• Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial.

      Begley, Cecily; Devane, Declan; Clarke, Mike; McCann, Colette; Hughes, Patricia; Reilly, Mary; Maguire, Roisin; Higgins, Shane; Finan, Alan; Gormally, Siobhan; et al. (2011-10-29)
      ABSTRACT: BACKGROUND: No midwifery-led units existed in Ireland before 2004. The aim of this study was to compare midwife-led (MLU) versus consultant-led (CLU) care for healthy, pregnant women without risk factors for labour and delivery. METHODS: An unblinded, pragmatic randomised trial was designed, funded by the Health Service Executive (Dublin North-East). Following ethical approval, all women booking prior to 24 weeks of pregnancy at two maternity hospitals with 1,300-3,200 births annually in Ireland were assessed for trial eligibility.1,653 consenting women were centrally randomised on a 2:1 ratio to MLU or CLU care, (1101:552). 'Intention-to-treat' analysis was used to compare 9 key neonatal and maternal outcomes. RESULTS: No statistically significant difference was found between MLU and CLU in the seven key outcomes: caesarean birth (163 [14.8%] vs 84 [15.2%]; relative risk (RR) 0.97 [95% CI 0.76 to 1.24]), induction (248 [22.5%] vs 138 [25.0%]; RR 0.90 [0.75 to 1.08]), episiotomy (126 [11.4%] vs 68 [12.3%]; RR 0.93 [0.70 to 1.23]), instrumental birth (139 [12.6%] vs 79 [14.3%]; RR 0.88 [0.68 to 1.14]), Apgar scores <8 (10 [0.9%] vs 9 [1.6%]; RR 0.56 [0.23 to 1.36]), postpartum haemorrhage (144 [13.1%] vs 75 [13.6%]; RR 0.96 [0.74 to 1.25]); breastfeeding initiation (616 [55.9%] vs 317 [57.4%]; RR 0.97 [0.89 to 1.06]). MLU women were significantly less likely to have continuous electronic fetal monitoring (397 [36.1%] vs 313 [56.7%]; RR 0.64 [0.57 to 0.71]), or augmentation of labour (436 [39.6%] vs 314 [56.9%]; RR 0.50 [0.40 to 0.61]). CONCLUSIONS: Midwife-led care, as practised in this study, is as safe as consultant-led care and is associated with less intervention during labour and delivery. Trial registration: Current Controlled Trials ISRCTN14973283.
    • Concealed pregnancy: a concept analysis [poster]

      Murphy Tighe, S; Lalor, Joan; School of Nursing & Midwifery, Trinity College Dublin, D’Olier St, Dublin 2. (Health Service Executive (HSE), 2014-02)
    • Guidelines for the management of pre-gestational and gestational diabetes mellitus from pre-conception to the postnatal period

      Health Service Executive (HSE) Office of the Nursing & Midwifery Services Director (Health Service Executive (HSE), 2010-07)
    • Positive lifestyle changes around the time of pregnancy: a cross-sectional study.

      O'Keeffe, Linda M; Dahly, Darren L; Murphy, Marion; Greene, Richard A; Harrington, Janas M; Corcoran, Paul; Kearney, Patricia M (BMJ Open, 2016-05)
      To examine the prevalence of positive lifestyle behaviours before and during pregnancy in Ireland.