Research Confirms Midwifery Care By Graduates in New Zealand Is Excellent

The New Zealand College of Midwives has welcomed the publication of a paper¹ which shows outcomes for pregnant women registered with a graduate midwife (in their first year of practice) are as good as those for women registered with more experienced midwives.

The research commissioned by the Ministry of Health and undertaken by Lynn Sadler and her research team explored perinatal mortality and found that first year of midwifery practice was not associated with an increased risk of perinatal death². 

NZCOM deputy Chief Executive Alison Eddy says the profession is reassured that the undergraduate and Midwifery First Year of Practice programmes (MFYP) are working well, and effectively supporting graduate midwives to provide safe, quality midwifery care for women and their babies.

“Sadler’s research is important as it disputes the findings of the Lawton et al (2015) paper which claimed an association between midwives in their first year of practice and increase perinatal mortality. 

At that time, Lawton’s study resulted in widespread national and international criticism due to the unclear methodology and a biased interpretation of the findings. The College was a loud critic and in turn was criticised for comments we made at that time. 

We are pleased our position has been vindicated and would hope in future researchers employ a more rigorous and ethical approach to both conducting research and disseminating their interpretation of the results” 

Alison Eddy says Sadler et al who used a rigorous and robust method of identifying the level of experience of the midwives and their perinatal outcomes, have identified the following issues with the Lawton et al paper:

• The methodology was not able to be replicated

• The authors did not make allowances for existing risk factors that increase the risk of perinatal death – regardless of who is providing care

• They conclude that the data used in the first study was not used appropriately or fit for purpose

Alison Eddy adds “Graduate midwives are more likely to be providing care for women who have existing health or social concerns that can lead to a higher risk of perinatal mortality. These women may also experience barriers to accessing maternity services.  There is a need to address this inequity of access to care and ensure increased support for the midwives providing that care.”

ENDS

¹Go here to read the paper

² Perinatal mortality rate Perinatal mortality rate is calculated in New Zealand as fetal deaths and early neonatal deaths per 1000 total babies born alive or born dead at 20 weeks gestation or beyond, or weighing at least 400g if gestation is unknown. In some places, this report refers to a UK definition of perinatal mortality, which was developed for the surveillance of perinatal deaths in the UK and is based on the UK legal definition of stillbirths, which excludes fetal deaths before 24 weeks gestation (CMACE 2011). From the 10th Annual Report of the Perinatal and Maternal Mortality Review Committee, NZ