Friday, October 10, 2008

Best outomes from midwifery care

A Cochrane systematic review. Which is internationally recognised as the best available evidence on a topic, has found that women who have midwifery led care have fewer antenatal problems and as good or better outcomes than other models of care. The reviewers conclude that all women should have the option of midwifery led care.
Below are the main results of this study from the reviewers

We included 11trials (12,276 women). Women who had midwife-led models of care were less likely to experience antenatal hospitalisation, risk ratio (RR) 0.90, 95% confidence interval (CI) 0.81 to 0.99), the use of regional analgesia (RR 0.81, 95% CI 0.73 to 0.91), episiotomy (RR 0.82, 95% CI 0.77 to 0.88), and instrumental delivery (RR 0.86, 95% CI 0.78 to 0.96) and were more likely to experience no intrapartum analgesia/anaesthesia (RR 1.16, 95% CI 1.05 to 1.29), spontaneous vaginal birth (RR 1.04, 95% CI 1.02 to 1.06), to feel in control during labour and childbirth (RR 1.74, 95% CI 1.32 to 2.30), attendance at birth by a known midwife (RR 7.84, 95% CI 4.15 to 14.81) and initiate breastfeeding (RR 1.35, 95% CI 1.03 to 1.76). In addition, women who were randomised to receive midwife-led care were less likely to experience fetal loss before 24 weeks' gestation (RR 0.79, 95% CI 0.65 to 0.97), and their babies were more likely to have a shorter length of hospital stay (mean difference -2.00, 95% CI -2.15 to -1.85). There were no statistically significant differences between groups for overall fetal loss/neonatal death (RR 0.83, 95% CI 0.70 to 1.00), or fetal loss/neonatal death of at least 24 weeks (RR 1.01, 95% CI 0.67 to 1.53).

Great news for New Zealand where all women do have access to midwifery led care. We have a huge responsibility to make sure that this does result in the best possible outcomes for mothers and babies.

I just have to put this video in here again. Midwives Rock!!


Sarah Stewart said...

Talk about great minds thinking a like. But you beat me to the cute video!!

Joy Johnston said...

Carolyn I came across your blog via Sarah Stewart's. I am also a midwife - in Melbourne, Victoria. That's a great video you posted. I'll put a link to it from the midwivesVictoria blog. Joy Johnston

Carolyn said...

Thanks for stopping by and commenting you two :)

infomidwife said...

This is a great Cochrane systematic review - good publicity for midwives and midwifery. NZ seems to be leaps and bounds ahead of us in Perth - I also just read about your funding for maternity services and on my blog I commented on the joint statement from the COMNZ and RANZCOG - wel done.

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