Main Article Content
low-risk pregnancy, midwives-led care, obstetrics and gynecologist-led care, liability, knowledge, Italy.
Aim. Assessing awareness of Italian low-risk pregnant patients on low-risk pregnancy care and what do they feel about their own pregnancy. Methods. A questionnaire was administered to 382 low-risk pregnant women. This questionnaire assessed general knowledge of low-risk pregnancy, low-risk pregnancy care, and how much patients rated ten topics of low-risk pregnancy care. It would be expected that the knowledge of each topic would associates with the patient’s perceived importance of that topic. Results. Poor knowledge of pregnancy care was proven. Patients seem to incorrectly overrate vaginal examinations and obstetric and gynecologist-led care, while they attribute appropriate importance to midwife-led care. The more examinations performed (vaginal examinations, sonographic checks, cardiotocographies), the higher their rating. Conclusions. In Italy, expectations of pregnant women about their own pregnancy are incorrectly trusted in the obstetrics and gynecologists. Both poor knowledge of pregnancy care and cultural perspectives on the birth process amongst Italian people explain the finding. Referring low-risk pregnant women to midwives would help them to rate more the care than the caregiver.
2. Ricchi A, Rossi F, Borgognoni P, et al. The midwifery-led care model: a continuity of care model in the birth path. Acta Biomed 2019; 90(6-S): 41-52.
3. https://apps.who.int/iris/bitstream/handle/10665/250796/9789241549912-eng.pdf;sequence=1 (accessed 13 Aug 2020).
4. Pozzi N, Cocca F, Pannella G, D’Addona M, Borrelli AC. Obstetric education and neonatal resuscitation at birth: an Italian survey. J Matern Fetal Neonatal Med 2020; doi: 10.1080/14767058.2020.1846701
5. Ferrazzi E, Visconti E, Paganelli AM, et al. The outcome of midwife-led labor in low-risk women within an obstetric referral unit. J Matern Fetal Neonatal Med 2015; 13: 1530-6.
6. Dante G, Neri I, Bruno R, Salvioli C, Facchinetti F. Perinatal and maternal outcomes in a midwife-led centre in Italy: a comparison with standard hospital assistance. Minerva Ginecol 2016; 68: 237-42.
7. Morano S, Cerutti F, Mistrangelo E, et al. Outcomes of the first midwife-led birth centre in Italy: 5 years’ experience. Arch Gynecol Obstet 2007; 4: 333-7.
8. Dani C, Papini S, Iannuzzi L, Pratesi S. Midwife-to-newborn ratio and neonatal outcome in healthy term infants. Acta Paediatr 2020; 109: 1787-90.
9. Svanera C, Nelli E, Colciago E, Fumagalli S. Midwifery-led care for normal childibirth pathway in Lombardy region. Minerva Ginecol 2017; 69: 115-7.
10. https://www.consulenzalegaleitalia.it/responsabilita-medica-ginecologo-ostetrica/ (accessed 18 Jan 2021).
11. http://www.fnopo.it/la-professione.htm (accessed 18 Jan 2021).
12. https://ape.agenas.it/documenti/provider/FNCO_Fed._Naz._Collegi_ostetriche.pdf (accessed 18 Jan 2021).
13. Amaral-Garcia S, Bertoli P, Grembi V. Does experience rating improve Obstetric practices? Evidence from Italy. Health Econ 2015; 24: 1050-64.
14. Indraccolo U, Indraccolo SR, Greco P, Fedeli P. A case of stillbirth caused by rupture of an intrahepatic hemangioma and the wish for litigation. Clin Exp Obstet Gynecol. 2020; 47 (3): 452-4.
15. Verteramo R, Picarelli V, Labianco S, et al. Vaginal deliveries after Cesarean section: heterogeneity of outcome according to the hospital policies in Italy. It J Gynaecol Obstet 2019; 31: 7-12.
16. Indraccolo U, Iannicco AM, Buccioni M, Micucci G. Dangers and expenses of a first-level Obstetric facility: a serious Italian concern. It J Gynaecol Obstet 2015; 27: 121-4.
17. Indraccolo U, Scutiero G, Matteo M, Indraccolo SR, Greco P. Cesarean section on maternal request: should it be formally prohibited in Italy? Ann Ist Sup Sanita 2015; 51: 162-6.
18. Indraccolo U. Punches and knocks to the physicians: choosing wisely or self protection? Recenti Prog Med 2016; 107: 607-8.
19. Davoli M, Colais P, Fusco M. [Give birth in Italy is a “surgical” procedure]. Recenti Prog Med 2016; 107: 559-61.
20. Magnavita N, Heponiemi T. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study. BMC Health Serv Res 2012; 12: 108.
21. Indraccolo U, Scutiero G, Greco P. Correction of the sensitivity reported in the 2015 Italian Society of Obstetrical and Gynecological Ecography (SIEOG) guidelines for the ecographic screening of fetal malformations: a meta-analytic approach. Clin Exp Obstet Gynecol 2018; 45: 651.
22. Frati P, Gulino M, Turillazzi E, Zaami S, Fineschi V. The physician’s breach of the duty to inform the parent of deformities and abnormalities in the foetus: “wrongful life” actions, a new frontiers of medical responsibility. J Matern Fetal Neonatal Med 2014; 27: 1113-7.
23. http://www.snlg-iss.it/cms/files/LG_Gravidanza.pdf (viewed 17 February 2017)
24. http://www.snlg-iss.it/cms/files/LG_Cesareo_finaleL.pdf (viewed 17 February 2017)
25. https://www.sigo.it/wp-content/uploads/2015/12/LineeGuidaSieog_2015.pdf (viewed 30 July 2020).
26. Grivell RM, Alfirevic Z, Gyte GM, Devane D. Antenatal cardiotocography for fetal assessment. Cochrane Database Syst Rev 2015; 2015: CD007863.
27. Hatem M, Sandall J, Devane D, Soltani H, Gates S. Midwife-led versus other models of care for childbearing women. Cochrane Database Syst Rev 2008: CD004667.
28. Wiebe HW, Boulé NG, Chari R, Davenport MH. The effect of supervised prenatal exercise on fetal growth: a meta-analysis. Obstet Gynecol 2015; 125: 1185-94.
29. Bricker L, Medley N, Pratt JJ. Routine ultrasound in late pregnancy (after 24 weeks’ gestation). Cochrane Database Syst Rev 2015: CD001451.
30. https://webarchive.nationalarchives.gov.uk/20130123200917/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_109832 (accessed 30 Jul 2020).
31. Scioscia M, Vimercati A, Cito L, Chironna E, Scattarella D, Selvaggi LE. Social determinants of the increasing caesarean section rate in Italy. Minerva Ginecol 2008; 60: 115-20.
32. Vernero S, Giustetto G. [A survey carried out among Italian physicians regarding non-required clinical examinations, treatments and procedures in the current clinical practice: results and considerations.] Recenti Prog Med 2017; 108: 324-32.
33. https://salute.regione.emilia-romagna.it/siseps/sanita/cedap/files/cedap_rapporto_dati-2018.pdf (accessed 23 Jan 2021).