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New Zealand chose wisely and well in 1996 to introduce its unique woman centred maternity model of care.
That’s according to the Chief Executive of the NZ College of Midwives, Karen Guilliland following results of a recent research study published this week in the UKs leading medical journal, the Lancet.
The study shows that midwifery lead maternity care, as we have in New Zealand (the LMC system), is safer and costs less regardless of the level of risk a pregnant women is believed to have.
“This is the first randomised trial demonstrating that all women* benefit by having continuity of midwifery care, not just women experiencing low risk or normal birth. It provides further evidence of other large New Zealand cohort studies that found similar outcomes.” says Ms Guilliland. (*women carrying more than one child were excluded from the trial).
The randomised control trial in Australia involved 1748 women from pregnancy to after the baby was born. 871 received care from a named midwife or a backup in hospital, and at home; 877 women received standard maternity care which in Australia is shared care with a general practitioner, care from hospital midwives, and rostered medical and midwifery staff.
Karen Guilliland 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.
Professor Sally Tracy, the study’s primary author, said the study refuted the common misconception that one-to-one caseload midwifery care was expensive.
“Caseload midwifery care has been largely overlooked because of the incorrect belief that the service will be too expensive and that the model is not safe for complex pregnancies. Our randomised trial showed that caseload care can achieve similar outcomes to standard care - and it costs the public purse significantly less.”
The controlled trial in Australia where women were randomly assigned to receive either caseload midwifery (antenatal, intrapartum, and postpartum care from a named midwife or a back-up in the hospital and at home; 871 women) or standard care (shared care from a general practitioner, hospital midwives, and rostered medical and midwifery staff; 877 women).
Antenatal Before birth
Intrapartum During labour
Postpartum care After the birth
Caseload midwifery Lead Maternity Carers (LMC’s) based in the community