"Laborist" Hospitals Produce Results

Pregnant women at laborist hospitals appear to have better pregnancy outcomes

(RxWiki News) Many hospital labor and delivery units have staff on the floor on an as-needed basis. Others employ a new model of round-the-clock staffing. There may be good reason for the new model.

Around-the-clock labor and delivery coverage is called the "laborist" model. It has been around for about 10 years.

Two recent unpublished studies offer evidence that this model leads to better outcomes for pregnant women.

Hospitals using the laborist model had fewer C-sections, fewer inductions, fewer preemies and shorter hospital stays for the mothers.

"Attend all prenatal appointments."

Both studies were presented at a conference on pregnancy. One study, led by Yvonne Cheng, MD, of the University of California at San Francisco, focused on cesarean section rates.

Looking at data from larger hospitals in which at least 1,200 babies were born each year, Dr. Cheng's team analyzed 740,019 total births from both laborist and non-laborist hospitals.

Hospitals not using the laborist model would have doctors available on an as-needed basis.

Although women in the laborist hospitals were more likely to have labor induced, they were less likely to have a C-section.

Laborist hospitals also saw a higher percentage of women who went into labor and/or had a vaginal birth after having had a previous C-section than the percentage of women in as-needed hospitals.

In the second study, led by Sindhu Srinivas, MD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, analyzed pregnancy outcomes among 626,772 births at eight laborist hospitals and 16 non-laborist hospitals.

In this study, there were 15 percent fewer inductions in the laborist hospitals and a very slight increase in C-sections (5 percent) - the opposite of the induction findings in the other study.

However, women in the laborist hospitals also stayed an average 2.2 hours less in the hospital overall, and there was a lower rate of babies' admissions to the neonatal intensive care unit (NICU).

There were also 17 percent fewer preterm births among the women in the laborist hospitals as compared to those in the non-laborist hospitals. Laborist hospitals also saw 6 percent fewer babies born underweight (5.5 pounds or less).

"Many hospitals have moved toward adopting the laborist model, and it's critically important to determine whether it is improving pregnancy outcomes," Dr. Srinivas said in a statement. "We thought the laborist model would improve pregnancy outcomes and now we have data that demonstrates that."

The studies have not yet been published in a peer-reviewed journal, so their results should be regarded as preliminary and still require review by researchers in the field.

The studies were presented February 16 at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in San Francisco. Information was unavailable regarding funding and conflicts of interest.

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Review Date: 
February 14, 2013