with no maternal deaths. Very few women required an analgesic, sedative, or tranquilizer during labor (9.8%). About 54 percent did require anesthesia during delivery.
In an effort to place birth center data in context, Fullerton and Severino (1992) compared the National Birth Center Study data to a sample of women giving birth in hospital settings. The authors reported that even when they controlled for complications and for differences in sociodemographic characteristics, women in hospitals were more likely to receive excessive care. Based on this finding, they concluded that data support the claim that for low-risk women birth centers are safe and acceptable alternatives to in-hospital maternity care.
Regarding the possibility of excessive hospital care, Butler, Abrams, Parker, Roberts and Russell (1993) reported that in hospital settings, cesarean childbirth has risen dramatically over the last 25 years, going from 4.5 percent to 23.8% of all deliveries. In almost every case, these deliveries are physician-managed.
Because at most birth centers, women receive care from certified nurse-midwives (with support staff), Butler and associates wondered whether the rate of cesarean delivery might differ as a function of whether delivery was physician or nurse-managed. The authors noted that their study had important implications because of the greatly increased chance of maternal infectious morbidity following cesarean birth. as well as longer hospital stays following delivery.
In their study, Butler and associates (1993) compared 3,551 physician-managed patients with 1,056 certified nurse-midwife-managed patients. Outcome measures included diagnosis of fetal distress, cesarean delivery when maternal characteristics of age, race, parity, fetal size, and delivery year were controlled for. All women in the study had at least five prenatal visits and delivered term, singleton, liveborn infants with no congenital abnor...