Table 2.
Comparison of intrapartum practices (N = 335)
| Bivariate comparison |
Adjusted analysisa |
|||||
|---|---|---|---|---|---|---|
| Triaged by a midwife (n = 175) | Triaged by a physician (n = 160) | Bivariate P value | Regression estimate (midwife vs physician) | 95% CI | P value | |
|
| ||||||
| Intrapartum care | ||||||
| Amniotomy, odds ratio, n (%) | 49 (28.0) | 52 (32.5) | .37b | 0.96 | 0.55–1.68 | .88c |
| Oxytocin augmentation, odds ratio, n (%) | 68 (39.8) | 87 (55.1) | .006b | 0.50 | 0.29–0.87 | .01c |
| Epidural, odds ratio, n (%) | 134 (77.0) | 147 (93.0) | <.001b | 0.29 | 0.12–0.69 | .005c |
| Nitrous oxide, odds ratio, n (%) | 33 (19.1) | 22 (13.9) | .21b | 1.56 | 0.77–3.17 | .22c |
| Instrumental vaginal birth, odds ratio, n (%) | 17 (11.5) | 7 (5.7) | .09b | 2.99 | 0.69–12.93 | .14c |
| Cesarean birth, odds ratio, n (%) | 26 (14.9) | 36 (22.5) | .07b | 0.31 | 0.14–0.67 | .003c |
| Cesarean characteristics | ||||||
| Indication for cesarean, odds ratio, n (%) | ||||||
| Dystocia | 16 (61.5) | 22 (61.1) | Reference | |||
| Fetal distress | 9 (34.6) | 13 (36.1) | .99d | 0.79 | 0.11–5.60 | .81c |
| Vaginal birth vs cesarean because of labor dystocia, odds ratio, n (%) | ||||||
| Vaginal birth | 149 (90.3)e | 124 (84.9) | Reference | |||
| Cesarean due to dystocia | 16 (9.7) | 22 (15.1) | .15b | 0.29 | 0.10–0.84 | .02c |
| Cervical dilatation in cm at admission, beta estimate, mean (SD) | 4.12 (2.14) | 3.49 (2.07) | .01f | 0.51 | 0.04–1.06 | .07g |
| Length of time from admission to birth (hours), hazard ratio, median (IQR) | 12.1 (7.7–18.1) | 14.8 (9.0–20.1) | .21h | 1.24 | 0.95–1.62 | .12i |
| Mode of birth within the first 24 h after admission, odds ratio, n (%) | ||||||
| Vaginal | 138 (89.6) | 114 (81.4) | Reference | |||
| esarean | 16 (10.3) | 26 (18.6) | .045b | 0.29 | 0.12–0.69 | .005c |
Abbreviations: CI, confidence interval; IQR, interquartile rage; NS, not significant.
a
Analysis adjusted for age, race, marital status, time of day, insurance, and body mass index.
b
Chi-square.
c
Logistic regression (odds ratio).
d
Fisher’s exact test.
e
The difference in the percent calculation is because of the different denominator comparing these 2 vaginal birth groups.
f
Student’s t test.
g
Linear regression.
h
Log-rank test.
i
Proportional hazard regression (hazard ratio).