This study supports the provision of care in freestanding midwifery selleckchem units as an alternative to tertiary level maternity units for women with low-risk pregnancies at the time of booking. Clinicians and policy makers may find these results useful in the planning and preservation of maternity services in areas where midwifery-only care is available in freestanding midwifery units. There is also scope for the development of standardised national protocols on freestanding midwifery units to improve the transparency of transfers and support the processes of development and evaluation. Further investigation into complex and longer term measures of

perinatal morbidity, transfer and the viability of freestanding midwifery units in rural/remote settings is required. Supplementary Material Author’s manuscript: Click here

to view.(2.1M, pdf) Reviewer comments: Click here to view.(194K, pdf) Acknowledgments The authors thank the midwives, managers, physicians and data custodians at the participating maternity units for their advice and cooperation. Footnotes Contributors: ST was the chief investigator of the Evaluating Midwifery Units study, and led its design and coordination. ST, AM, CG, MT and MF were involved in the design of the study. CG was responsible for coordinating the New Zealand arm of the study. MT conducted data analysis and provided statistical advice. AM, ST and MT were involved in interpreting the data. AM was responsible for coordinating the Australian arm of the study, including data collection, cleaning of the data, data analyses and interpretation. She drafted the manuscript and wrote the final version. All authors critically revised the manuscript, provided comment and approved the final version for publication. Funding: The Evaluating Midwifery Units study was funded by the National Health and Medical Research Council of Australia ((NHMRC) Evaluating Maternity Units–Grant Application

Number 571901). The grant wholly supported the study for a period of 3 years. The NHMRC did not have a role in the study design, in the collection, analysis or interpretation Anacetrapib of the data, the writing of the report or the decision to submit this article for publication. Competing interests: None. Ethics approval: The study was approved by the Northern Sydney Local Health District Ethics Committee, the Hunter New England Human Research Ethics Committee and The University of Sydney Human Research Ethics Committee (NSW HREC reference number: HREC/09/HNE/78). Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available.
Defective medicines are a major public health problem.1–4 Different surveys in lower income countries and lower middle income countries have found that defective medicines are readily available.