Bibliographic record
Abstract
Throughout the literature varying opinions exist concerning the health outcomes, service utilization and patient satisfaction as they relate to maternal and infant care given by physicians versus midwifery care. This study looks at the following question; what differences are there in health outcomes, service utilization, and patient satisfaction, between women who are cared for by either physicians or midwives and vaginally deliver a singleton healthy baby in hospital? This study employs a secondary analysis of data from the TOMIS II study. The TOMIS II data was collected from 250 women in each of five hospital sites in Ontario in 2002. The analysis showed that, except for the breastfeeding, all of the measures of maternal and infant health outcome did not statistically differ between physician-care and midwifery care. With respect to service utilization, the results indicated that family physician visits, length of stay, and utilization of the Healthy babies, Healthy Children (HBHC) resulted in statistically significant lower service utilization by mothers in the midwifery group, while the other measures were found not to be different. Patient satisfaction measures revealed that women receiving midwifery services were much more satisfied with their care than were women receiving physician-based services. Five conclusions were drawn from this study; midwifery care is a viable option for maternity care in Ontario for low-risk birth mothers; the utilization of midwives reduces the total amount of services being used in the health care system; women are more satisfied with their care when they have midwives participating in all parts of their care; health policy in Ontario should focus its efforts to expand midwifery to make it a viable option for maternal and infant care to all healthy women; health care policy should support publicly funded midwifery in each of the jurisdictions in Canada, as a cost-effective approach to care with comparable outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".