OBJECTIVE: To compare the outcomes of an adapted pilot Changing Childbirth initiative providing continuity of care by a group of known midwives with traditional maternity care. DESIGN: Between-groups trial to compare levels of satisfaction and clinical outcomes for two groups of women, cared for either under this Changing Childbirth scheme or the traditional model of care. METHOD: Of the 200 women who agreed to participate in the project, 100 were randomly allocated to the pilot scheme and 100 to the traditional care package. During the postpartum period, information was collected via a questionnaire about participants' levels of satisfaction with a variety of aspects of care provided during the antenatal, delivery and postpartum periods. Data about clinical outcomes for the two groups were also obtained. RESULTS: Women in the pilot group had significantly more continuity of care throughout each of the three periods, were generally more satisfied with their care, felt that they had more choice over a variety of aspects of care and experienced no compromise in clinical outcomes (P = 0.05 or less in each case). IMPLICATIONS FOR PRACTICE: Many previous attempts to introduce the Changing Childbirth initiative have revealed significant problems, particularly with regard to the continuity of carer requirement. Taking account of local health care needs and existing provision, the present study adapted this concept to continuity of care. This did not apparently affect any of the guiding principles contained in the original document, and yet enhanced satisfaction. It would appear that the Changing Childbirth agenda can be adapted and integrated with local health care situations without sacrificing any of the overarching principles.
RCT Entities:
OBJECTIVE: To compare the outcomes of an adapted pilot Changing Childbirth initiative providing continuity of care by a group of known midwives with traditional maternity care. DESIGN: Between-groups trial to compare levels of satisfaction and clinical outcomes for two groups of women, cared for either under this Changing Childbirth scheme or the traditional model of care. METHOD: Of the 200 women who agreed to participate in the project, 100 were randomly allocated to the pilot scheme and 100 to the traditional care package. During the postpartum period, information was collected via a questionnaire about participants' levels of satisfaction with a variety of aspects of care provided during the antenatal, delivery and postpartum periods. Data about clinical outcomes for the two groups were also obtained. RESULTS:Women in the pilot group had significantly more continuity of care throughout each of the three periods, were generally more satisfied with their care, felt that they had more choice over a variety of aspects of care and experienced no compromise in clinical outcomes (P = 0.05 or less in each case). IMPLICATIONS FOR PRACTICE: Many previous attempts to introduce the Changing Childbirth initiative have revealed significant problems, particularly with regard to the continuity of carer requirement. Taking account of local health care needs and existing provision, the present study adapted this concept to continuity of care. This did not apparently affect any of the guiding principles contained in the original document, and yet enhanced satisfaction. It would appear that the Changing Childbirth agenda can be adapted and integrated with local health care situations without sacrificing any of the overarching principles.
Authors: Helen L McLachlan; Della A Forster; Mary-Ann Davey; Judith Lumley; Tanya Farrell; Jeremy Oats; Lisa Gold; Ulla Waldenström; Leah Albers; Mary Anne Biro Journal: BMC Pregnancy Childbirth Date: 2008-08-05 Impact factor: 3.007