An overview of the first ‘no exit’ midwifery group practice in a tertiary maternity hospital in Western Australia: Outcomes, satisfaction and perceptions of care

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• 作者：Lucy Lewis^a ; ^b ; ^{Lucy.lewis@curtin.edu.au} ; ^{Lucy.Lewis@health.wa.gov.au} ; Yvonne L. Hauck^a ; ^b ; ^{y.hauck@curtin.edu.au} ; ^{yvonne.hauck@health.wa.gov.au} ; Caroline Crichton^c ; ^{caroline.crichton@health.wa.gov.au} ; Alissa Pemberton^c ; ^{Alissa.Pemberton@health.wa.gov.au} ; Megan Spence^c ; ^{Megan.Spence@health.wa.gov.au} ; Georgina Kelly^c ; ^{georgina.kelly@health.wa.gov.au}
• 关键词：Childbirth ; Caseload midwifery ; Midwifery group practice ; Continuity of care ; Women's experiences
• 刊名：Women and Birth
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：29
• 期：6
• 页码：494-502
• 全文大小：447 K
• 卷排序：29

文摘

Midwifery group practice (MGP) is a care model offered by a primary midwife in a small team. Evidence confirms MGP is acceptable to women, safe and cost effective.MethodsWe aimed to provide a systematic overview of the first ‘no exit’ MGP in a Western Australian (WA) tertiary maternity hospital, using a mixed methods approach, involving four phases. Between July 2013 and June 2014: phase one assessed MGP characteristics, obstetric and neonatal outcomes by parity; phase two examined women's satisfaction by mode of delivery; and phase three qualitatively explored perceptions of care. Phase four compared the proportion of MGP women and the 2012 WA birthing population.FindingsPhase one included 232 MGP women; 87% achieved a vaginal birth. Phase two included 97% (226 of 232) women, finding 98% would recommend the service. Phase three analysis of 62 interviews revealed an overarching theme ‘Continuity with Midwives’ encompassing six sub-themes: only a phone call away; home away from home; knowing me; a shared view; there for me; and letting it happen. Phase four compared the MGP cohort to 33,393 WA women. Intrapartum MGP women were more likely than the WA population to have a vaginal birth (87% vs 65%, P ≤ 0.001) and intact perineum (49% vs 36%, P ≤ 0.001) and less likely to use epidural/spinal analgesia (34% vs 59%, P ≤ 0.001), or have a caesarean (13% vs 35%, P ≤ 0.001).ConclusionsMixed methods enabled systematic examination of this new ‘no exit’ MGP confirming safety and acceptability. Findings contribute to our knowledge of MGP models.