Abstract
BackgroundMaternal and neonatal outcomes are influenced by the nature of antenatal care. Standard pregnancy care is provided on an individual basis, with one-on-one appointments between a client and family doctor, midwife or obstetrician. A novel, group-based antenatal care delivery model was developed in the United States in the 1990s and is growing in popularity beyond the borders of the USA. The purpose of this study was to evaluate outcomes in clients receiving interprofessional group perinatal care versus interprofessional individual care in a Canadian setting.MethodsClients attending the South Community Birth Program (SCBP), an interprofessional, collaborative, primary care maternity program, offering both individual and group care, were invited to participate in the study. Pregnancy knowledge and satisfaction scores, and perinatal outcomes were compared between those receiving group versus individual care. Chi-square tests, general linear models and logistic regression were used to compare the questionnaire scores and perinatal outcomes between cohorts.ResultsThree hundred three clients participated in the study. Group care was comparable to individual care in terms of mode of birth, gestational age at birth, infant birth weight, breastfeeding rates, pregnancy knowledge, preparedness for labour and baby care, and client satisfaction. The rates of adverse perinatal outcomes were extremely low amongst SCBP clients, regardless of the type of care received (preterm birth rates ~5%). Breastfeeding rates were very high amongst all study participants (> 78% exclusive breastfeeding), as were measures of pregnancy knowledge and satisfaction.ConclusionsThis is the first Canadian study to compare outcomes in clients receiving interprofessional group care versus individual care. Our observation that interprofessional group care outcomes and satisfaction were as good as interprofessional individual care has important implications for the antenatal care of clients and for addressing the projected maternity provider crisis facing Canada, particularly in small and rural communities. Further study of group-based care including not only client satisfaction, but also provider satisfaction, is needed. In addition, research into the role of interprofessional care in meeting the needs and improving perinatal outcomes of different populations is necessary.
Highlights
Maternal and neonatal outcomes are influenced by the nature of antenatal care delivery [1]
Age was slightly higher in clients participating in individual care, and the proportion of nulliparous clients was much higher in group care than in individual care (Table 1)
In our setting, Connecting Pregnancy group care is comparable to individual care in terms of mode of birth, gestational age at birth, birth weight, breastfeeding rates, client satisfaction, pregnancy knowledge, and readiness for labour and baby care
Summary
Maternal and neonatal outcomes are influenced by the nature of antenatal care. A novel, group-based antenatal care delivery model was developed in the United States in the 1990s and is growing in popularity beyond the borders of the USA. Maternal and neonatal outcomes are influenced by the nature of antenatal care delivery [1]. Standard care during pregnancy is provided on an individual basis, with one-on-one appointments between a client and family doctor, midwife or obstetrician [2]. A novel, group-based maternity care delivery model was developed in the United States in the 1990s and is growing in popularity beyond the borders of the USA. The model involves assessment, support and education, bringing clients out of private clinic rooms and into groups for their care, with the added aim of building community and support amongst clients [3].
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