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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Della A. Forster, Helen L. McLachlan, Mary-Ann Davey, Mary Anne Biro, Tanya Farrell, Lisa Gold, Maggie Flood, Touran Shafiei, Ulla Waldenström

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Continuity 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.

Methods

Pregnant 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.

Results

Two 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).

Conclusion

For women at low risk of medical complications, caseload midwifery increases women’s satisfaction with antenatal, intrapartum and postpartum care.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN01260700007​3404 (registration complete 23rd January 2007).
Literature
1.
Department of Human Services Victoria. Future directions for Victoria’s maternity services. Melbourne: Victorian Department of Human Services; 2004.
2.
McLachlan H, Forster D, Davey M, Farrell T, Gold L, Biro M, et al. 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. 2012;119(12):1483–92.CrossRefPubMed
3.
Hatem M, Sandall J, Devane D, Soltani H, Gates S. Midwife-led versus other models of care for childbearing women. Cochrane Database Syst Rev. 2008;4:CD004667.
4.
Biro M, Waldenstrom U, Brown S, Pannifex J. Satisfaction with team midwifery care for low and high-risk women: a randomized controlled trial. Birth. 2003;30(1):1–9.CrossRefPubMed
5.
Rowley MJ, Hensley MJ, Brinsmead MW, Wlodarczyk JH. Continuity of Care by a midwife team versus routine care during pregnancy and birth: a randomised trial. Med J Aust. 1995;163:289–93.
6.
Waldenstrom U, Brown S, McLachlan H, Forster D, Brennecke S. Does team midwife care increase satisfaction with antenatal, intrapartum and postpartum care? A randomized controlled trial. Birth. 2000;27:156–67.CrossRefPubMed
7.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2013;8:CD004667.PubMed
8.
Fellowes D, Horsley A, Rochefort J. Is continuity of care a top priority for all women? Br J Midwifery. 1999;7(1):36–40.CrossRef
9.
Goberna-Tricas J, Banús-Giménez M, Palacio-Tauste A, L-S S. Satisfaction with pregnancy and birth services: the quality of maternity care services as experienced by women. Midwifery. 2011;27(6):e231–237.CrossRefPubMed
10.
Shafiei T, Small R, McLachlan H. Women’s views and experiences of maternity care: A study of immigrant Afghan women in Melbourne. Australia. Midwifery. 2012;28(2):198–203.
11.
12.
Davey MA, Brown S, Bruinsma F. What is it about antenatal continuity of caregiver that matters to women? Birth. 2005;32(4):262–71.CrossRefPubMed
13.
Bruinsma F, Brown S, Darcy MA. Having a baby in Victoria 1989-2000: women’s views of public and private models of care. Aust N Z J Public Health. 2003;27(1):20–6.CrossRefPubMed
14.
Shields N, Turnbull D, Reid M, Holmes A, McGinley M, Smith LN. Satisfaction with midwife-managed care in different time periods: a randomised controlled trial of 1299 women. Midwifery. 1998;14(2):85–93.CrossRefPubMed
15.
Green J, Renfrew M, Curtis P. Continuity of carer: what matters to women? A review of the evidence. Midwifery. 2000;16(3):186–96.CrossRefPubMed
16.
Freeman LM. Continuity of carer and partnership. A review of the literature. Women Birth. 2006;19:39–44.CrossRefPubMed
17.
McLachlan H, Forster D, Davey M-A, Lumley J, Farrell T, Oats J, et al. COSMOS: COmparing Standard Maternity care with One-to-one midwifery Support: a randomised controlled trial. BMC Pregnancy Childbirth. 2008;8(1):35.PubMedCentralCrossRefPubMed
18.
Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth. 1994;21(1):4–13.CrossRefPubMed
19.
StataCorp. STATA 10.0 Statistics/Data Analysis. College Station. Texas: StataCorp; 2007.
20.
StataCorp. STATA, vol. 11.2. Texas: StataCorp LP; 2009.
21.
22.
Consultative Council on Obstetric and Paediatric Mortality and Morbidity. 2010 and 2011, Victoria’s Mothers and Babies, Victoria’s Maternal, Perinatal, Child and Adolescent Mortality. Melbourne: State Government of Victoria; 2014.
23.
Consultative Council on Obstetric and Paediatric Mortality and Morbidity. In: Quality SaPEB, editor. Births in Victoria 2007 and 2008. Melbourne: Department of Health; 2010.
Metadata
Title
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
Authors
Della A. Forster
Helen L. McLachlan
Mary-Ann Davey
Mary Anne Biro
Tanya Farrell
Lisa Gold
Maggie Flood
Touran Shafiei
Ulla Waldenström
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0798-y

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