The Library
Midwife-led versus other models of care for childbearing women
Tools
Hatem, Marie, Sandall, Jane, Devane, Declan, Soltani, Hora and Gates, Simon (2008) Midwife-led versus other models of care for childbearing women. Cochrane Database of Systematic Reviews (Number 4). Article No. CD004667. doi:10.1002/14651858.CD004667.pub2
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.1002/14651858.CD004667.pub2
Abstract
Background:
Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led and other models of care.
Objectives:
To compare midwife-led models of care with other models of care for childbearing women and their infants.
Search strategy:
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2008), Cochrane Effective Practice and Organisation of Care Group's Trials Register (January 2008), Current Contents (1994 to January 2008), CINAHL (1982 to August 2006), Web of Science, BIOSIS Previews, ISI Proceedings, (1990 to 2008), and the WHO Reproductive Health Library, No. 9.
Selection criteria:
All published and unpublished trials in which pregnant women are randomly allocated to midwife-led or other models of care during pregnancy, and where care is provided during the ante-and intrapartum period in the midwife-led model.
Data collection and analysis:
All authors evaluated methodological quality. Two authors independently checked the data extraction.
Main results:
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 .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).
Authors' conclusions:
All women should be offered midwife-led models of care and women should be encouraged to ask for this option.
Item Type: | Journal Item | ||||
---|---|---|---|---|---|
Subjects: | R Medicine R Medicine > RG Gynecology and obstetrics |
||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
Library of Congress Subject Headings (LCSH): | Midwifery, Obstetrics -- Statistics, Maternal health services -- Evaluation | ||||
Journal or Publication Title: | Cochrane Database of Systematic Reviews | ||||
Publisher: | John Wiley & Sons Ltd. | ||||
ISSN: | 1469-493X | ||||
Official Date: | 2008 | ||||
Dates: |
|
||||
Number: | Number 4 | ||||
Number of Pages: | 130 | ||||
Page Range: | Article No. CD004667 | ||||
DOI: | 10.1002/14651858.CD004667.pub2 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access | ||||
Description: | Intervention review |
Data sourced from Thomson Reuters' Web of Knowledge
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |