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Put yourself in a pregnant woman’s shoes. Would you rather give birth at a facility that has an OB/GYN hospitalist onsite around the clock to mitigate any possible childbirth complications or take your chances and hope a doctor can be summoned quickly by phone when you check in with full labor contractions at 3 a.m.?
There are major advantages to having a full-time obstetric hospitalist (often called laborist) onsite 24/7 in the Labor and Delivery unit (or Obstetric Emergency Department [OBED] if your hospital has one). Nearly 10% of births develop complications. While that may seem statistically small, it certainly looms large if you are one among the 10%.
A study published in the American Journal of Obstetrics and Gynecology (AJOG) examined data from a 550,000 cases and concluded that the employment of full-time hospitalists/laborists is associated with a fewer labor inductions and spontaneous preterm births. Preterm births remain this country’s leading cause of infant death. The advantage of having a hospitalist on hand is that the clinician’s sole focus is on the L&D unit without distractions or competing duties. This around-the-clock presence supports a natural progression of labor in uncomplicated pregnancies.
“The potential reduction in inductions could result from changes in practice behavior secondary to continuous coverage and less pressure to schedule deliveries for convenience because of office hours or personal conflicts,” the study’s authors wrote. It is important to note that labor inductions increase the risk for cesarean delivery. The study found that full-time hospitalists experienced about 5% fewer cesarean deliveries compared with traditional staffing models. Labor inductions in the United States have been on the rise, increasing from 9.5% in 1990 to 22.1% in 2004.
Overall, the study concludes that the hospitalist/laborist model shows promise and could lead to fewer adverse obstetrical outcomes and costs.
This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.
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