Continuity of care by a primary midwife (caseload midwifery) increases women’s satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial

BMC Pregnancy and Childbirth

Research Article

Lisa Gold¹  Ulla Waldenström²  Mary-Ann Davey³  Touran Shafiei³  Maggie Flood³  Helen L. McLachlan⁴  Della A. Forster⁵  Mary Anne Biro⁶  Tanya Farrell⁷ 

[1] Deakin Health Economics, Deakin University, 3125, Burwood, Australia;Department of Women’s and Children’s Health, Division of Reproductive and Perinatal Health, Karolinska Institutet, Stockholm, Sweden;Judith Lumley Centre, La Trobe University, 215 Franklin St., 3000, Melbourne, Australia;Judith Lumley Centre, La Trobe University, 215 Franklin St., 3000, Melbourne, Australia;School of Nursing and Midwifery, La Trobe University, 3086, Bundoora, Australia;Judith Lumley Centre, La Trobe University, 215 Franklin St., 3000, Melbourne, Australia;The Royal Women’s Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, 3052, Parkville, Australia;School of Nursing and Midwifery, Monash University, 3800, Clayton, Australia;The Royal Women’s Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, 3052, Parkville, Australia;

关键词: Caseload midwifery;    Continuity of care/r;    Satisfaction;    Experience;    Randomised controlled trial;   

DOI  :  10.1186/s12884-016-0798-y

 received in 2015-07-08, accepted in 2016-01-05,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundContinuity of care by a primary midwife during the antenatal, intrapartum and postpartum periods has been recommended in Australia and many hospitals have introduced a caseload midwifery model of care. The aim of this paper is to evaluate the effect of caseload midwifery on women’s satisfaction with care across the maternity continuum.MethodsPregnant women at low risk of complications, booking for care at a tertiary hospital in Melbourne, Australia, were recruited to a randomised controlled trial between September 2007 and June 2010. Women were randomised to caseload midwifery or standard care. The caseload model included antenatal, intrapartum and postpartum care from a primary midwife with back-up provided by another known midwife when necessary. Women allocated to standard care received midwife-led care with varying levels of continuity, junior obstetric care, or community-based general practitioner care. Data for this paper were collected by background questionnaire prior to randomisation and a follow-up questionnaire sent at two months postpartum. The primary analysis was by intention to treat. A secondary analysis explored the effect of intrapartum continuity of carer on overall satisfaction rating.ResultsTwo thousand, three hundred fourteen women were randomised: 1,156 to caseload care and 1,158 to standard care. The response rate to the two month survey was 88 % in the caseload group and 74 % in the standard care group. Compared with standard care, caseload care was associated with higher overall ratings of satisfaction with antenatal care (OR 3.35; 95 % CI 2.79, 4.03), intrapartum care (OR 2.14; 95 % CI 1.78, 2.57), hospital postpartum care (OR 1.56, 95 % CI 1.32, 1.85) and home-based postpartum care (OR 3.19; 95 % CI 2.64, 3.85).ConclusionFor women at low risk of medical complications, caseload midwifery increases women’s satisfaction with antenatal, intrapartum and postpartum care.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN012607000073404 (registration complete 23rd January 2007).

【 授权许可】

CC BY   
© Forster et al. 2016