Le basi scientifiche

Gli studi più recenti

Una recente pubblicazione (Cochrane Review) giunge alla conclusione che le donne assistite con cure ostetriche gestite da levatrici, presentano esiti migliori dal punto di vista della salute che non quelle seguite con il modello di assistenza medica convenzionale. Vedi qui.

La prestigiosa rivista scientifica Lancet ha recentemente pubblicato un’analisi dei costi di un sistema di cure ostetriche gestite da levatrici. I risultati di questa ricerca hanno mostrato che questi modelli sono altrettanto sicuri, ma meno costosi dell’assistenza medica convenzionale. Vedi qui.

Questi importanti risultati sono riassuntie e commentati nelle seguenti pubblicazioni: „The conversation“ come pure “The Independent“

Riferimenti
(complemento alla sezione "per saperne di più")

N° 1: Confronti fra modelli con assistenza globale diretta da levatrici e assistenza standard abituale

Bauer, N.H. H. (2011) Der Hebammenkreißsaal. Ein Versorgungskonzept zur Förderung der physiologischen Geburt. Osnabrück: Universitätsverlag bei V&R unipress.

Bauer, N.H., Schücking, B.A., Pohlabeln, H., zu Sayn-Wittgenstein ,F. (2011) Der Hebammenkreißsaal - Ein klinisches Versorgungskonzept zur Förderung der physiologischen Geburt. Z Geburtshilfe Neonatol DOI: 10.1055/s-0031-1293234 -

Bauer, N.N., & Schücking,(2009) „Habe mich sehr gut aufgehoben gefühlt. Meine Fragen wurden jederzeit beantwortet.“- Nutzerinnenorientierung in der Geburtshilfe-Interventionsstudie Versorgungskonzept Hebammenkreißsaal, Z Geburtshilfe Neonatol, DOI: 10.1055/s-0029-1222734

Begley, C., Devane, D., Clarje, M., McCann, C., Hughes, P., Reilly, M., et al. (2011).Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial. BMC Pregnancy and Childbirth,11(85).

Birthplace in England Collaborative Group. (2011). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ, 343d7400. doi:10.1136/bmj.d7400.

Campbell, R., MacFarlane, A., Hempsall, V., Hatchard, K. (1999). Evaluation of midwife-led care provided at the Royal Bournemouth Hospital. Midwifery 15, 183-193.

Cignacco, E., Büchi, S. (2004). „Hebammengeburt” – ein neues Betreuungsmodell in der Schweiz. Die Hebamme, 17,: 84-90.

Cignacco, E., Büchi, S., Oggier, W. (2004). Hebammengeleitete Geburtshilfe in einem Schweizer Spital. Pflege, 17, 253-261.

Bodner-Adler, B., Bodner, K., Kimberger, O., Lozanov, P., Husslein, P., Mayerhofer, K. (2004). Influence of the birth attendant on maternal and neonatal outcomes during normal vaginal delivery: a comparison between midwife and physician management. Wiener Klinische Wochenschrift, 30; 116. 379-384.

Cheung, N., Mander, R., Wang, X., Fu, W., Zhou, H., & Zhang, L. (2011). Clinical outcomes of the first midwife- led normal birth unit in China: a retrospective cohort study. Midwifery, 27, 582-587.

Davis, D., Baddock, S., Pairman, S., Hunter, M., Benn, C., Wilson, D., et al. (2011). Planned Place of Birth in New Zealand: Does it Affect Mode of Birth and Intervention Rates among Low-Risk Women? Birth, 38, 111- 119.

Dixon, L., Prileszky, G., Guilliland, K., Hendry, C., Miller, S., Anderson, J. (2012). What evidence supports the use of free-standing midwifery led units. New Zealand College of Midwives Journal. 46, p13.

Eide, B., Nilsen, A., & Rasmussen, S. (2009). Births in two different delivery units in the same clinic - A prospective study of healthy primiparous women. BMC Pregnancy and Childbirth, 9(25).

Gülmezoglu, AM., Souza, JP., Taneepanichskul, S., Ruyan, P., Attygalle, DE., Shrestha, N., Mori, R., Nguyen, DH., Hoang, TB., Rathavy, T., Chuyun, K., Cheang, K., Festin, M., Udomprasertgul, V., Germar, MJ., Yanqiu, G., Roy, M., Carroli, G., Ba-Thike, K., Filatova, E., Villar, J. (2010). Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08, The Lancet, 375,(9713), 490-99.

Hatem M, Sandall J, Devane D, Soltani H, Gates S. (2008). Midwife-led versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD004667. DOI:

Hodnett, E.D., Downe, S., Walsh, D., Weston, J., (2010). Alternative versus conventional institutional settings for birth. Cochrane Database of Systematic Reviews 9. doi:10.1002/14651858.CD000012.pub3, art. no. CD000012.

Hundley, V., Cruikckshank, F. M., Lang, G. D., Glazener, C. M. A., Milne, J. M., Turner, M., Blyth, D., Mollison, J., Donaldson, C. (1994). Midwife managed delivery unit: a randomised controlled comparison with consultant led care. BMJ, 309: 1400-1404.

Hundley, V., Milne, J., Glazener, C., Mollison, J. (1997). Satisfaction and the three C’s: continuity, choice and control. Women’s views from a randomised controlled trial of midwife-led care. Br J Obstet Gynaec, 104: 1273-1280.

Janssen, P. A., Saxell, L., Page, L., Klein, M., Liston, R., Lee, S. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician, CMAJ, 181(6-7): 377–383. doi: 10.1503/cmaj.081869

Laws, P., Tracy, S., & Sullivan, E. (2010). Perinatal outcomes of women intending to give birth in birth centers in Australia. Birth, 37(1), 28-36.

MacVicar, J., Dobbie, G., Owen-Johnstone, L., Jagger, C., Hopkins, M. (1993). Simulated home delivery in hospital: a randomized controlled trial. Br J Obstet Gynaec, 100, 316-323.

McCourt, C., Rance, S., Rayment, J., & Sandall, J. (2011). Birthplace qualitative organizational case studies: how maternity care systems may affect the provision of care in different birth settings .Birthplace in England research programme. Final report part 6: NIHR Service Delivery and Organisation programme. Available from http://www.netscc.ac.uk/hsdr/files/project/SDO_FR6_08-1604-140_V02.pdf

Oakley, D., Murray, M., Murtland, T., Hayashi, R., Andersen, H., Mayes, F., Rooks, J. (1996). Comparisons of Outcomes of Maternity Care by Obstetricians and Certified Nurse-Midwives. Obstetrics & Gynaecology, 88, 823-829.

Overgaard, C., A Moller, Fenger-Gron, M., Knudsen, L., & Sandall, J. (2011). Freestanding midwifery unit versus obstetric unit: a matched cohort study of outcomes in low-risk women. BMJ Open, 2(e000262). doi:10.1136/bmjopen-2011-000262, available from http://bmjopen.bmj.com/content/1/2/e000262.full

Rath, M.E. (2012). Hebammengeleitete Schwangerenvorsorge im Vergleich zu anderen Betreuungsmodellen, Die Hebamme, 25(4), 236-240

Rogers, C., Harman, J., & Selo-Ojeme, D. (2011). Perceptions of birth in a stand-alone centre compared to other options. British Journal of Midwifery, 19(4).

Rutledge Stapleton, S., Osborne, C., Illuzzi, J. (2013). Outcomes of Care in Birth Centers: Demonstration of a Durable Model Original Review Journal of Midwifery &Women’s Health doi:10.1111/jmwh.12003 available from http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12003/full

Scarella, A., Chamy, V., Sepúlveda, M., Belizán, J. (2011). Medical audit using the Ten Group Classification System and its impact on the cesarean section rate. European Journal of Obstetrics & Gynecology and Reproductive Biology, 154, 136–140.

Sinni, S.V., Wallace, E.M., Cross, W.M., (2011). Patient safety: a literature review to inform an evaluation of a maternity service. Midwifery, 27 (6), e274–e278.

Skinner, J., & Lennox, S. (2006). Promoting normal birth: a case for birth centres. New Zealand College of Midwives Journal, 34, 15-18.

Soltani H, Sandall J. (2012). Organisation of maternity care and choices of mode of birth: a worldwide view. Midwifery, 28(2):146-9. doi: 10.1016/j.midw.2012.01.009.

Stewart, M., McCandish, R., Henderson, J., & Brocklehurst, P. (2004). Report of a structured review of birth centre outcomes. United Kingdom: Maternity Research Group of the National Service Framework for Children, Young People and Maternity Services. Available from https://www.npeu.ox.ac.uk/files/downloads/reports/Birth-Centre-Review.pdf

Sutcliffe, K., Caird, J., Kavanagh, J., Rees, R., Oliver, K., Dickson, K., Woodman, J., Barnett-Paige, E., Thomas, J. (2012). Comparing midwife-led and doctor-led maternity care: a systematic review of reviews. J Adv Nurs. ,68(11). 2376-86. doi: 10.1111/j.1365-2648.2012.05998.x.

Symon, A., Winter, C., Inkster, M., & Donnan, P. (2009). Outcomes for births booked under an independant midwife and births in NHS maternity units: matched comparison study. BMJ, 338,b2060 http://dx.doi.org/10.1136/bmj.b2060.

Tracy, S., Caplice, S., Laws, P., Wang, Y., Tracy, M., & Sullivan, E. (2007). Birth centers in Australia: A national population-based study of perinatal mortality associated with giving birth in a birth center. Birth, 34, 194-201.

Turnbull, D., Holmes, A., Shields, N., Cheyne, H., Twaddle, S., Gilmour, W., McGinley, M. (1996). Randomized, controlled trial of efficiacy of midwife-managed care. The Lancet, 348, 213-218.

Waldenstrom, U., Nilsson, C.A., (1997). A randomized controlled study of birth centre care versus standard maternity care: effects on women’s health. Birth, 24, 17–26.

Waldenstrøm, U., Nilsson, CA; Winbladh, B. (1997). The Stockholm Birth Centre Trial: maternal and infant outcome. British Journal of Obstretics and Gynaecology; 104: 410, 418.

Waldenstrøm, U., Turnbull, D. (1998). A systematic review comparing continuity of midwifery care with standard maternity services. Br J Obstet Gynaec 105, 1160-1170.

Walsh, D., & Downe, S. (2004). Outcomes of Free-Standing, Midwife-Led Birth Centers: A Structured Review. Birth, 31(3), 222-229.

Walsh, D., Devane, D. (2012). A metasynthesis of midwife-led care. Qual Health Res. J, 22(7), 897-910. doi: 10.1177/1049732312440330.

N° 2: Fattori che influiscono sulla scelta del luogo dove partorire

Houghton, G., Bedwell, C., Forsey, M., Baker, L., & Lavender, T. (2008). Factors influencing choice in birth place - an exploration of the views of women and their partners and professionals. Evidence Based Midwifery, 6(2), 59-64.

N° 3: Tassi di parti cesarei in Svizzera

BAG Bundesamt für Gesundheit, Qualitätsindikatoren der Schweizer Akutspitäler (2012). verfügbar unter: http://www.bag.admin.ch/hospital/index.html?webgrab_path=aHR0cDovL3d3dy5iYWctYW53LmFkbWl uLmNoL2t1di9zcGl0YWxzdGF0aXN0aWsvcG9ydGFsX2RlLnBocD9sYW5nPWRlJmFtcDtuYXZpZD1xaXNz&la ng=de

BFS Bundesamt für Statistik Gesundheit, Medienmitteilungen 26.11.2012 , Statistiken der stationären Gesundheitsversorgung 2011: Provisorische Zahlen, verfügbar unter http://www.bfs.admin.ch/bfs/portal/de/index/themen/14/22/press.html?pressID=8416

N° 4: Le ragioni del parto cesareo

Betrán, AP., Merialdi, M., Lauer, JA., Bing-Shun, W., Thomas, J., Van Look, P., Wagner, M: (2007). Rates of caesarean section: analysis of global, regional and national estimates. Paediatric and Perinatal Epidemiology, 21(2). 98-113.

Niino, Y: (2011). The increasing caesarean rate globally and what we can do about it. BioScience Trends; 5(4): 139-150.

Stjernholm,Y., Petersson, K., Eneroth, E. (2010). Changed indications for cesarean sections. Acta Obstetricia et Gynecologica, 89(1). 49-53.

Wagner, M. (2000). Choosing caesarean section. The Lancet, 356(9242).1677-80.

N° 5: Quali tassi di parti cesarei sono giustificati?

WHO/OMS Policy brief (2010). Caesarean section without medical indication increases risk of short-term adverse outcomes for mothers. Verfügbar unter http://whqlibdoc.who.int/hq/2010/WHO_RHR_HRP_10.20_eng.pdf

WHO/OMS World Health Report. (2010). The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage , Background Paper, 30 verfügbar unter: http://www.who.int/healthsystems/topics/financing/healthreport/30C- sectioncosts.pdf

N° 6: Le donne auspicano un parto fisiologico e non un cesareo

Lutz, U., Kolip, P., (2006) Die GEK-Kaiserschnitt-Studie , Siegburg: Asgard Verlagsservice GmbH. verfügbar unter: http://www.ipp.uni-bremen.de/downloads/abteilung2/projekte/GEK_Kaiserschnittstudie.pdf

N° 7: Conseguenze a corto e a lungo termine del parto cesareo

Huh, S Y., Rifas-Shiman, S L., Zera, C. A., Rich Edwards, J W., Oken, E., Weiss, S T., Gillman, M. W. (2012). Delivery by ceasarean section and risk of obesity in pre-school age: a prospective cohort study. British Medical Journal , 97, (7)

Lutz, U., Kolip, P., (2006) Die GEK-Kaiserschnitt-Studie., Siegburg: Asgard Verlagsservice GmbH. verfügbar unter: http://www.ipp.uni-bremen.de/downloads/abteilung2/projekte/GEK_Kaiserschnittstudie.pdf

Niino, Y: (2011). The increasing caesarean rate globally and what we can do about it. BioScience Trends; 5(4): 139-150

Souza, JP., Gülmezoglu, A., Lumbiganon, P., Laopaiboon, M., Carroli, G., Fawole, B., Ruyan, P. (2010). Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004–2008 WHO Global Survey on Maternal and Perinatal Healt. BMC Medicien, 8 (1):71. Available from http://www.biomedcentral.com/content/pdf/1741-7015-8-71.pdf

Villar, J., Carroli, G., Zavaleta, N., Donner, A., Wojdyla, D., Faundes, A., Velazko, A., Bataglia, V., Langer, A., Narváez, A., Valladares, E., Shah, A., Campodónico, L., Romero, M., Reynoso, S., Simônia de Padua, K., Giordano, D., Kublickas, M., Acosta, A. (2007). Survey on Maternal and Perinatal Health Research Group: Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ, 335:1025

WHO/OMS World Health Report. (2010). The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage , Background Paper, 30 Avialable from http://www.who.int/healthsystems/topics/financing/healthreport/30C- sectioncosts.pdf

N° 8: Le donne sottovalutano il cesareo; cosa sanno le donne del cesareo

Meiman, M. C. Heather, H,(2012), Women's knowledge of options for birth after Caesarean Section, Women and Birth. 25(3):e19-26. doi: 10.1016/j.wombi.2011.08.001.

N° 9: Le/gli esperte/i vedono la levatrice in una posizione chiave

Hodnett, ED., Gates, S., Hofmeyr, GJ., Sakala, C., Weston, J.. (2011). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD003766

WHO/OMS (2002). Strategic Directions for Strengthening Nursing and Midwifery Services. Verfügbar unter http://whqlibdoc.who.int/publications/2002/924156217X.pdf

Wagner, M. (2001). Fish can’t see water: the need to humanize birth. International Journal of Gynecology & Obstetrics,75, 25-37

N° 10: Le levatrici sono il miglior sostegno per le donne

Niino, Y: (2011). The increasing caesarean rate globally and what we can do about it. BioScience Trends; 5(4): 139-150

N° 11: Tassi di cesarei ridotti nei modelli di unità per cure ostetriche dirette da levatrici

Bernitz, S., Rolland, R., Blix, E., Jacobson, M., Sjoborg, K., & Oian, P. (2011). Is the operative delivery rate in low- risk women dependant on the level of birth care? A randomised controlled trial. BJOG An International Journal of Obstetrics and Gynaecology, 118(11), 1357-1364.

Catling-Paull, C., Johnston, R., Ryan, C., Foureur, M., Homer, C. (2011): Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review. Journal of advanced Nursing, 67(8), 1662–1676.

Chaillet, N., Dumont, A. (2007). Evidence-Based Strategies for Reducing Cesarean Section Rates: A Meta- Analysis. Birth. 34(1), 53

Continuous Labor Support Reduces Risk of Cesarean Section and Other Adverse Outcomes in Women and Newborns

Cheung, N., Mander, R., Wang, X., Fu, W., Zhou, H., & Zhang, L. (2011). Clinical outcomes of the first midwife- led normal birth unit in China: a retrospective cohort study. Midwifery,27, 582-587.

Davis, D., Baddock, S., Pairman, S., Hunter, M., Benn, C., Wilson, D., et al. (2011). Planned Place of Birth in New Zealand: Does it Affect Mode of Birth and Intervention Rates Among Low-Risk Women? Birth, 38, 111- 119.

Maassen, M., Hendrix, M., Vugt, H. V., Veersema, S., Smits, F., & Nijhuis, J. (2008). Operative deliveries in low- risk pregnancies in the Netherlands: Primary verses secondary care. Birth, 35(4), 277-282

McLachlan, HL., Forster, DA ., Davey, MA., Farrell, T,. Gold, L .,e Biro, MA., Albers, L., Flood, M., Oats, J., Waldenstroem, U. (2012) Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial BJOG An International Journal of Obstetrics and Gynaecology, 119(12), 1483-92. doi: 10.1111/j.1471- 0528.2012.03446.x

Niino, Y: (2011). The increasing caesarean rate globally and what we can do about it. BioScience Trends; 5(4): 139-150.

Van Dillen, J., Lim, F., Van Rijssel, E. (2008). Introducing caesarean section audit in a regional teaching hospital in The Netherlands. European Journal of Obstetrics & Gynecology and Reproductive Biology 139. 2008; 151–156.

N° 12: Costi delle cure ostetriche dirette da levatrici confrontati con i costi delle cure standard.

Childbirth Connection, Catalyst for Payment Reform, Center for Healthcare Quality and Payment Reform (2013) The Cost of having a Baby in ihe United States, The Truven Health Analytics Marketscan Study, Available online from http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a- Baby-Executive-Summary.pdf

Henderson, J., & Petrou, S. (2008). Economic Implications of Home Briths and Birth Centers: A Structured Review. Birth, 35(2), 136-146

Homer, C.S., Matha, D.V., Jordan, L.G., Wills, J., Davis, G.K., (2001). Community-based continuity of midwifery care versus standard hospital care: a cost analysis. Australian Health Review: A Publication of the Australian Hospital Association, 24(1). 85-93.

Hundley, V.A., Donaldson, C., Lang, G.D., et al., (1995). Costs of intrapartum care in a midwife-managed delivery unit and a consultant-led labour ward. Midwifery ,11, 103–109.

Ryan P, Revill P, Devane D, Normand C. (2012). An assessment of the cost-effectiveness of midwife-led care in the United Kingdom. Midwifery. In Press, Corrected Proof, Available online from http://dx.doi.org/10.1016/j.midw.2012.02.005

Schroeder, E., Petrou, S., Patel, N., Hollowell, J., Puddicombe, D., Redshaw, M., et al.,(2012). Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. British Medical Journal 344,e2292.

Stone, P.W., Zwanziger, J., Hinton Walker, P., Buenting, J., (2000). Economic analysis of two models of low-risk maternity care: a freestanding birth centre compared to traditional care. Research in Nursing & Healt, 23, 279–289.

Toohill, J., E. Turkstra, et al. (2012). "A non-randomised trial investigating the cost-effectiveness of Midwifery Group Practice compared with standard maternity care arrangements in one Australian hospital." Midwifery 28(6), e874-e879.

Tracy, S.K., Tracy, M.B., (2003). Costing the cascade: estimating the cost of increased obstetric intervention in childbirth using population data. BJOG, 110, 717–724.

Altri riferimenti

Biró, M., Waldenstrøm, U., Brown, S., Pannifex, J. (2003). Satisfaction with Team Midwifery Care for Lowand High risk Women: A Randomized Controlled Trial. Birth, 30 , 1-10.

Büchi, S. (2013). Hebammegeburten - ein attraktives Geburtsmodell für schwangere Frauen und für Hebammen im Spital, hebamme.ch, 3, 26-30.

Bundesamt für Gesundheit BAG (2013).Kaiserschnittgeburten in der Schweiz, Synthese wissenschaftlicher Analysen, Grundlagenbericht zur Beantwortung des Postulates Maury Pasquier http://www.bag.admin.ch/themen/medizin/13641/index.html?lang=de&download=NHzLpZeg7t,lnp6I0 NTU042l2Z6ln1acy4Zn4Z2qZpnO2Yuq2Z6gpJCLdX18fWym162epYbg2c_JjKbNoKSn6A—

Bundesamt für Gesundheit BAG (2013,) Kaiserschnittgeburten in der Schweiz, Bericht in Erfüllung des Postulates Maury Pasquier, http://www.bag.admin.ch/themen/medizin/13641/index.html?lang=de&download=NHzLpZeg7t,lnp6I0 NTU042l2Z6ln1acy4Zn4Z2qZpnO2Yuq2Z6gpJCLdX18e2ym162epYbg2c_JjKbNoKSn6A—

Hartz, D. L., M. Foureur, et al. (2012). Australian caseload midwifery: The exception or the rule. Women and Birth 25(1): 39-46.

König, M. & Schildberger, B. (2013) Hebammengeleitete Geburtshilfe in Österreich – Selbstbestimmung, Verantwortung und Wahlfreiheit, hebamme.ch, 3, 31-33.

Künzi K., Detzel P. (2007) Innovationen in der ambulanten Grundversorgung durch vermehrten Einbezug nichtärztlicher Berufsleute. Neuchâtel, verfügbar unter http://www.obsan.admin.ch/bfs/obsan/de/index/01/02.html?publicationID=2951.

Maury Pasquier, L. (2010). Hebammen Ein Berufsstand: Umfassende Betreuung/Begleitung, hebamme. ch,11, 4-5.

Nielsen, R. (2013). Das Modell Hebammekreissaal wird sich auf die Dauer etablieren, hebamme.ch, 33-35.

Sayn-Wittgenstein, F. zu (Hrsg.) (2007). Geburtshilfe neu denken. Bericht zur Situation und Zukunft des Hebammenwesens in Deutschland. Bern: Verlag Hans Huber. März 2013 /mh

Schweizerischer Hebammenverband SHV Informations- und Positionspapier zur hohen Kaiserschnittrate in der Schweiz, 2. Dezember 2008, verfügbar unter http://www.hebamme.ch/x_data/allgdnld//kaiserschnittrated.pdf

Soltani, H. and J. Sandall (2012). "Organization of maternity care and choices of mode of birth: A worldwide view." Midwifery 28(2): 146-149.

Verbund Hebammenforschung Fachhochschule Osnabrück (2007).Handbuch Hebammenkreissaal, von der Idee zur Umsetzung, , verfügbar unter http://www.hebammenforschung.de/fileadmin/groups/95/Handbuch_Hebammenkreisssaal.pdf

Zecha, G.(2013). Hebammenkreissaal – ein Gewinn für alle Beteiligten, hebamme.ch, 33-37.

Le basi scientifiche

Gli studi più recenti

Riferimenti(complemento alla sezione "per saperne di più")

Riferimenti
(complemento alla sezione "per saperne di più")