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

Br J Obstet Gynaecol. 1983 Feb;90(2):123-8. doi: 10.1111/j.1471-0528.1983.tb08895.x.


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 and spent 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 less than or equal to 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Obstetrical
  • Delivery, Obstetric*
  • England
  • Family Practice
  • Female
  • Humans
  • Infant, Newborn
  • Labor, Obstetric*
  • Maternal Health Services / organization & administration*
  • Obstetrics and Gynecology Department, Hospital
  • Outcome and Process Assessment, Health Care*
  • Pregnancy
  • Risk
  • Time Factors