An evaluation of midwifery group practice. Part I: Clinical effectiveness

Abstract

Background: Midwifery Group Practice (MGP) is a continuity of midwifery care model for women in all risk groups (Low, Moderate and High) available at a tertiary metropolitan hospital in Australia. This demonstration study aimed to compare the clinical effectiveness of MGP with other models of care at the hospital. Methods: Comparisons of clinical outcomes were made between women who received care under MGP (n = 618) and those receiving ‘Other’ modes of care at the hospital (n = 3548) between three risk categories over a 15-month period. Results: There were more Low (MGP n = 218, 35.3%, ‘Other’ n = 773, 21.8%) and fewer High Risk (MGP n = 46, 7.4%, ‘Other’ n = 564, 15.9%) women in MGP, with similar proportions of Moderate Risk women (MGP n = 354, 57.3%, ‘Other’ n = 2211, 62.3%). Significant differences include: fewer assisted deliveries for Moderate Risk women in MGP (27.7% MGP, 46.1% ‘Other’); fewer labour inductions (Low Risk: 12.8% MGP, 25.1% ‘Other’; Moderate Risk: 21.8% MGP, 29.5% ‘Other’; High Risk: 19.6% MGP, 34.9% ‘Other’); less epidural analgesia (Low Risk: 22.5% MGP, 49.0% ‘Other’; Moderate Risk: 20.3% MGP, 38.4% ‘Other’; High Risk: 17.4% MGP, 32.6% ‘Other’); and differences in the overall pattern of perineal trauma. No significant differences were found in the incidence of post-partum haemorrhage, antenatal hospital admissions, or neonatal admission to Special or Intensive Care. Conclusions: MGP is clinically effective when practiced in a routine setting.