NDLI: The effect of primary midwife-led care on women's experience of childbirth: results from the COSMOS randomised controlled trial.

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The effect of primary midwife-led care on women's experience of childbirth: results from the COSMOS randomised controlled trial.

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The effect of primary midwife-led care on women's experience of childbirth: results from the COSMOS randomised controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	McLachlan, H. L. Forster, D. A. Davey, M-A Farrell, T. Flood, M. Shafiei, T. Waldenström, U.
Description	Country affiliation: Australia Author Affiliation: McLachlan HL ( Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.); Forster DA ( Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.); Davey MA ( The Royal Women's Hospital, Parkville, Vic., Australia.); Farrell T ( Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.); Flood M ( Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Department of Health, Melbourne, Vic., Australia.); Shafiei T ( The Royal Women's Hospital, Parkville, Vic., Australia.); Waldenström U ( Judith Lumley Centre and School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.)
Abstract	OBJECTIVE: To determine the effect of primary midwife-led care ('caseload midwifery') on women's experiences of childbirth. DESIGN: Randomised controlled trial. SETTING: Tertiary care women's hospital in Melbourne, Australia. POPULATION: A total of 2314 low-risk pregnant women. METHODS: Women randomised to caseload care received antenatal, intrapartum and postpartum care from a primary midwife, with some care provided by a 'back-up' midwife. Women in standard care received midwifery-led care with varying levels of continuity, junior obstetric care or community-based medical care. MAIN OUTCOME MEASURES: The primary outcome of the study was caesarean section. This paper presents a secondary outcome, women's experience of childbirth. Women's views and experiences were sought using seven-point rating scales via postal questionnaires 2 months after the birth. RESULTS: A total of 2314 women were randomised between September 2007 and June 2010; 1156 to caseload and 1158 to standard care. Response rates to the follow-up questionnaire were 88 and 74%, respectively. Women in the caseload group were more positive about their overall birth experience than women in the standard care group (adjusted odds ratio 1.50, 95% CI 1.22-1.84). They also felt more in control during labour, were more proud of themselves, less anxious, and more likely to have a positive experience of pain. CONCLUSIONS: Compared with standard maternity care, caseload midwifery may improve women's experiences of childbirth. TWEETABLE ABSTRACT: Primary midwife-led care ('caseload midwifery') improves women's experiences of childbirth.
File Format	HTM / HTML
ISSN	14700328
e-ISSN	14710528
Journal	BJOG: An International Journal of Obstetrics & Gynaecology
Issue Number	3
Volume Number	123
Language	English
Publisher	Wiley
Publisher Date	2016-02-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Obstetrics Discipline Gynecology Delivery, Obstetric Psychology Midwifery Parturition Patient Satisfaction Pregnancy Primary Health Care Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology

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