Midwives autonomy in discharge women after physiological childbirth

BACKGROUND: International literature identifies the midwife as the professional figure deals with women and newborns in the context of childbirth; it is however found to be still difficult to ensure this continuity of care. In Italy both the national laws and the indications of Emilia Romagna region promote this practice, ensuring the midwives management of the low risk women immediately after childbirth. The aim of the study is to investigate and describe the midwives autonomy as regards the post-partum discharge. METHODS: The computerised medical records were consulted to identify the mothers after childbirth who can be discharged independently by the obstetrician following the guidelines of the Emilia-Romagna region. RESULT S: A retrospective analysis of 1371 medical records related to the period January-June 2017 showed that 41% of discharges were managed handled by the midwives, while the remaining 59% by obstetricians. Fifty-seven percent of the women followed by the family counselling service were discharged by the obstetricians and 43% independently by the midwives. Considering the women followed by a private physician 62% were discharged by the obstetricians and 38% by the midwives. CONCLUSIONS: The study shows that, in a short time from the beginning of the project, the results as regards midwives autonomy were excellent. Indeed the midwives discharges does not differed significantly from the medical ones, and care continuity between the hospital and territory is strengthened. Further studies must include questionnaires concerning satisfaction of the mother not administered in this sample of women