Australian Maternity Services

Introduction

A significant number of studies have been carried out on continuity of midwifery. The studies carried out have analysed various aspects of the subjects such as the effect of continuity of midwifery on health outcomes among new mothers and expectant women and attitudes of patients and physicians towards continuity of midwifery (Cummins, Denney-Wilson & Homer, 2015). Results of the various studies carried out on the subject have led to varied results. The results have both similarities and differences. In this paper, the similarities and differences in the results in six articles will be addressed. Recommendations on how to apply the findings to Australian maternity services will be provided.

Similarities in the findings

There are a number of similarities in the findings in the six articles obtained literature search. One of them is that the results in the articles reveal a positive relationship between continuity of midwifery and health outcomes. Results in the articles indicate that continuity of midwifery improves health outcomes among pregnant mothers or new mothers. For instance, McLachlan et al (2012) established that continuity of midwifery reduces the rate of caesarean births. Similar results were obtained by Sandall et al (2016) who found that continuity of midwifery reduced instrumental births, preterm births, and infant mortality. Reduction of caesarean births as a result was observed by Tracy et al (2013). In their study, Tracy et al (2013) found that women who were subjected to continuity of midwifery had a lower rate of caesarean births as compared to those who were subjected to standard care.

Another similarity is that the results indicate that continuity of midwifery is more effectiveness than to other models of care such as standard care. Majority of the studies compared continuity of midwifery and other models of care to determine which practice was more effective in terms of enhancing health outcomes among pregnant women and all the results reveal that continuity of midwifery is more effective. For example, Tracy et al (2013) compared the effectiveness of continuity of midwifery and standard of care and found that continuity of midwifery was more effective in terms of reducing caesarean births. Similar results were observed by Sandall et al (2016) who established that continuity of midwifery was more effective in reducing instrumental births, preterm births, and infant mortality as compared to other models.

The results also share a similarity in terms of the experiences and views of different stakeholders on continuity of midwifery. The results in a number of the papers indicate that there is a generally positive experience and view on continuity of midwifery. Both midwives and patients indicate that taking part in continuity of midwifery provided them with a positive experience. For example, cummins, Denney-Wilson and Homer (2015) found that new graduate midwives valued the experience of working in midwifery continuity of care. The new graduates indicated that continuity of midwifery provided them with an opportunity to develop valuable relationships with the women they were providing care as well as the midwives they were working alongside. They also revealed that continuity of midwifery allowed them to acquire knowledge and skills that would help them work as midwives.

Similar results of positive experience were also obtained by Gu, Zhang, and Ding (2011) who found that Chinese midwives had positive experiences while continuity of midwifery care to pregnant women. The midwives indicated that providing continuity of midwifery care to women provided them with a sense of self-achievement. It also helped them to develop coping strategies. With regard to the experiences and views of mothers, Williams, Lago, Lainchbury, and Eagar (2010) found that the views of mothers concerning continuity of midwifery were generally positive. Mothers indicated that continuity of midwifery care enabled them to develop positive relationships with the midwives that provided them with comfort and reassurance during pregnancy, labour, and even early motherhood.

Differences

Despite the similarities in the results, there were also a number of differences. One of the differences is that while some results show that continuity of midwifery is superior in all aspects, others showed that in some aspects, continuity of midwifery produced similar results as other models. For example, Sandall et al (2016) established that continuity of midwifery was more effective in reducing instrumental births, preterm births, and infant mortality as compared to other models. However, Tracy et al (2013) found that while continuity of midwifery helped to reduce caesarean, proportions of instrumental births were similar in both continuity of midwifery care and standard care.

Another difference is in whether there were any negative experiences. While some results indicate that there were only positive experiences, others indicate that there were also negative experiences besides the positive ones. For example, Gu, Zhang, and Ding (2011) established that there were also negative experiences among the midwives when providing continuity of midwifery care to pregnant women.

Recommendations

The findings in the articles can be applied in the Australian maternity services in various ways. One way in which the findings can be applied is to implement the positive findings of continuity of midwifery (McLachlan et al., 2012). The findings in the articles indicate that continuity of midwifery is more effective. This knowledge can be applied in the Australian maternity services by introducing the continuity of midwifery care in the services.

Another way in which the findings should be applied in the Australian maternal services is look for ways of eliminating the negative aspects of continuity of midwifery. As indicated in one of the studies, continuity of midwifery has also its negative aspect particularly to midwives (Sandall et al., 2016). This knowledge can be used to improve the working environment for midwives in the Australian maternity services.

Conclusion

Basically, the results in the six articles have both similarities and differences. Some of the similarities include: the results in the articles reveal a positive relationship between continuity of midwifery and health outcomes; continuity of midwifery is more effectiveness than to other models of care such as standard care; and there is a generally positive experience and view on continuity of midwifery. The differences include: some results show that continuity of midwifery is superior in all aspects while others show that in some aspects, continuity of midwifery produced similar results as other models; and some results indicate that there were only positive experiences while others indicate that there were also negative experiences.

References

• Cummins, A. M., Denney-Wilson, E., & Homer, C. S. E. (2015). The experiences of new graduate midwives working in midwifery continuity of care models in Australia. Midwifery, 31(4), 438-444.
• Gu, C., Zhang, Z., & Ding, Y. (2011). Chinese midwives’ experience of providing continuity of care to labouring women. Midwifery, 27(2), 243-249.
• McLachlan, H. L., Forster, D. A., Davey, M. A., Farrell, T., Gold, L., Biro, M. A., ... & Waldenström, U. (2012). 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 & gynaecology, 119(12), 1483-1492.
• Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife‐led continuity models versus other models of care for childbearing women. The Cochrane Library.
• Tracy, S. K., Hartz, D. L., Tracy, M. B., Allen, J., Forti, A., Hall, B., & Bisits, A. (2013). Caseload midwifery care versus standard maternity care for women of any risk: M@ NGO, a randomised controlled trial. The Lancet, 382(9906), 1723-1732.
• Williams, K., Lago, L., Lainchbury, A., & Eagar, K. (2010). Mothers’ views of caseload midwifery and the value of continuity of care at an Australian regional hospital. Midwifery, 26(6), 615-621.

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