Australian research has shown that one-on-one midwife care — the standard approach in New Zealand — is just as effective as, and cheaper than the standard Australian system which shares pregnancy care between several professionals.
A randomised controlled trial of midwife care found continued care from an individual midwife throughout pregnancy, birth, and after the baby is born (caseload midwifery) is just as safe as standard maternity care (shared between different midwives and medical practitioners) for all women irrespective of risk, and costs significantly less.
The study, published in the Lancet, found no difference between the groups in number of caesareans, use of epidurals, instrumental births, admission to neonatal intensive care, or preterm birth.
However, women who received caseload midwifery care were less likely to have an elective caesarean (before the onset of labour), more likely to have a spontaneous labour, required a lower amount of pain drugs, had less blood loss following birth, needed to stay in hospital for less time, and had improved breastfeeding rates-which together, say the authors, accounted for the lower cost of caseload midwifery.
“The caseload model of midwifery care has been largely overlooked in maternity systems because of a perception that the service will be too expensive and that the model is not safe for complex pregnancies,” explained lead author Professor Sally Tracy from the University of Sydney in Australia. “Our results show that in women of any risk caseload midwifery is safe and cost effective.”
World needs to ‘catch up’ with New Zealand
The research has been welcomed by the Chief Executive of the NZ College of Midwives, Karen Guilliland, who was quick to note that midwife lead maternity care has been the New Zealand standard since 1996. She says this important study makes it clear that the rest of the world needs to catch up with New Zealand if service models are to keep the maternity service affordable and improved outcomes for women and babies is the goal.
“While women in New Zealand expect to have their own midwife providing their care from pregnancy test to 4-6 weeks after the birth of the baby the rest of the world has been slow to accept this model of care as a government funded option” she explains in a media release.