A study in Obstetrics & Gynecology found that rates of cesarean delivery at Marin General Hospital in California decreased to 25% from 31.7% after the provider implemented a collaborative midwife/laborist model. The rate of vaginal birth after cesarean rose to 22.4%, up from 13.3% under the hospital's previous private practice model.
An increasing number of hospitals are moving away from relying solely on on-call obstetricians and hiring staff obstetric hospitalists, or laborists. Obstetrician and gynecologist Caroline Keller said the availability of laborists can be a comfort for patients. A single-center study in the American Journal of Obstetrics and Gynecology found that the presence of full-time laborists was associated with a reduction in the rate of cesarean sections.
Decreases in the rates of preterm birth and induced labor were associated with hospitals' use of laborists, researchers from the University of Pennsylvania in Philadelphia reported at a Society for Maternal-Fetal Medicine meeting. Similar results were found at hospitals with round-the-clock access to laborists in a study from the University of California at San Francisco.
Laborists or OB hospitalists are a new addition to some hospital staffs and aid in delivering babies for other physicians' patients. The specialty is designed to fill the gap caused by a growing number of Ob-Gyns who have stopped delivering babies because of high malpractice insurance costs or scheduling constraints. It is a switch for patients, too, who don't meet the physician who is going to delivery their baby until they get to the hospital.