Getting the first birth right : a retrospective cohort study of birth outcomes for primiparous women receiving standard care in the birth suite versus continuity of midwifery care in the birth centre at the Canberra Hospital

Abstract

Introduction: The aim of this research is to compare outcomes for a cohort of primiparous women who have accessed the Canberra Midwifery Program (CMP) with those who received standard public care at The Canberra Hospital. This will inform our understanding of the clinical outcomes of primiparous women accessing varying maternity models of care at The Canberra Hospital in order to determine best practice and assist future planning. Methods: The study was conducted using data collected from records held by The Canberra Hospital for the period 1st January 2010 to 31st December 2011. A retrospective comparative cohort study design was implemented drawing on data from two databases. Results: The study found significantly increased rates of normal vaginal birth (57.5% vs. 48.9% p=0.002) and spontaneous vaginal birth (38% vs. 22.4% p= <0.001) and correspondingly decreased rates of assisted vaginal birth (23.5% vs. 28.5% p= 0.05) and caesarean sections (18.8% vs. 22.5% p=0.115) in the CMP cohort. There were also fewer interventions in the CMP group including: induction of labour, epidural anaesthesia and use of narcotics in labour. There were significantly increased rates of breast feeding initiation within an hour of birth and early transfer home (within 24 hours of birth) within the CMP cohort and no differences in neonatal outcomes. Conclusion: Continuity of midwifery care/carer with the Canberra Midwifery Program is associated with a statistically significant difference in some clinical outcomes for primiparous women at this site.

Date of Award	2015
Original language	English
Supervisor	Deborah DAVIS (Supervisor), Jennifer Browne (Supervisor), Sally Ferguson (Supervisor) & Jan Taylor (Supervisor)