Little difference in deliveries between on-call and regular obstetricians: study

Though many pregnant women worry that their baby won't be delivered by their obstetrician,leading to a lower standard of care, a new study largely puts that concern to rest.

Conducted at Royal Victoria Hospital in Montreal, the study tracked 28,000 deliveries between 1991 and 2001 to determine whether having one's own OBGYN versus an on-call doctor made a difference in the type of delivery.

The study found that almost 77 per cent of deliveries were by the patient's own obstetrician, and 23 per cent byan on-call obstetrician.

The findings are published in the latest issue of the Canadian Medical Association Journal.

The studyfound that women who had their babies delivered by an on-call physician had higher rates of caesarean section 11.9 per cent versus 11.4 per cent of women whose own doctor presided at the delivery.

Women with on-call doctors also had a higher incidence of third- or fourth-degree vaginal tears (7.9 per cent versus 6.4 per cent) and lower rates of episiotomy, a surgical cut made at the opening of the vagina to aid delivery (38 per cent versus 43 per cent).

Women who had their own OBGYNs deliver their babies experienced longer labour, with an average of 557 minutes versus 539 minutes for the on-call group. Fifty-three per cent of the deliveries took place between 7 a.m. and 7 p.m.

Deliveries attended by regular-care obstetricians were also more likely than those attended by on-call obstetricians to be induced, to require administration of oxytocin, a hormone,and to require an epidural.

No differences were observed in birth-weight categories or mean birth-weight between the two groups.

No significant difference in outcomes

Overall, researchers felt the difference in deliveries was minor. "The difference was really marginal," said Dr. Haim Abenhaim, one of the study's authors and an obstetrician at Sainte-Justine Hospital in Montreal.

"When we look at the absolute numbers, they weren't enormous enough for us to feel that they actually make an important enough difference to change the way that we provide obstetrical care."

Jacqueline Lau, a Toronto resident, was happy to have her son Sebastien, now 19 months, delivered by her own OBGYN. Sheechoed the sentiments of many mothers-to-be: "You have a relationship for nine months they know your body inside out."