Genveje


Medicalization in childbirth – unintended consequences of interventionsMedicalization in childbirth – unintended consequences of interventions

Intervention rates in pregnancy and childbirth have been increasing over a longer period nationally. The aim of the ph.d is to map the unintended consequences of this change in practice.

This study will be the first in-depth study to evaluate Danish birth practices over the past decades with a focus on reasons for and consequences of interventions.  

An increasing number of women receive interventions, and since interventions per se can cause short or long-term consequences, the results are of substantial public health relevance. High intervention rates can pull resources away from other services in overloaded health systems, and the results can contribute to professional and political decisions on the organization of maternity care. Results can be used to improve patient safety and possibly also to reduce cost in childbirth.

Om projektet og resultater

The PhD includes three studies, all using national register data but with different methodological approaches. The study population consists of all live- and stillborn children in Denmark 1998-2015 (N~1,100,000) and their mothers. 

Data include information from The Danish National Patient Register, The Danish Medical Birth Registry, The Danish National Diabetes Register, The Danish Register of Causes of Death, The Danish Pathology Register, and Statistics Denmark. The dataset is situated at Statistics Denmark and was established by the Midwifery Department, Copenhagen, as part of the quality assessment study MIPAC.

The 3 studies of the ph.d:

#1a Medicalization in birth care 1 – is there a correlation between changes in population characteristics and the rise in obstetric interventions during the years 1998-2015?

#1b Medicalization in birth care 2 – is there a change in obstetric interventions for low risk women during the years 1998-2015?

#2 Have numbers of interventions increased over time for the individual woman in birth? – Is there a possible cascade effect of interventions in Danish obstetric practice during the years1998-2015?

The planned 3-4 papers will be published in international, peer-reviewed, scientific journals, preferably with open access. The results will further be disseminated by professional, clinically-oriented events. Finally, I plan on completion a conference of Danish / Nordic midwives where implications for practice are discussed. 

Samarbejdspartnere

PhD-admission: Graduate School of Health Sciences, Aarhus University

Project group:
Eva Rydahl, Midwife, Master in Health Science, Lecturer at Department of Midwifery, Metropolitan University College, Copenhagen 
Main supervisor: Rikke Damkjær Maimburg, Midwife, MPH, PhD, Associate Professor at Department of Clinical Medicine, Aarhus University Hospital & Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark, is main supervisor for the entire project. 
Co-supervisor: Mette Juhl, Midwife, MPH, PhD, Associate Lecturer (Danish: Docent) at Department of Midwifery, Metropolitan University College, Copenhagen, and Associate Professor at Dep. Public Health, University of Copenhagen. 

Additional collaborators:
Laust Hvas Mortensen, Associate Professor of Epidemiology the University of Copenhagen
Ole Olsen; Statistician, The Research Unit for General Practice. University of Copenhagen.
Eugene Declercq, Professor at Department of Community Health Sciences, Boston University School of Public Health, US.

The study is supported financially by The Danish Association of Midwives, Herlev Hospital, and Metropolitan University College, Copenhagen.

​Read more about Eva Rydahl on UC-viden

Tidsplan 

1/3/2016 – 18/1/2020

FoU-miljø og institut

The Bachelor’s Program in Midwifery, Metropolitan University College, Institute of Nutrition and Midwifery. 

Kontakt

Eva Rydahl

Lektor, Ph.d.-studerende

Tlf.: +45 51380409