Childbirth experience in women participating in a continuity of midwifery care project

Annika Karlström,Birgitta Larsson,Ingegerd Hildingsson

doi:10.1016/j.wombi.2020.04.010

Annika Karlström, Birgitta Larsson + Show 1 more

Open Access

https://doi.org/10.1016/j.wombi.2020.04.010

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Abstract

BackgroundContinuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Previous studies have shown certain factors are associated with a positive birth experience, including continuity of midwifery care. AimThe aim was to investigate women's childbirth experiences in relation to background data, birth outcome and continuity with a known midwife, in a rural area of Sweden. MethodsAn experimental cohort study. Participating women were offered continuity of midwifery care in pregnancy and birth, during selected time periods. Data were collected in mid-pregnancy and two months after birth. The Childbirth Experience Questionnaire was used to determine women's birth experiences. ResultA total of 226 women responded to the follow-up questionnaire. Not living with a partner, fear of giving birth, and a birth preference other than vaginal were associated with a less positive birth experience. Having had a vaginal birth with no epidural, no augmentation and no birth complication all yield a better birth experience. Women who had had a known midwife were more likely to have had a positive birth experience overall, predominantly in the domain Professional support. ConclusionsThe results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. The results also pointed out the benefits of a less medicalized birth as important for a good birth experience, and that some women may need extra support to avoid a less positive birth experience.

Highlights

Continuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies
Support during labour has been acknowledged by others to be important for a positive childbirth experience [5,11] and so have continuity models of midwifery care [12]
Continuity models of midwifery care have been proven beneficial to women and babies [12] and are highly recommended by WHO as one important factor when it comes to creating a positive birth experience [1]

Summary

Introduction

Continuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Conclusions: The results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. Continuity models of midwifery care have been proven beneficial to women and babies [12] and are highly recommended by WHO as one important factor when it comes to creating a positive birth experience [1]. Continuity models usually provide woman-centred and individualized care from a known midwife or a small group of midwives, throughout pregnancy and birth. Such models generally create positive experiences of pregnancy and birth [12,13,14]. The majority (88.6%) preferred to have a vaginal birth, 5.5% a caesarean section, and 5.5% did not express any birth preference

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