Research Issues in the Assessment of Birth Settings Report of a Study (1982) / Chapter Skim
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4: Variables
4: Variables
Pages 55-66
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From page 55... ...
The committee was able to develop a list of variables that might be considered in the study of birth settings and to develop several approaches for their conceptualization. However, it became clear that more research is needed to develop accurate outcome measures other than mortality.
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From page 56... ...
RELEVANT EXAMPLES OF PROGNOSTIC VARIABLES Race, maternal age, parity, socioeconomic status, and medical obstetric risk level are well known influences on the outcome of pregnancy. Other variables, such as personality characteristics, attitudes, health behavior, and beliefs may also be important determinants of outcome.
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From page 57... ...
Selfselection is one of the most difficult problems in research on alternative birth settings and may be hard to overcome. RELEVANT EXAMPLES OF OUTCOME OR DEPENDENT VARIABLES Pregnancy outcome traditionally was measured by late fetal, neonatal, and maternal mortality.
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From page 58... ...
Place of birth variables describe the building, surroundings, abDosphere, equipment, and supplies that make up the environment where birth occurs. Provider variables describe physical, psychological, professional or technical training, and social aspects of the persons who give care to the childbearing family.
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From page 59... ...
Specific aspects of maternity care that are likely to influence outcome regardless of the setting are especially useful measures. Such practices might include electronic fetal monitoring for low-risk women as compared with high-risk women, routine cesarean section following a previous birth by cesarean section, use of anesthesia or analgesics, routine delivery of a breech by cesarean section, and the routine use of episiotomy.
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From page 60... ...
Some components of the perinatal death rate are only slightly influenced by medical care. These include many deaths due to congenital anomalies, deaths in infants whose birth weights are less than 750 grams, and deaths in the first few months of life due to Sudden Infant Death Syndrome.
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From page 61... ...
Some useful measures could include Apgar scores and the presence of some abnormality. Other factors to be recorded might include extrauterine adjustment and physiological processes such as body temperature, time and details of the first feeding, weight (including time to regain birth weight)
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From page 62... ...
In particular Table 1 of that appendix indicates the many areas for which no information exists on psychological aspects of family members• experiences related to childbearing. SOUBCES OF DATA FOR STUDY OF VARIABLES AND OU'l'COMES Vital statistics, medical records, and large-scale surveys are sources of data useful for analysis of events that occur infrequently in the population.
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From page 63... ...
Thus, data to answer questions about psychosocial events may have to come from new research studies. However, the increasing levels of multidisciplinary collaboration among biomedical, behavioral, and social scientists offer promise that the existing obstacles to producing a scientific literature on childbirth settings can be overcome.
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From page 64... ...
1977. Perinatal deathsa Analysis by clinical cause of assess value of induction of labor.
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From page 65... ...
1982. Identifying the sources of the recent decline in perinatal mortality rates in California.
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