Stillbirths within the framework of midwifery pilot projects in Quebec

Conseil de Evaluation des technologies de la Sante du Quebec
Record ID 31999009814
English, French
Authors' objectives:

This report aims to:

- Carry out a meta-analysis of the scientific literature in order to 'illustrate what is usually expected in midwifery practice'

- Complete an epidemiological analysis of each stillbirth case.

Authors' recommendations: Available scientific literature is not conclusive regarding the association between stillbirth and midwifery practice. The combined results of the RCTs indicate that care led by midwives is associated with a slightly higher stillbirth rate than that associated with care led by physicians. However, this difference is not statistically significant, and is reduced when the analysis is restricted to low-risk pregnant women. To address the second part of the mandate, the Committee examined each of the 19 recorded stillbirth cases to determine whether appropriate care was provided. This applied to the overall management of pregnancy, involving several types of health care professionals. Ten of the 19 stillbirth cases were associated with inappropriate care, among which eight deaths were considered possibly or probably avoidable. The underlying causes of inappropriate care include the difficulty in recognizing an abnormal condition and failure to act appropriately once a problem is detected, communication problems between professionals, delays encountered when faced with emergency situations, and ambiguous definition of professional responsibilities when transfer of care and joint follow-up have taken place, and the lack of documentation of the information provided to the pregnant woman on recommended interventions during the care process.
Authors' methods: Meta-analysis, epidemiological analysis
Project Status: Completed
Year Published: 1999
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Fetal Death
  • Midwifery
  • Physicians, Family
  • Prenatal Care
Organisation Name: Conseil d'Evaluation des Technologies de la Santé du Québec
Contact Address: Conseil d'Evaluation des Technologies de la Santé du Québec, 2021, avenue Union, #1040, Montréal, Québec H3A S29, Canada. Tel: 514-873-2563; FAX: 514-873-1369
Contact Name:
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Copyright: Conseil d'Evaluation des Technologies de la Sante du Quebec (CETS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.