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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

Forster, Della A., McLachlan, Helen L., Davey, Mary-Ann, Biro, Mary Anne, Farrell, Tanya, Gold, Lisa, Flood, Maggie, Shafiei, Touran and Waldenström, Ulla 2016, 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, BMC pregnancy and childbirth, vol. 16, Article number: 28, pp. 1-13, doi: 10.1186/s12884-016-0798-y.

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Title 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
Author(s) Forster, Della A.
McLachlan, Helen L.
Davey, Mary-Ann
Biro, Mary Anne
Farrell, Tanya
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
Flood, Maggie
Shafiei, Touran
Waldenström, Ulla
Journal name BMC pregnancy and childbirth
Volume number 16
Season Article number: 28
Start page 1
End page 13
Total pages 13
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016
ISSN 1471-2393
Keyword(s) caseload midwifery
continuity of care/r
satisfaction
experience
randomised controlled trial
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Summary 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.
Language eng
DOI 10.1186/s12884-016-0798-y
Field of Research 111799 Public Health and Health Services not elsewhere classified
1114 Paediatrics And Reproductive Medicine
1117 Public Health And Health Services
1110 Nursing
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085113

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.