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Background: The objective was to determine if antenatal anemia is associated with postpartum red blood cell (RBC) transfusion.Study Design and Methods: Women who gave birth at a regional, tertiary care maternity hospital between December 1, 2015, and September 31, 2016, with a documented antenatal hemoglobin (Hb) concentration were included. Women were grouped into those who were either anemic (Hb < 11.0 g/dL) or nonanemic. The change in Hb concentration and RBC transfusion rates were compared between the anemic and nonanemic women, as well as by the mode of delivery (vaginal vs. Cesarean). To estimate the volume of blood loss in a normal delivery, the mean postpartum Hb concentration decrease for the not transfused women was calculated by subtracting the nadir postpartum Hb concentration from the antenatal Hb concentration and averaging these concentrations according to delivery route.Results: Of 8039 cases analyzed, 1562 (19%) had antenatal anemia and 6477 (81%) were nonanemic. Of the anemic women, 57 (3.6%) received an RBC transfusion compared to 49 (0.76%) of the nonanemic women (p = 0.0001; odds ratio, 4.97; 95% confidence interval, 3.38-7.31). Antenatal anemia was significantly associated with receiving an RBC transfusion regardless of mode of delivery for those who delivered vaginally (p = 0.0001) or by Cesarean (p = 0.0001) compared to those who were nonanemic. The mean postpartum Hb concentration decrease was 1.12 ± 1.12 g/dL for vaginal deliveries and 1.34 ± 0.21 g/dL for Cesarean deliveries in the not transfused women (p = 0.0001).Conclusion: Although the overall rate of transfusion was low, antenatal anemia was significantly associated with receiving a postpartum RBC transfusion. [ABSTRACT FROM AUTHOR]

Background For safety reasons an in-hospital birth center was replaced by a modified form of birth center care with the same medical guidelines and equipment as in standard care. The aim of this study was to investigate women's and men's satisfaction with modified care compared with standard care. Methods Women in both groups gave birth from July 2007 to July 2008. The same medical low-risk criteria during pregnancy applied to both groups. Of those invited to the study, 547 (82.7%) women in modified birth center care and 445 (66.7%) men returned a questionnaire posted 2 months after the birth, and 786 (71.6%) women and 639 (58.2%) men in standard care. Odds ratios ( ORs) for being satisfied were calculated with 95 percent confidence intervals ( CIs) and adjusted for possible confounders. We also explored the effects of different components of care on overall satisfaction. Results Adjusted ORs for being satisfied overall were approximately doubled in the modified birth center group compared with the standard care group: antenatal care- OR: 2.1 (95% CI: 1.6-2.7) in women and OR: 2.2 (95% CI: 1.5-2.8) in men; intrapartum care- OR: 2.2 (95% CI: 1.7-2.9) in women and OR: 1.7 (95% CI: 1.3-2.4) in men; and postpartum care- OR: 1.7 in women (95% CI: 1.4-2.2) and OR: 2.1 (95% CI: 1.6-2.8) in men. Important explanations of these differences included perception of the midwife as being more supportive, the presence of a calmer environment and atmosphere (intrapartum), and the option for fathers to stay overnight (postpartum). Conclusion In-hospital birth center with medical equipment on site increased overall satisfaction with all episodes of care compared with standard care. ( BIRTH 39:2 June 2012) [ABSTRACT FROM AUTHOR]