A comparison of low‐risk pregnant women booked for delivery in two systems of care: shared‐care (consultant) and integrated general practice unit. II. Labour and delivery management and neonatal outcome

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Abstract
Summary. A random sample of low‐risk pregnant women were equally divided into four groups of 63 nulliparae and multiparae each booked for care in a integrated general practice unit (GPU) and a shared‐care (consultant) system. Selection criteria included only women who were admitted because they were in spontaneous labour or thought they were. Nulliparous women booked for shared‐care came into hospital at a less advanced state of cervical dilatation than those booked for the GPU andspent longer (11 compared with 8 h) in hospital before delivery; the comparable durations in multiparae were 6 and 4 h. Both the first and second stages of labour were longer in the GPU‐booked women but they received less pethidine and fewer had epidural analgesia; they received less electronic fetal monitoring, augmentation and forceps delivery, and fetal distress was diagnosed less often. The 1‐min Apgar score was < 6 in 17.5% of infants of nulliparae booked for the shared‐care system compared with 1.6% of those booked for the GPU. The intubation rate of infants of nulliparae was 11% in the shared‐care system compared with no intubations in the GPU. These comparisons demonstrate the simplicity and safety of delivery of low‐risk women in the GPU as compared with deliveries of similar women in a shared‐care (consultant) unit.