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Midwife-led continuity models versus other models of care for childbearing women

  1. Jane Sandall1,*,
  2. Hora Soltani2,
  3. Simon Gates3,
  4. Andrew Shennan1,
  5. Declan Devane4

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 21 AUG 2013

Assessed as up-to-date: 22 JUL 2013

DOI: 10.1002/14651858.CD004667.pub3


How to Cite

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub3.

Author Information

  1. 1

    Women's Health Academic Centre, King's Health Partners, Division of Women's Health, King's College, London, London, UK

  2. 2

    Sheffield Hallam University, Centre for Health and Social Care Research Centre, Sheffield, UK

  3. 3

    Division of Health Sciences, Warwick Medical School, The University of Warwick, Warwick Clinical Trials Unit, Coventry, UK

  4. 4

    National University of Ireland Galway, School of Nursing and Midwifery, Galway, Ireland

*Jane Sandall, Division of Women's Health, King's College, London, Women's Health Academic Centre, King's Health Partners, 10th Floor, North Wing, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. jane.sandall@kcl.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions), comment added to review
  2. Published Online: 21 AUG 2013

SEARCH

[Figure 1]
Figure 1. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 2]
Figure 2. 'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
[Figure 3]
Figure 3. Funnel plot of comparison: 1 Midwife-led versus other models of care for childbearing women and their infants (all), outcome: 1.1 Regional analgesia (epidural/spinal).
[Figure 4]
Figure 4. Funnel plot of comparison: 1 Midwife-led versus other models of care for childbearing women and their infants (all), outcome: 1.2 Caesarean birth.
[Figure 5]
Figure 5. Funnel plot of comparison: 1 Midwife-led versus other models of care for childbearing women and their infants (all), outcome: 1.16 Episiotomy.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 1 Regional analgesia (epidural/spinal).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 2 Caesarean birth.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 3 Instrumental vaginal birth (forceps/vacuum).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 4 Spontaneous vaginal birth (as defined by trial authors).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 5 Intact perineum.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 6 Preterm birth (< 37 weeks).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 7 Overall fetal loss and neonatal death.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 8 Antenatal hospitalisation.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 9 Antepartum haemorrhage.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 10 Induction of labour.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 11 Amniotomy.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 12 Augmentation/artificial oxytocin during labour.
[Analysis 1.13]
Analysis 1.13. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 13 No intrapartum analgesia/anaesthesia.
[Analysis 1.14]
Analysis 1.14. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 14 Opiate analgesia.
[Analysis 1.15]
Analysis 1.15. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 15 Attendance at birth by known midwife.
[Analysis 1.16]
Analysis 1.16. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 16 Episiotomy.
[Analysis 1.17]
Analysis 1.17. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 17 Perineal laceration requiring suturing.
[Analysis 1.18]
Analysis 1.18. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 18 Mean labour length (hrs).
[Analysis 1.19]
Analysis 1.19. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 19 Postpartum haemorrhage (as defined by trial authors).
[Analysis 1.20]
Analysis 1.20. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 20 Breastfeeding initiation.
[Analysis 1.21]
Analysis 1.21. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 21 Duration of postnatal hospital stay (days).
[Analysis 1.22]
Analysis 1.22. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 22 Low birthweight (< 2500 g).
[Analysis 1.23]
Analysis 1.23. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 23 5-minute Apgar score below or equal to 7.
[Analysis 1.24]
Analysis 1.24. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 24 Neonatal convulsions (as defined by trial authors).
[Analysis 1.25]
Analysis 1.25. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 25 Admission to special care nursery/neonatal intensive care unit.
[Analysis 1.26]
Analysis 1.26. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 26 Mean length of neonatal hospital stay (days).
[Analysis 1.27]
Analysis 1.27. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 27 Fetal loss/neonatal death before 24 weeks.
[Analysis 1.28]
Analysis 1.28. Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 28 Fetal loss/neonatal death equal to/after 24 weeks.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 1 Regional analgesia (epidural/spinal).
[Analysis 2.2]
Analysis 2.2. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 2 Caesarean birth.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 3 Instrumental vaginal birth (forceps/vacuum).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 4 Spontaneous vaginal birth (as defined by trial authors).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 5 Intact perineum.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 6 Preterm birth (< 37 weeks).
[Analysis 2.7]
Analysis 2.7. Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/one-to-one or team), Outcome 7 Overall fetal loss and neonatal death.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 1 Regional analgesia (epidural/spinal).
[Analysis 3.2]
Analysis 3.2. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 2 Caesarean birth.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 3 Instrumental vaginal birth (forceps/vacuum).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 4 Spontaneous vaginal birth (as defined by trial authors).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 5 Intact perineum.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 6 Preterm birth (< 37 weeks).
[Analysis 3.7]
Analysis 3.7. Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 7 Overall fetal loss and neonatal death.