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November 29, 2011

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Landmark Articles Published

The largest ever examination of planned home births in the United States found that among low-risk women, planned home births result in low rates of birth interventions without an increase in adverse outcomes for mothers and newborns, and result in health benefits to mothers and their infants.

The study—which looked at nearly 17,000 women and their newborns—found that for planned home births with a midwife in attendance:

  • Over 93% women had a normal physiologic birth
  • A cesarean rate of 5%
  • Only 2.5% of babies admitted to the NICU in the first six weeks of life
  • 87% of women with previous cesareans had their babies vaginally
  • Of the 10.9% of women who transferred from home to hospital during labor, the majority moved for non-emergent reasons, like a slow, non-progressing labor, or maternal exhaustion
  • At six weeks postpartum, nearly all babies were breastfed

Cheyney M, Bovbjerg M, Everson C, Gordon W, Hannibal D, & Vedam S. Outcomes of care for 16,984 planned home births in the United States: The Midwives Alliance of North America Statistics Project, 2004-2009.

Cheyney M, Bovbjerg M, Everson C, Gordon W, Hannibal D, & Vedam S. Development and validation of a national data registry for midwife-led births: The Midwives Alliance of North America Statistics Project 2.0 dataset.

Click here for MANA's study summary and fact sheets. Click here for MANA blogpost.

MANA Division of Research

The mission of the Midwives Alliance Division of Research (DOR) is to increase the capacity for and dissemination of rigorous research and innovation in maternal-infant health. In particular, the DOR aims to facilitate research on the characteristics and outcomes of midwifery care, including measures of quality, safety, and best practice. To achieve these goals the members of the DOR are engaged in several initiatives:

The DOR maintains the MANA Statistics Registry, a web-based registry of maternal and infant health data from midwife-led births. Midwives have obtained consent from women and families across North America to provide detailed information about their maternity care. Participating midwives can use the information to track and evaluate their own practice statistics. Researchers can access the de-identified data to study the process and outcomes of midwifery care. MANA Stats is currently the largest U.S. database of high quality information describing planned home and birth center births.

The DOR reports nationwide benchmarking statistics from the MANA Stats Registry to assist participating midwives to assess their own practice outcomes within the context of national perinatal data.

The Division of Research also provides resources to midwives and families on the evidence basis for midwifery care for pregnancy, childbirth, newborn and women’s health across settings (home, office, birth center, hospital).

The MANA Statistics Registry: Making high-quality data available for researchers

The DOR provides access to the largest high-quality dataset of midwife-attended births in home and birth center settings in the United States.

The DOR aims to facilitate research on the characteristics of midwifery care, including measures of quality, safety, and best practice, and the effects of birth place on maternal-infant outcomes.

The role of gathering and providing access to high-quality data is common across a number of research fields. For example, other national organizations are gathering, validating, and facilitating access to data for researchers to develop a better understanding Alzheimers and improving cancer outcomes.

The DOR: Providing benchmarking statistics for midwives.

The DOR benchmarking data give midwives the ability to compare their practice statistics to those of other maternity care providers across the country. Comparing (or “benchmarking”) one’s statistics to a larger sample of similar providers is a critical step in continuous quality assurance, allowing for reflective practice and identifying whether/ where improvements are needed.

State midwifery organizations: public health evaluation

Midwives in Oregon and Vermont currently use the MANA Stats Registry reports to track and evaluate trends and aggregate outcome data for the purposes of quality assessment, evaluation, and assurance for maternal newborn population health within the state, and monitoring of continuing competency of providers.

Community partners: conducting independent, credible research

The de-identified data are available, via an application process including independent ethics board review, to researchers who wish to examine some aspect of midwifery care, physiologic labor and birth, or effects of birth place on outcomes. Please note that currently the dataset contains information generated primarily by healthy women who plan home and birth center births. Hence, this data cannot be reliably used to study perinatal outcomes across the entire population of pregnant women. We encourage researchers and students with an interest in these topics to review our data application handbook or contact us to discuss your ideas.

September 23, 2011

Recent Research Project Using MANA Stats

Researcher(s): Valerie Armendariz, Temple University

September 14, 2011

FAM has awarded a grant to the Division of Research to undertake the following project: A Feasibility Study for Annual Reporting of Midwifery Care Statistics. What does this mean? It’s more exciting than it sounds. The DOR has its eyes on a very big and game-changing goal: we want to report every year on the outcomes of MANA Stats contributors, just as the National Center for Healthcare Statistics reports on US outcomes and rates (like cesarean-section rate, prematurity rate, etc.) We want to do this at the same time as the NCHS, and we think the comparisons will be very enlightening! As the steward of one of the two largest datasets in North America on out-of-hospital births, the MANA DOR is perfectly poised to provide this information, which should help the public and policymakers become aware of the benefits of midwifery care. This will require a lot of capacity-building and a very solid financial and personnel situation, because once we start doing this, we will need to do it every year, and with an impeccable level of research professionalism. The purpose of the feasibility study is to identify assets and challenges and craft a plan, including funding, for making this a reality. If you are interested in helping to make this happen, please contact anyone on the Division of Research!

September 13, 2011

The MANA Statistics Project now gives you the choice between two data forms. The form most contributors will begin with upon enrolling is called the Minimal Form. It collects all the essential information including demographics of your clients, their pregnancy history, birth, postpartum and outcomes. It is easy to use, taking about 8-10 minutes to complete. The Minimal Form is the ideal form to use when starting out with MANAstats because you will most likely already be charting all the information it asks for. The Minimal Form is designed to make data contribution easy and sustainable even for busy practices, or practices with multiple midwives and apprentices.