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

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

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 ACTRN012607000073404 (registration complete 23rd January 2007).

Figures

Fig. 1
Fig. 1
Trial profile
Fig. 2
Fig. 2
Comparison of women’s assessment of different aspects of antenatal, intrapartum and postpartum care, and overall assessment of these episodes of care and domiciliary postnatal care. Odds Ratios (ORs) based on comparisons of score on 7-point scales ranging from ‘1’ (Disagree strongly) to ‘7’ (Agree strongly). All p values for ORs shown are p < 0.001

References

    1. Department of Human Services Victoria . Future directions for Victoria’s maternity services. Melbourne: Victorian Department of Human Services; 2004.
    1. 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):1483–1492. doi: 10.1111/j.1471-0528.2012.03446.x.
    1. 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.
    1. 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. doi: 10.1046/j.1523-536X.2003.00211.x.
    1. 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.
    1. 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;27:156–167. doi: 10.1046/j.1523-536x.2000.00156.x.
    1. 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.
    1. Fellowes D, Horsley A, Rochefort J. Is continuity of care a top priority for all women? Br J Midwifery. 1999;7(1):36–40. doi: 10.12968/bjom.1999.7.1.8401.
    1. 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. doi: 10.1016/j.midw.2010.10.004.
    1. 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.
    1. Waldenström U. Continuity of carer and satisfaction. Midwifery. 1998;14:207–213. doi: 10.1016/S0266-6138(98)90092-4.
    1. Davey MA, Brown S, Bruinsma F. What is it about antenatal continuity of caregiver that matters to women? Birth. 2005;32(4):262–271. doi: 10.1111/j.0730-7659.2005.00384.x.
    1. 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):20–26. doi: 10.1111/j.1467-842X.2003.tb00375.x.
    1. 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. doi: 10.1016/S0266-6138(98)90003-1.
    1. Green J, Renfrew M, Curtis P. Continuity of carer: what matters to women? A review of the evidence. Midwifery. 2000;16(3):186–196. doi: 10.1054/midw.1999.0208.
    1. Freeman LM. Continuity of carer and partnership. A review of the literature. Women Birth. 2006;19:39–44. doi: 10.1016/j.wombi.2006.05.002.
    1. 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. doi: 10.1186/1471-2393-8-35.
    1. Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth. 1994;21(1):4–13. doi: 10.1111/j.1523-536X.1994.tb00909.x.
    1. StataCorp . STATA 10.0 Statistics/Data Analysis. College Station. Texas: StataCorp; 2007.
    1. StataCorp . STATA. Texas: StataCorp LP; 2009.
    1. Gupta SK. Intention-to-treat concept: A review. Perspect Clin Res. 2011;2(3):109–112. doi: 10.4103/2229-3485.83221.
    1. 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.
    1. Consultative Council on Obstetric and Paediatric Mortality and Morbidity . In: Births in Victoria 2007 and 2008. Quality SaPEB, editor. Melbourne: Department of Health; 2010.

Source: PubMed

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