Midwife-led Continuity of Care Model Essay

Annotated Bibliography 1

Introduction

Midwife-led continuity of care (CoC) models have gained significance as primary care providers for childbearing women all around the world (Forster et al., 2016). This issue explores an important component of mother and infant health, as the care model chosen during pregnancy and childbirth has a substantial impact on outcomes. Although the advantages of midwife-led CoC have been highlighted, a thorough analysis is required to determine whether these models vary from other models in terms of morbidity, mortality, efficacy, and psychosocial outcomes (Sandall et al., 2016). It is observed that the findings of this study are crucial for guiding healthcare decisions and policies regarding maternity care.

Main Body

The primary aim of this research work titled, “Midwife?led continuity models versus other models of care for childbearing women”, authored by Sandall et al., (2016) is to compare the midwife-led continuity models of care (CoC) with other models of care for pregnant women as well as their infants. The primary objective was to evaluate differences among factors like morbidity and mortality, effectiveness, and psychosocial outcomes between midwife-led CoC and alternative care models (Sandall et al., 2016). A quantitative research strategy has been employed in this systematic review study (Sürücü & Maslakci, 2020). It analyzed data from 15 trials involving 17,674 women to provide evidence-based comparisons of different models of care (Sandall et al., 2016). The review conducted a thorough search in the Cochrane Pregnancy and Childbirth Group's Trials Register and referenced other relevant studies (Sandall et al., 2016). The GRADE approach was utilized to assess quality of evidence (Mustafa et al., 2013).

While evaluating the results of this article, the potential advantages of midwife-led CoC for childbearing women are found. Women who had CoC guided by a midwife were significantly less likely to have certain interventions, such as regional analgesia (epidural/spinal), instrumental vaginal births (forceps/vacuum), and preterm births (Sandall et al., 2016). This implies that midwife-led CoC may help to lessen the need for medical interventions throughout pregnancy and labor, which is important for encouraging more natural and minimally invasive birth experiences (Forster et al., 2016). One of the most promising findings was that women in midwife-led CoC were more likely to experience spontaneous vaginal births (Forster et al., 2016). This is considered as optimal mode of childbirth while being medically feasible. This result demonstrates the value and efficacy of midwife-led care in assisting women in giving birth with less interventions (Sandall et al., 2016). It is observed that the study's most significant finding was that women receiving CoC from midwives expressed higher levels of satisfaction, demonstrating the psychological advantages of this type of care (Sandall et al., 2016). However, the study’s result did not show any changes that were statistically significant in outcomes like cesarean births or intact perineum. This indicates that some elements of maternal and newborn health may not be significantly influenced by the chosen care style (Sandall et al., 2016).

On the other hand, the strength of this particular study includes its comprehensive and standardized methodology in synthesizing evidence from multiple trials, large sample size, and high-quality evidence assessment like GRADE approach (Mustafa et al., 2013). One of the limitations is its reliance on published and unpublished trials which might introduce a publication bias. Moreover, the midwifery techniques might vary depending on region and healthcare system. This diversity was not taken into consideration in the study, which could limit the generalizability of the results.

Conclusion

It is acknowledged that this article highlights the benefits of midwife-led continuity models of care which involves increased maternal satisfaction and reduced interventions. The study, conducted through a quantitative systematic review, provided robust evidence. However, the need for further research to explore specific findings, such as the reduction in preterm births and fetal losses associated with midwife-led CoC is understood.

List of Outcomes

References

Forster, D. A., McLachlan, H. L., Davey, M. A., Biro, M. A., Farrell, T., Gold, L., ... & Waldenström, U. (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 , 16, 1-13. https://doi.org/10.1186/s12884-016-0798-y

Mustafa, R. A., Santesso, N., Brozek, J., Akl, E. A., Walter, S. D., Norman, G., ... & Schünemann, H. J. (2013). The GRADE approach is reproducible in assessing the quality of evidence of quantitative evidence syntheses. Journal of Clinical Epidemiology , 66(7), 736-742. https://doi.org/10.1016/j.jclinepi.2013.02.004

Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife?led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews , (4). 10.1002/14651858.CD004667.pub5

Sürücü, L., & Maslakci, A. (2020). Validity and reliability in quantitative research . Business & Management Studies: An International Journal , 8(3), 2694-2726. 

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