Getting the first birth right: A retrospective study of outcomes for low-risk primiparous women receiving standard care versus midwifery model of care in the same tertiary hospital

Nola Wong, Jenny BROWNE, Sally FERGUSON, Deborah DAVIS

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: There is national and international concern for increasing obstetric intervention in childbirth and rising caesarean section rates. Repeat caesarean section is a major contributing factor, making primiparous women an important target for strategies to reduce unnecessary intervention and surgeries in childbirth. Aim: The aim was to compare outcomes for a cohort of low risk primiparous women who accessed a midwifery continuity model of care with those who received standard public care in the same tertiary hospital. Methods: A retrospective comparative cohort study design was implemented drawing on data from two databases held by a tertiary hospital for the period 1 January 2010 to 31 December 2011. Categorical data were analysed using the chi-squared statistic and Fisher's exact test. Continuous data were analysed using Student's t-test. Comparisons are presented using unadjusted and adjusted odds ratios, with 95% confidence intervals (CIs) and p-values with significance set at 0.05. Results: Data for 426 women experiencing continuity of midwifery care and 1220 experiencing standard public care were compared. The study found increased rates of normal vaginal birth (57.7% vs. 48.9% p= 0.002) and spontaneous vaginal birth (38% vs. 22.4% p=
Original languageEnglish
Pages (from-to)279-284
Number of pages6
JournalWomen and Birth
Volume28
Issue number4
DOIs
Publication statusPublished - 2015

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Birth Order
Midwifery
Tertiary Care Centers
Retrospective Studies
Parturition
Continuity of Patient Care
Repeat Cesarean Section
Unnecessary Procedures
Cesarean Section
Obstetrics
Cohort Studies
Odds Ratio
Databases
Confidence Intervals
Students

Cite this

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title = "Getting the first birth right: A retrospective study of outcomes for low-risk primiparous women receiving standard care versus midwifery model of care in the same tertiary hospital",
abstract = "Background: There is national and international concern for increasing obstetric intervention in childbirth and rising caesarean section rates. Repeat caesarean section is a major contributing factor, making primiparous women an important target for strategies to reduce unnecessary intervention and surgeries in childbirth. Aim: The aim was to compare outcomes for a cohort of low risk primiparous women who accessed a midwifery continuity model of care with those who received standard public care in the same tertiary hospital. Methods: A retrospective comparative cohort study design was implemented drawing on data from two databases held by a tertiary hospital for the period 1 January 2010 to 31 December 2011. Categorical data were analysed using the chi-squared statistic and Fisher's exact test. Continuous data were analysed using Student's t-test. Comparisons are presented using unadjusted and adjusted odds ratios, with 95{\%} confidence intervals (CIs) and p-values with significance set at 0.05. Results: Data for 426 women experiencing continuity of midwifery care and 1220 experiencing standard public care were compared. The study found increased rates of normal vaginal birth (57.7{\%} vs. 48.9{\%} p= 0.002) and spontaneous vaginal birth (38{\%} vs. 22.4{\%} p=",
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AU - DAVIS, Deborah

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