An evaluation of Midwifery Group Practice. Part I: Clinical effectiveness

Abstract

Midwifery Group Practice (MGP) is a continuity of midwifery care model for women in all risk groups (Low, Moderate and High) available at a tertiary metropolitan hospital in Australia. This demonstration study aimed to compare the clinical effectiveness of MGP with other models of care at the hospital. Comparisons of clinical outcomes were made between women who received care under MGP (n=618) and those receiving 'Other' modes of care at the hospital (n=3548) between three risk categories over a 15-month period. There were more Low (MGP n=218, 35.3%, 'Other' n=773, 21.8%) and fewer High Risk (MGP n=46, 7.4%, 'Other' n=564, 15.9%) women in MGP, with similar proportions of Moderate Risk women (MGP n=354, 57.3%, 'Other' n=2211, 62.3%). Significant differences include: fewer assisted deliveries for Moderate Risk women in MGP (27.7% MGP, 46.1% 'Other'); fewer labour inductions (Low Risk: 12.8% MGP, 25.1% 'Other'; Moderate Risk: 21.8% MGP, 29.5% 'Other'; High Risk: 19.6% MGP, 34.9% 'Other'); less epidural analgesia (Low Risk: 22.5% MGP, 49.0% 'Other'; Moderate Risk: 20.3% MGP, 38.4% 'Other'; High Risk: 17.4% MGP, 32.6% 'Other'); and differences in the overall pattern of perineal trauma. No significant differences were found in the incidence of post-partum haemorrhage, antenatal hospital admissions, or neonatal admission to Special or Intensive Care. MGP is clinically effective when practiced in a routine setting.