Tuesday, October 14, 2008

Cochrane Review regarding midwifery care

This was just released a couple days ago from the Cochrane review on the midwifery model of care...just more evidence supporting midwifery care!!!

Midwife-led versus other models of care for childbearing women

Midwife-led care confers benefits for pregnant women and their babies and is recommended.
In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.


dx_acutefelicity said...

This is amazing to hear!!!!!!!!!
I am a BSN nursing student who aspires to be a Certified Nurse Midwife/Family Nurse Practitioner. When people ask me what I want to do and I tell them my plans to be a nurse midwife, they say things like "Ooooh, that is so gross" or "Oh, just give me the drugs, I could never go without an epidural"

I hope to go into nurse midwifery with a natural, holistic approach. This article you posted is something all people should read before they make judgements about nurse midwifes. :-)

slh35661 said...

Last night I finally watched The Business of Being Born. Yup, I think I am the last midwife in the country to see it. But what struck me is how well that movie shows midwifery care and how it makes you feel you want to change the model of care in this country ASAP. I am so glad to see the Cochrane review now coming out saying as much.