Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study
Abstract Background The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-09-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03204-3 |
| _version_ | 1828864848513990656 |
|---|---|
| author | Pien Offerhaus Suze Jans Chantal Hukkelhoven Raymond de Vries Marianne Nieuwenhuijze |
| author_facet | Pien Offerhaus Suze Jans Chantal Hukkelhoven Raymond de Vries Marianne Nieuwenhuijze |
| author_sort | Pien Offerhaus |
| collection | DOAJ |
| description | Abstract Background The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. Methods We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. Results In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. Conclusions We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care – both antenatally and in the intrapartum period – and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women. |
| first_indexed | 2024-12-13T04:16:17Z |
| format | Article |
| id | doaj.art-13cce9f4460d481996d83accc0cc887d |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T04:16:17Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-13cce9f4460d481996d83accc0cc887d2022-12-21T23:59:52ZengBMCBMC Pregnancy and Childbirth1471-23932020-09-0120111110.1186/s12884-020-03204-3Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort studyPien Offerhaus0Suze Jans1Chantal Hukkelhoven2Raymond de Vries3Marianne Nieuwenhuijze4Research Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD UniversityTNO, Department of Child HealthPerinedResearch Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD UniversityResearch Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD UniversityAbstract Background The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. Methods We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. Results In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. Conclusions We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care – both antenatally and in the intrapartum period – and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women.http://link.springer.com/article/10.1186/s12884-020-03204-3Continuity of careCaseload midwiferyPrimary health careBirth outcomes |
| spellingShingle | Pien Offerhaus Suze Jans Chantal Hukkelhoven Raymond de Vries Marianne Nieuwenhuijze Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study BMC Pregnancy and Childbirth Continuity of care Caseload midwifery Primary health care Birth outcomes |
| title | Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study |
| title_full | Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study |
| title_fullStr | Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study |
| title_full_unstemmed | Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study |
| title_short | Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study |
| title_sort | women s characteristics and care outcomes of caseload midwifery care in the netherlands a retrospective cohort study |
| topic | Continuity of care Caseload midwifery Primary health care Birth outcomes |
| url | http://link.springer.com/article/10.1186/s12884-020-03204-3 |
| work_keys_str_mv | AT pienofferhaus womenscharacteristicsandcareoutcomesofcaseloadmidwiferycareinthenetherlandsaretrospectivecohortstudy AT suzejans womenscharacteristicsandcareoutcomesofcaseloadmidwiferycareinthenetherlandsaretrospectivecohortstudy AT chantalhukkelhoven womenscharacteristicsandcareoutcomesofcaseloadmidwiferycareinthenetherlandsaretrospectivecohortstudy AT raymonddevries womenscharacteristicsandcareoutcomesofcaseloadmidwiferycareinthenetherlandsaretrospectivecohortstudy AT mariannenieuwenhuijze womenscharacteristicsandcareoutcomesofcaseloadmidwiferycareinthenetherlandsaretrospectivecohortstudy |