Table 3 Quality indicators for low-risk labor care provided primarily by midwives in Japan
No. Indicator | Rating result | Median | Agreement (%)b |
|---|---|---|---|
1. Primipara who has enrolled in a childbirth class about antenatal care and delivery by 36 weeks gestation | adopted | 8 | 8 (72.7%) |
2. Discussed a birth plana | added and adopted | 9 | 11 (100%) |
3. Initial assessment of labor risk at admission | adopted | 7 | 10 (90.9%) |
4. Assessment during first stage labor | adopted | 8 | 8 (72.7%) |
5. Assessment during second stage labor | adopted | 9 | 10 (90.9%) |
6. Women with a term, singleton infant in vertex position delivered by Cesarean section | adopted | 8 | 10 (90.9%) |
7. Women with a term, singleton infant in vertex position delivered by Vaginal delivery | adopted | 9 | 11 (100%) |
8. Women with a term, singleton infant in vertex position delivered by Instrument delivery | adopted | 9 | 11 (100%) |
9. Women with a term, singleton infant in vertex position delivered by labor inductiona | modified and adopted | 8 | 9 (81.8%) |
10. Term infant with Apgar score less than 7 at five minutes after birth | adopted | 9 | 9 (81.8%) |
11. Living infant with birth injuries | adopted | 7 | 9 (81.8%) |
12. Respiratory support: Resuscitation for asphyxiated term neonate with low oxygen concentrations and oxygen saturation measured by pulse oximetry immediately after birtha | added and adopted | 8 | 10 (90.9%) |
13. Women with perineal tear and no episiotomy | adopted | 9 | 11 (100%) |
14. Second degree perineal lacerationa | added and adopted | 8 | 9 (81.8%) |
15. Third or fourth degree perineal laceration | adopted | 8 | 11 (100%) |
16. Postpartum hemorrhage more than 500 g within 2 h of birth | adopted | 8 | 10 (90.9%) |
17. Infant admission to pediatrics department within a week after birth (excludes those with congenital anomalies) | adopted | 8 | 9 (81.8%) |
18. Infants that were fed only breast milk at the time of discharge from the hospital | adopted | 8 | 11 (100%) |
19. Peer review of severe adverse events with medical staff | adopted | 8 | 9 (81.8%) |
20. Woman switched to receive care provided primarily by obstetricians from midwifery ward | adopted | 8 | 11 (100%) |
21. Mother received cessation counseling intervention (including guidance on smoking cessation) if identified as either a tobacco user or passive smoker | adopted | 7 | 6 (54.5%) |
22. Infant administered vitamin K three times by one month after birth | adopted | 9 | 11 (100%) |
23. Infants who had been fed only breast milk at the time of the health examination for children of 1 month of agea | added and adopted | 9 | 11 (100%) |
24. Women with second degree perineal laceration, not due to instrument delivery | not adopted | 1 | 4 (36.4%) |
25. Women that unintentionally retained foreign objects during labor and delivery | not adopted | 5 | 4 (36.4%) |
26. Neonatal bloodstream infections within 48 h of birth | not adopted | 5 | 2 (18.2%) |
27. Medication error made in non-recommended abbreviations, symbols or dose designations used in medical prescriptions | not adopted | 1 | 0 (0%) |
28. Women with complex social factors who were offered additional support and information on public resources | not adopted | 2 | 1 (9.1%) |
29. Women that received antenatal or postnatal guidance regarding body weight and physical activity | not adopted | 6 | 5 (45.4%) |