Table 3

Birth and neonatal outcomes (by line of care at onset of labour) of the unmatched (A) and the matched (B) cohort

Birth characteristics(A) Unmatched cohort(B) Matched cohort
Midwife-led careObstetrician-led careOR (95% CI)Midwife-led careObstetrician-led careOR (95% CI)
All birthsn=46 764n=10 632n=10 632n=10 632
Mode of birth
Spontaneous41.469 (89%)8.295 (78%)2.21 (2.09 to 2.33)9520 (89%)8.295 (78%)2.41 (2.23 to 2.61)
Caesarean section*1.125 (2.4%)948 (8.9%)0.25 (0.23 to 0.28)260 (2.5%)948 (8.9%)0.26 (0.22 to 0.29)
 Suspected fetal distress221 (0.5%)234 (2.2%)54 (0.5%)233 (2.2%)
 Non-progressive labour716 (1.5%)483 (4.5%)145 (1.4%)483 (4.5%)
 Combined150 (0.3%)103 (1.0%)36 (0.3%)103 (1.0%)
 Other reason37 (0.1%)127 (1.2%)9 (0.1%)127 (1.2%)
 Missing1 (0.002%)1 (0.01%)0 (0%)1 (0.01%)
Instrumental vaginal birth4.170 (8.9%)1.389 (13.1%)0.65 (0.61 to 0.70)852 (8.0%)1.389 (13.1%)0.58 (0.53 to 0.63)
 Suspected fetal distress1.096 (2.3%)500 (4.7%)261 (2.5%)500 (4.7%)
 Non-progressive labour2.492 (5.3%)731 (6.9%)508 (4.8%)731 (6.9%)
 Combined554 (1.2%)140 (1.3%)108 (1.0%)140 (1.3%)
 Other reason18 (0.04%)16 (0.2%)7 (0.07%)16 (0.2%)
 Missing10 (0.02%)2 (0.02%)4 (0.04%)2 (0.02%)
Postpartum haemorrhage2.001 (4.3%)662 (6.2%)0.67 (0.61 to 0.74)460 (4.3%)662 (6.2%)0.68 (0.60 to 0.77)
Pain medication
 Epidural1396 (3.0%)851 (8.0%)0.35 (0.32 to 0.39)294 (2.8%)851 (8.0%)0.33 (0.29 to 0.37)
 Other3521 (7.5%)1.842 (17%)0.39 (0.37 to 0.41)763 (7.2%)1.842 (17.3%)0.37 (0.34 to 0.40)
Line of care at birth
 Midwife led31.161 (67%)6 (0.1%)Not applicable7230 (68%)6 (0.1%)Not applicable
 Obstetrician led15.603 (33%)10.626 (99.9%)3402 (32%)10.626 (99.9%)
Vaginal births onlyn=45 639n=9684n=10 372n=9684
Manual placenta removal630 (1.4%)323 (3.3%)0.41 (0.35 to 0.46)151 (1.5%)323 (3.3%)0.43 (0.35 to 0.52)
Perineal lacerations
 Third or fourth degree tear1272 (2.8%)248 (2.6%)1.09 (0.95 to 1.25)275 (2.4%)248 (2.6%)0.96 (0.80 to 1.14)
Episiotomy
 Without instrumental birth†5333 (12.9%)1550 (18.7%)0.64 (0.60 to 0.68)1103 (11.6%)1550 (18.7%)0.57 (0.52 to 0.62)
 With instrumental birth‡3206 (76.9%)1030 (74.2%)1.16 (1.01 to 1.33)643 (75.5%)1030 (74.2%)1.07 (0.88 to 1.31)
Other neonatal outcomesn=46 764n=10 632n=10 632n=10 632
Five-minute Apgar score <7305 (0.7%)94 (0.9%)0.74 (0.58 to 0.93)74 (0.70%)94 (0.88%)0.79 (0.58 to 1.07)
NICU admittance for >24 hours85 (0.2%)45 (0.4%)0.43 (0.30 to 0.62)20 (0.19%)45 (0.42%)0.44 (0.26 to 0.75)
  • *Only in intrapartum Caesarean section, there were no women with elective Caesarean section in our cohort (excluded).

  • †For the denominator, we used all spontaneous vaginal births.

  • ‡For the denominator, we used all instrumental vaginal births.

  • NICU, neonatal intensive care.