-sectional descriptive study was conducted on 122 midwives working in 24 maternity hospitals in the Barcelona (region) which were selected using purposive sampling from January to March 2017. Data were collected using two questionnaires (demographic information, job burnout using Spanish Burnout Inventory with 20 items and four subscales). Data analysis was performed using SPSS software version 21 and Chi-Square, U Mann-Whitney, and Kruskall-Wallis. P<0.05 was considered statistically significant. RESULTS: None of the participants obtained a critical level of BS. 37 (30.33%) participants scored medium burnout and 47 (38.52%) recorded low burnout. Statistically, work stress (P=0.01), marital status (P=0.006), attendance of more than three women per shift (P=0.001), the number of children (P=0.01), parity (P=0.005), health status (P=0.04), and being on sick leave over last year (P=0.04) were significantly correlated with medium-high levels of burnout. Burnout scores were higher in midwives having a life partner and those without children. CONCLUSION: Following the results, no participant obtained a critical level of BS; about one-third of them scored medium-high burnout. However, specific interventions are suggested to be conducted to maintain the midwives' motivation and prevent burnout development.