Abstract
Introduction: Birthing Centers (BC) are
increasingly accepted worldwide as an alternate
low cost place of birth. The concept is especially
relevant for developing countries with limited
resources and constraints regarding availability of
specialists and hospital beds. The various studies
have concluded that when proper risk analyses are
conducted and referral rules followed, there is no
evidence of increased maternal or perinatal risk at
BC compared to standard hospital deliveries.
Materials and Methods: This was a prospective,
observational and comparative hospital based study
done at Paropakar Maternity and Women’s Hospital
(PMWH),Kathmandu.The study was conducted on
pregnant women without any known risk factors for
complications who were admitted in BC and labor
ward (LW) for delivery. Details on mode of delivery,
genital tract status, Postpartum hemorrhage (PPH)
and neonatal outcomes were collected. Descriptive
data analysis was done using SPSS.
Results: Out of 5132 deliveries, 25.3% had no
known risk factor and hence were eligible for study;
no statistically significant difference was observed
between BC & LW in relation to mode of delivery,
perineal trauma, PPH and neonatal outcomes;
however, practice of episiotomy was significantly
less frequent in BC.
Conclusion: When proper risk analyses are
conducted and referral rules followed, there is no
evidence of adverse obstetrics outcome at BC as
compared to standard hospital deliveries. Triaging
of low risk pregnancy to a BC is a viable strategy,
especially in a resource poor country. This lessens
the burden in standard maternity unit so that
specialists will be able to provide a quality care to
high risk pregnancies.
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