Caseload Midwifery For Women At Low Risk Of Medical Complications: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$604,527.00
Summary
In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing ....In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing caseload care. Studies of continuity of midwifery teams have reported reduced caesareans and other interventions in labour. They have also found increased satisfaction, with no statistically significant differences in health outcomes for babies. Women who are identified at low medical risk will be recruited from the antenatal clinic of a large, tertiary, public maternity hospital. Women will be randomly allocated to caseload midwifery or standard low risk care. Those allocated to caseload will receive pregnancy, birth and postnatal care from a primary midwife with one or two pregnancy visits to be conducted by a 'back-up' midwife. The midwife will collaborate with obstetricians and other health professionals as necessary. This will be the first RCT of caseload midwifery care in Australia and only the third one conducted anywhere. It is a unique opportunity to provide a rigorous evaluation of a model that is beginning to be implemented widely in Australia. The trial will provide much needed information regarding the outcomes of caseload midwifery including interventions in childbirth, safety, costs, women's satisfaction with care and impact on the midwifery workforce. The study will provide data that will inform clinical practice and guide service providers involved in the organisation of maternity services.Read moreRead less
A Randomised Controlled Trial Of Outpatient Cervical Priming For Induction Of Labour
Funder
National Health and Medical Research Council
Funding Amount
$611,611.00
Summary
This study aims to compare two approaches that prepare pregnant women before they are induced to give birth. Eligible women who agree to be in the study will be allocated to receive (a) the usual, standard care already used in SA hospitals or, (b) a new method. In the new approach, women will have their labour primed by a midwife and will be discharged and further monitored by the midwife from hospital. This approach might give women a more satisfying experience with less medical intervention.
Effects Of A Midwife-led Counselling Intervention To Improve Postpartum Womens Mental Health
Funder
National Health and Medical Research Council
Funding Amount
$674,240.00
Summary
Prevention of perinatal mental health difficulties is a national priority. In addition to depressed mood, some mothers experience a range of anxiety disorders. Many women report that problems are not discussed or diagnosed and few receive help. We will conduct a trial and qualitative evaluation of an early counselling intervention for distressed postpartum women. The intervention, offered by trained midwives, aims to reduce anxiety, depression and promote positive parenting.
A Randomised Controlled Trial Of Caseload Midwifery Care
Funder
National Health and Medical Research Council
Funding Amount
$761,311.00
Summary
There is concern about the rising levels of caesarean section in Australia and some evidence that women may benefit from caseload midwifery care. This randomised control trial will determine whether caseload midwifery care can reduce interventions and is as safe as usual hospital maternity care. A Cochrane systematic review of midwifery led care versus routine care was designed to answer these questions.This will be the first randomised controlled trial to contribute to this review