• Marianne M P Mead and Diane Kornbrot.
• Department of Midwifery and Child, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK.
• Midwifery. 2004 Mar 1; 20 (1): 15-26.

ObjectiveTo develop an intrapartum intervention scoring tool which could be used to define maternity units as either 'lower intrapartum intervention' or 'higher intrapartum intervention' units. This scoring tool was designed to form the basis of a comparison of the perception of risk by midwives working in either 'lower intrapartum intervention' or 'higher intrapartum intervention' units.DesignThree aspects were included: (1) the systematic data reduction of the St. Mary's Maternity Information System database used by 11 maternity units to include Caucasian nulliparous women suitable for midwifery-led care; (2) the calculation and the ranking of frequency distributions for the following interventions/management: (a) the management of breech presentation and of one previous caesarean section, the choice of home birth; and (b) augmentation of labour, use of electronic fetal monitoring, use of epidural, method of delivery; (3) the sum of the individual intrapartum ranking marks made up the final intrapartum score for each unit.ResultsIntrapartum interventions varied considerably between units. The scoring system enabled units to be described as either 'Lower intrapartum intervention' or 'Higher intrapartum intervention' units.ConclusionsRoutinely collected computerised data can be used to identify the outcomes of intrapartum care. This study suggests that the analysis of computerised data could provide a suitable basis for the audit and the comparison of intrapartum interventions for the care of women suitable for midwifery-led care.

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