UN CO RR EC TE D PR OO F An intrapartum intervention scoring system for the comparison ofmaternity units ’ intrapartum care of nulliparouswomen suitable formidwifery - led care

Objective: to develop an intrapartum intervention scoring toolwhich could be used to def|nematernity units as either ‘lower intrapartum intervention’or ‘higher intrapartum intervention’ units.This scoring toolwas designed to formthe basis of a comparison of the perceptionofriskbymidwivesworkingin either ‘lowerintrapartumintervention’or ‘higher intrapartum intervention’ units. Design: three aspectswere included: (1) the systematic data reduction of the St Mary’s Maternity Information Systemdatabase usedby11maternity units to include Caucasian nulliparouswomen suitable formidwifery-led care; (2) the calculation and the ranking of frequency distributions for the following interventions/management: (a) themanagement of breech presentation and of one previous caesarean section, the choice of home birth; and (b) augmentation of labour, use of electronic fetalmonitoring, use of epidural,method of delivery; (3) the sumof the individual intrapartumrankingmarksmade up the f|nal intrapartumscore for each unit. Results: intrapartum interventions varied considerably between units.The scoring system enabled units to be described as either ‘Lower intrapartum intervention’or ‘Higher intrapartum intervention’ units. Conclusions: routinely collected computeriseddata can be used to identify the outcomes of intrapartumcare.This study suggests that the analysis of computeriseddata couldprovide a suitable basis for the audit and the comparison of intrapartuminterventions for the care of women suitable formidwifery-led care. & 2003 Published by Elsevier Ltd.