Midwifery Continuity of Care Outcomes

Introduction

Comparison

There are a number of similarities in the findings of the six papers. One of them is with respect to the outcome of midwifery continuity of care. The findings indicate that midwifery continuity of care results in better health outcomes as compared to other forms of care such as standard care. For example, the findings by Tracy et al (2013) indicate that elective caesarean section was 8% under the midwifery continuity of care and 11% under standard care. Unassisted births, on the other hand, were 56% under midwifery continuity of care while under standard care it was 52%. The results by Tracy et al (2013) were collaborated by findings in the study carried out Sandall et al (2016). The findings by Sandall et al (2016) indicate that women who were subjected to midwife-led continuity care experienced less regional analgesia, instrumental birth, preterm birth, and foetal loss. Another similarity in the findings of the studies was on the views of the midwives and patients concerning midwifery continuity of care. It can be established from the findings that midwifery continuity of care is viewed positively in general by both midwives and patients. For instance, findings by Cummins, Denney-Wilson and Homer (2015) reveal that new graduate midwives had positive experiences while providing midwifery continuity of care to pregnant women. The new graduate midwives indicated that midwifery continuity of care provided them with an opportunity to develop good relationships with the women under their care as well as acquire knowledge and skills that prepared them for their roles as midwives. With respect to the views of women on midwifery continuity of care, findings in a study by Brown and Taylor (2016) indicate that women valued midwifery services provided by student midwives. They also valued and were satisfied with the continuity relationships they had with the student midwives. In general, the findings by Brown and Taylor (2016) indicate that women value the presence of a midwife during their pregnancy and childbearing and would recommend midwifery continuity of care to other women.

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Differences

Despite the similarities in the findings, there are also various differences. One of the differences is with respect to which aspects of health outcomes that midwifery continuity of care enhances. For example, while some findings depict reduced rates of caesarean sections when pregnant mothers are subjected to midwifery continuity of care, other findings reveal that there is no difference in the number of caesarean sections when midwifery continuity of care is applied as compared to standard care. Findings by Tracy et al (2013) indicate that there is no difference in the caesarean sections between midwifery continuity of care and standard care while Sandall et al (2016) that there were significant differences in the level of caesarean sections between midwifery continuity of care and standard care.

Another difference is with regard to the welfare of midwives. Some findings indicate that midwives working under midwifery continuity of care are happy with the program. However, other findings indicate that while midwifery continuity of care provides a learning opportunity, it is also strenuous and stressful. For example, Cummins, Denney-Wilson and Homer (2015) established that new graduate midwives were happy to work under the midwifery continuity of care program because it allowed them to learn and gain skills on how to be better midwives. On the other hand, Fenwick, Sidebotham, Gamble and Creedy (2018) found that midwives at risk of psychological distress due to strenuous working schedules.

Summary

The findings in the six papers provided touch on a number of aspects of midwifery continuity of care. Some of the aspects the findings touch on include the effectiveness of midwifery continuity of care, experiences of both midwives and women under the midwifery continuity of care, and emotional wellbeing of midwives working under the midwifery continuity of care program. The findings reveal that midwifery continuity of care is generally more effective as compared to other forms of care such as the standard care. Findings in the six papers indicate that women who are subjected to midwifery continuity of care experienced better health outcomes during pregnancy and birth. For instance, findings in the papers reveal that women who were under the midwifery continuity of care showed a higher level of unassisted birth, reduced level of instrumental birth, and lower levels of infant mortality.

With respect to the experiences under midwifery continuity of care, the findings in the six papers indicate that the program provides positive experiences for both midwives and expectant mothers. However, the program has also the potential of distressing midwives due to the strenuous work schedules.

Recommendations

The findings in the papers can be applied to the Australian maternity services. For example, there is need to introduce the midwifery continuity of care in the Australian maternity services. Midwifery continuity of care has proved to be very important in helping expectant mothers. Introduction of midwifery continuity of care will thereby help improve the health outcomes in the Australian maternity services.

The findings in the six papers should also be applied in the Australian maternity services by developing a better midwifery continuity of care program. While the findings indicate that both midwives and expectant women have had positive experiences under midwifery continuity of care, midwives also experience psychological distress due to work overload. Such information can be used to design a continuity of care program that is not only focused on improving the health outcomes of expectant mothers but also the experiences of midwives.

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Conclusion

Basically, the results in the six articles have both similarities and differences. Some of the similarities include: the results in the papers indicate a positive relationship between midwifery continuity of care and health outcomes; midwifery continuity of care is more effective as compared to other models of care such as standard care; and there is a generally positive experience and view of midwifery of continuity of care among both midwives and expectant mothers. However, the findings in the papers have differences with respect to which aspects of health outcomes that midwifery continuity of care enhances. The findings should be applied to the Australian maternity services in order to improve health outcomes in maternity.

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References

Browne, J., & Taylor, J. (2014). ‘It's a good thing…’: Women's views on their continuity experiences with midwifery students from one Australian region. Midwifery, 30(3), e108- e114.

Cross-Sudworth, F., Williams, M., & Gardosi, J. (2015). Community midwifery care and social care pathways. Evidence Based Midwifery.

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.

Fenwick, J., Sidebotham, M., Gamble, J., & Creedy, D. K. (2018). The emotional and professional wellbeing of Australian midwives: a comparison between those providing continuity of midwifery care and those not providing continuity. Women and Birth, 31(1), 38-43.

Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife‐led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews, (4).

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.

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