Computerized "real-time" bedside medication documentation and preventable error : a study of documentation behavior changes

An inferential study comparing maternal and newborn morbidity and mortality between two groups of low risk pregnancies was conducted. Group I was comprised of 100 home births managed by certified nurse-midwives with a non-interventionist philosophy of obstetrical practice. Group II was comprised of 100 hospital deliveries managed by obstetricians with an interventionist philosophy of obstetrical practice. Data collection was by retrospective chart review. There was no significant difference between labor and delivery complications in the two groups. Analysis of fetal/neonatal complications showed more recorded intrapartum fetal distress, newborn jaundice requiring treatment with bililights, forceps related bruising, and cephalhematomas in the hospital delivery group. Analysis of maternal postpartum complications showed more recorded uterine atony requiring treatment with oxytocics, in addition to those given immediately after delivery of the placenta, in the hospital delivery group. It can not always be determined whether the differences are a result of intervention and non-intervention in a normal labor, or differences in charting and follow-up of patients. There were no maternal or newborn deaths in this study. Ultimately, both groups had a safe, healthy outcome. This study did not support the philosophy that additional medical and obstetrical procedures rendered in the hospital deliveries results in improved outcome for a low risk pregnancy. Offering options to these women as to type and amount of intervention would seemingly not increase maternal and newborn mortality or morbidity.