Primary outcome
The rate of the composite adverse maternal outcome was statistically higher among the low annual volume group (9.8% vs. 9.4%, p<0.01). However, a multivariate regression analysis adjusting for: maternal age, parity, TOLAC, oxytocin augmentation, persistent occipito-posterior presentation and CNMs’ practice duration, revealed no significant association between low annual volume and composite adverse maternal outcomes, aOR 1.01, 95% CI [0.97-1.05].