Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care

Objective. We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based care. Methods. We studied 2957 low-risk, low-income women: 1808 receiving collaborative care and 1149 receiving traditional care. Results. Major antepartum (adjusted risk difference [RD]=-0.5%; 95% confidence interval [Cl]=-2.5, 1.5), intrapartum (adjusted RD=0.8%; 95% Cl =-2.4, 4.0), and neonatal (adjusted RD=-1.8%; 95% Cl=-3.8, 0.1) complications were similar, as were neonatal intensive care unit admissions (adjusted RD=-1.3%; 95%CI=-3.8, 1.1). Collaborative care had a greater number of normal spontaneous vaginal deliveries (adjusted RD = 14.9%; 95% Cl = 11.5, 18.3) and less use of epidural anesthesia (adjusted RD=-35.7%;95%CI=-39.5,-31.8). Conclusions. For low-risk women, both scenarios result in safe outcomes for mothers and babies. However, fewer operative deliveries and medical resources were used in collaborative care.