Care considerations for caesarean births in a non-obstetric hospital

Abstract

Births in non-maternity hospitals pose significant challenges to ensure delivery of safe and effective care. We conducted a retrospective chart review examining the maternal and neonatal demographics and care needs of women delivering in a non-obstetric general hospital over a 10-year period. Cardiac conditions and placenta accreta spectrum disorder were the most common reasons for birth in this location. All 37 births occurred on a weekday, with 29 during core working hours (8 a.m.–4 p.m.). All cases required obstetric, midwifery, anaesthesiology, neonatology and inter-hospital transfer services. Level 3 support was required for 15 women following birth. Neuraxial anaesthesia was utilised in the majority of cases (24/37, 64.8%). One in six infants were breastfed on discharge, with a mean gestational age at birth of 34 weeks. We demonstrate the significant input of the multi-disciplinary and highlight the importance of addressing both obstetric and neonatal considerations outside of their native care setting.