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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

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Begley 2011 {published and unpublished data}
  • Begley C, Devane D, Clarke M, McCann C, Hughes P, Reilly M, et al. Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the republic of Ireland: a randomised trial [Thesis-under review for publication]. Trinity College, University of Dublin, 2011.
  • Begley C, Devane D, Clarke M, McCann C, Hughes P, Reilly M, et al. Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial. BMC Pregnancy and Childbirth 2011;11:85.
Biro 2000 {published data only}
Flint 1989 {published data only}
  • Flint C. Know your midwife. Nursing Times 1988;84:28-32.
  • Flint C, Poulengeris P, Grant AM. The 'Know your midwife' scheme - a randomised trial of continuity of care by a team of midwives. Midwifery 1989;5:11-6.
  • Flint C, Poulengeris, P. The 'Know your midwife' Report. London: Heinemann, 1987.
Harvey 1996 {published data only}
Hicks 2003 {published data only}
Homer 2001 {published data only}
Kenny 1994 {published data only}
  • Kenny P, Brodie P, Eckerman S, Hall J. Final Report. Westmead Hospital Team Midwifery Project Evaluation. Sydney: University of Sydney, 1994.
MacVicar 1993 {published data only}
McLachlan 2012 {published data only}
  • Flood M, Forster DA, Davey MA, McLachlan HL. Serious adverse event monitoring in a RCT of caseload midwifery (COSMOS). Journal of Paediatrics and Child Health 2012;48(Suppl 1):113.
  • McLachan H. A randomised trial comparing One-to-One midwifery care with standard hospital maternity care for women at low risk, in order to decrease operative birth and other interventions and increase the duration of breastfeeding and women's satisfaction with care, with no increase in costs of care. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 19 February 2008).
  • McLachlan H, Forster D, Davey MA, Farrell T, Gold L, Oats J, et al. A randomised controlled trial of caseload midwifery for women at low risk of medical complications (COSMOS) - primary and secondary outcomes. Women and Birth 2011;24 Suppl 1:S13.
  • McLachlan HL, Forster DA, Davey MA, Farrell T, Gold L, Biro MA, et al. Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: The COSMOS randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology 2012;119(12):1483-92.
  • McLachlan HL, Forster DA, Davey MA, Farrell T, Gold L, Oats J, et al. A randomised controlled trial of caseload midwifery for women at low risk of medical complications (COSMOS): Maternal and infant outcomes. Journal of Paediatrics and Child Health 2011;47(Suppl 1):33.
  • McLachlan HL, Forster DA, Davey MA, Farrell T, Gold L, Waldenstrom U, et al. A randomised controlled trial of caseload midwifery for women at low risk of medical complications (COSMOS): Women's satisfaction with care. Journal of Paediatrics and Child Health 2012;48(Suppl 1):41-2.
  • McLachlan HL, Forster DA, Davey MA, Lumley J, Farrell T, Oats J, et al. Cosmos: comparing standard maternity care with one-to-one midwifery support: a randomised controlled trial. BMC Pregnancy and Childbirth 2008;8:35.
North Stafford 2000 {published data only}
  • North Staffordshire Changing Childbirth Research Team. A randomised study of midwifery caseload care and traditional 'shared-care'. Midwifery 2000;16:295-302.
Rowley 1995 {published data only}
  • Rowley MJ, Hensley MJ, Brinsmead MW, Wlodarczyk JH. Continuity of care by a midwife team vs routine care during pregnancy and birth: a randomised trial. Medical Journal of Australia 1995;163:289-93.
Turnbull 1996 {published data only}
  • Cheyne H, Mcginley M, Turnbull D, Holmes A, Shields N, Greer I, et al. Midwife managed care: results of a randomised controlled trial of 1299 women. Prenatal and Neonatal Medicine 1996;1(Suppl 1):129.
  • Holmes A, McGinley M, Turnbull D, Shields N, Hillan E. A consumer driven quality assurance model for midwifery. British Journal of Midwifery 1996;4(10):512-8.
  • McGinley M, Turnbull D, Fyvie H, Johnstone I, MacLennan B. Midwifery development unit at Glasgow Royal Maternity Hospital. British Journal of Midwifery 1995;3(7):362-71.
  • Shields N, Holmes A, Cheyne H. Knowing your midwife in labour. British Journal of Midwifery 1995;7(8):504-10.
  • Shields N, Reid M, Cheyne H, Holmes A, McGinley M, Turnbull D, et al. Impact of midwife-managed care in the postnatal period: an exploration of psychosocial outcomes. Journal of Reproductive and Infant Psychology 1997;15:91-108.
  • Shields N, Turnbull D, Reid M, Holmes A, Cheyne H, McGinley M, et al. Satisfaction with midwife-managed care in different time periods: a randomised controlled trial of 1299 women. Midwifery 1998;14:85-93.
  • Shields N, Turnbull D, Reid M, Holmes A, Cheyne H, McGinley M, et al. Women's satisfaction and continuity of care with midwife managed care. Prenatal and Neonatal Medicine 1996;1(1):320.
  • Turnbull D, Holmes A, Cheyne H, Shields N, McGinley M, McIlwaine G, et al. Does midwife-led care work? The results of a randomised controlled trial of 1299 women. 27th British Congress of Obstetrics and Gynaecology; 1995 July 4-7; Dublin, Ireland. 1995:527.
  • Turnbull D, Holmes A, Shields N, Cheyne H, Twaddle S, Harper Gilmour W, et al. Randomised, controlled trial of efficacy of midwife-managed care. Lancet 1996;348:213-8.
  • Turnbull D, McGinley M, Fyvie M, Johnstone IEA. Implementation and evaluation of a midwifery development unit. British Journal of Midwifery 1995;3(9):465-8.
  • Turnbull D, Reid M, McGinley M, Shields N. Changes in midwife attitudes to their professional role following implementation of the midwifery development unit. Midwifery 1995;11(3):110-9.
  • Turnbull D, Shields N, McGinley M, Holmes A, Cheyne H, Reid M, et al. Professional issues: can midwife-managed units improve continuity of care?. British Journal of Midwifery 1999;7(8):499-503.
  • Young D, Lees A, Twaddle S. The costs to the NHS of maternity care: midwife-managed vs shared. British Journal of Midwifery 1997;5(8):465-72.
  • Young D, Shields N, Holmes A, Turnbull D, Twaddle S. Aspects of antenatal care. A new style of midwife-managed antenatal care: costs and satisfaction. British Journal of Midwifery 1997;5:540-5.
Waldenstrom 2001 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Berglund 1998 {published data only}
Berglund 2007 {published data only}
  • Berglund A, Lindberg M, Nystrom L, Lindmark G. Combining the perspectives of midwives and doctors improves risk assessment in early pregnancy. Acta Obstetricia et Gynecologica Scandinavica 2007;86(2):177-84.
  • Berglund A, Lindmark G. Midwife managed care - impact on use of health services: and area-based randomised controlled trial. XVI FIGO World Congress of Obstetrics & Gynecology (Book 4); 2000 Sept 3-8; Washington DC, USA. 2000:116.
Bernitz 2011 {published data only}
  • Bernitz S, Aas E, Oian P. Economic evaluation of birth care in low-risk women. A comparison between a midwife-led birth unit and a standard obstetric unit within the same hospital in Norway. A randomised controlled trial. Midwifery 2012;28(5):591-9.
  • Bernitz S, Rolland R, Blix E, Jacobsen M, Sjoborg K, Oian P. Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial. BJOG : an international journal of obstetrics and gynaecology 2011;118(11):1357-64.
  • Bernitz S, Rolland R, Blix E, Jacobsen M, Sjoborg K, Oian PL. Is the operative delivery rate in low-risk women dependent on birth care level? A randomised controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2012;91(Suppl 159):45-6.
Chambliss 1991 {published data only}
  • Chambliss L, Daly C, Medearis AL, Ames M, Turnquist R, Kayne M, et al. Significant differences in cesarean birth rates for resident physician and nurse midwife services are the result of selection criteria. American Journal of Obstetrics and Gynecology 1991;164:313.
  • Chambliss LR, Daly C, Medearis AL, Ames M, Kayne M, Paul R. The role of selection bias in comparing cesarean birth rates between physician and midwifery management. Obstetrics & Gynecology 1992;80(2):161-5.
Chapman 1986 {published data only}
Giles 1992 {published data only}
  • Giles W, Collins J, Ong F, MacDonald R. Antenatal care of low risk obstetric patients by midwives. A randomized controlled trial. Medical Journal of Australia 1992;157:158-61.
Heins 1990 {published data only}
  • Heins HC, Nance NW, McCarthy BJ, Efird CM. A randomized trial of nurse-midwifery prenatal care to reduce low birth weight. Obstetrics & Gynecology 1990;75:341-5.
Hildingsson 2003 {published data only}
Hundley 1994 {published data only}
  • Hundley VA, Cruickshank FM, Lang GD, Glazener CMA, Milne JM, Turner M, et al. Midwife managed delivery unit: a randomised controlled comparison with consultant led care. BMJ 1994;309:1400-4.
  • Hundley VA, Cruickshank FM, Milne JM, Glazener CMA, Lang GD, Turner M, et al. Satisfaction and continuity of care: staff views of care in a midwife-managed delivery unit. Midwifery 1995;11:163-73.
  • Hundley VA, Donaldson C, Lang GD, Cruickshank FM, Glazener CMA, Milne JM, et al. Costs of intrapartum care in a midwife managed delivery unit and a consultant led labour ward. Midwifery 1995;11:103-9.
James 1988 {unpublished data only}
  • James DK. A comparison of a schematic approach to antenatal care and conventional shared care. Personal communication 1988.
Kelly 1986 {unpublished data only}
  • Kelly J. Comparison of two different methods of delivering antenatal care, one with components provided by an obstetrician, the other by a midwife. Personal communication 1986.
Klein 1984 {published data only}
  • Klein M, Papageorgiou AN, Westreich R, Spector-Dunsky L, Elkins V, Kramer MS, et al. Care in a birth room vs a conventional setting: a controlled trial. Canadian Medical Association Journal 1984;131:1461-6.
Law 1999 {published data only}
  • Law YY, Lam KY. A randomized controlled trial comparing midwife-managed care and obstetrician-managed care for women assessed to be at low risk in the initial intrapartum period. Journal of Obstetrics & Gynaecology Research 1999;25:107-12.
Marks 2003 {published data only}
  • Marks MN, Siddle K, Warwick C. Can we prevent postnatal depression? A randomized controlled trial to assess the effect of continuity of midwifery care on rates of postnatal depression in high-risk women. Journal of Maternal-Fetal and Neonatal Medicine 2003;13:119-27.
Runnerstrom 1969 {published data only}
Slome 1976 {published data only}
  • Slome C, Wetherbee H, Daly M, Christensen K, Meglen M, Thiede H. Effectiveness of certified nurse-midwives. A prospective evaluation study. American Journal of Obstetrics and Gynecology 1976;124:177-82.
Stevens 1988 {unpublished data only}
  • Stevens A. A randomised controlled trial of community antenatal care in central Birmingham. Personal communication 1988.
Tucker 1996 {published data only}
  • Ratcliffe J, Ryan M, Tucker J. The costs of alternative types of routine antenatal care for low-risk women: shared care vs care by general practitioners and community midwives. Journal of Health Services & Research Policy 1996;1:135-40.
  • Tucker JS, Hall MH, Howie PW, Reid ME, Barbour RS, Florey CD, et al. Should obstetricians see women with normal pregnancies? A multicentre randomised controlled trial of routine antenatal care by general practitioners and midwives compared with shared care led by obstetricians. BMJ 1996;312:554-9.
Waldenstrom 1997 {published data only}
Walker 2012 {published data only}
  • Walker DM, DeMaria L, Suarez L, Gonzales D, Romero M, Padron A. Are all skilled birth attendants created equal? evidence from mexico. International Journal of Gynecology and Obstetrics 2012;119(Suppl 3):S516-S517.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Nagle 2011 {published data only}
  • Nagle C, Skouteris H, Hotchin A, Bruce L, Patterson D, Teale G. Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial. BMC Public Health 2011;11:174.
Tracy 2008 {unpublished data only}
  • Hartz DL, Tracy S, Kildea S, Tracy M, Foureur M, Hall B, et al. Does caseload midwifery reduce caesarean section operation rates: The m@ngo trial. Journal of Paediatrics and Child Health 2012;48(Suppl 1):27.
  • Tracy SK. A randomised controlled trial of caseload midwifery care. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 31 July 2009) 2009.
  • Tracy SK, Hartz D, Hall B, Allen J, Forti A, Lainchbury A, et al. A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options). BMC Pregnancy and Childbirth 2011;11:82.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Altman 1996
Anderson 2008
Ashcroft 2003
  • Ashcroft B, Elstein M, Boreham N, Holm S. Prospective semistructured observational study to identify risk attributable to staff deployment, training, and updating opportunities for midwives. BMJ 2003;327(7415):584.
Benjamin 2001
Brocklehurst 2011
  • Brocklehurst P,  Hardy P,  Hollowell J,  Linsell L,  Macfarlane A,  McCourt C,  et al. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 2011;343:d7400.
Cook 2000
De Vries 2001
  • De Vries R, Benoit C, Van Teijlingen E, Wrede S. Birth by Design: Pregnancy, Maternity Care and Midwifery in North America and Northern Europe. New York: Routledge, 2001.
Deeks 2001
  • Deeks JJ, Bradburn MJ, Altman DG. Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta-analysis in Context. London: BMJ Publication, 2001.
Devane 2007
Flint 1987
  • Flint C, Poulengeris P. The 'Know your Midwife' Report. London: Heinemann, 1987.
Freeman 2007
  • Freeman GK, Woloshynowych M, Baker R, Boulton M, Guthrie B, Car J, et al. Continuity of Care 2006: What Have We Learned Since 2000 and What are Policy Imperatives Now? Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). London: NCCSDO, 2007.
Gates 2005
  • Gates S. Methodological Guidelines. In: The Editorial Team. Pregnancy and Childbirth Group. About The Cochrane Collaboration (Collaborative Review Groups (CRGs)) 2005, Issue 2.
Green 2000
Haggerty 2003
Higgins 2005
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.4 [updated March 2005]. In: The Cochrane Library, Issue 2, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Higgins 2011
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Hodnett 2000
Hodnett 2012
Johnson 2005
  • Johnson M, Stewart H, Langdon R, Kelly P, Yong L. A comparison of the outcomes of partnership caseload midwifery and standard hospital care in low risk mothers. Australian Journal of Advanced Nursing 2005;22(3):21-7.
Koblinsky 2006
McCourt 2006
  • McCourt C, Stevens S, Sandall J, Brodie P. Working with women: developing continuity in practice. In: Page LA, McCandlish R editor(s). The New Midwifery. 2nd Edition. Churchill Livingstone, 2006:141-66.
Olsen 2012
RCOG 2001
  • Royal College of Obstetricians and Gynaecologists. The National Sentinel Caesarean Section Audit Report. London: RCOG Clinical Effectiveness Support Unit, 2001. [: ISBN 1-900364-66-2.]
RevMan 2003
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
RevMan 2012
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
Rooks 1999
Ryan 2013
Sandall 2001
  • Sandall J, Davies J, Warwick C. Evaluation of the Albany Midwifery Practice: Final Report. London: King's College, London, Florence Nightingale School of Nursing and Midwifery, 2001.
Saultz 2003
  • Saultz JW. Defining and measuring interpersonal continuity of care. Annals of Family Medicine 2003;1(3):134-43.
Saultz 2004
Saultz 2005
Sutcliffe 2012
Waldenstrom 1998
Walsh 2012
WHO 2006
  • World Health Organization. The World Health Report: Working Together for Health. Geneva: WHO, 2006.
Young 1997
  • Young D, Lees A, Twaddle S. The costs to the NHS of maternity care: midwife-managed vs shared. British Journal of Midwifery 1997;5(8):465-72.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Hatem 2008