Unsurprisingly, after an analysis of 13 studies, involving 16,242 women in Australia, Britain, Canada, Ireland and New Zealand, has found “…that having the same midwife provides significant benefits for women who have a medium or low risk during their pregnancy.”
Some of the findings were that women with midwife-led care had a 16% reduced rate of episiotomy, 12% less forceps and ventouse delivery, 13% less likely to have an epidural and more likely to have a spontaneous labour, though on average had longer labours by 30 minutes and there was no more or less chance of a caesarean birth.
Mothers with high-risk pregnancies should still be able to consult with specialists and other medical professionals.
This seems like common sense to me, that women who are able to have continued care with the same midwife throughout their pregnancies are more likely to have better outcomes for the birth of their baby. Having continued care allows a mother to get to know her midwife and build trust and understanding; also this allows the midwife to have ongoing discussions about that mother’s preferences and needs. She’s also more likely to give birth with someone she’s met before.
With both my pregnancies my antenatal care was through a maternity clinic, I saw a different midwife for each appointment, I had no person who was my main point of contact, or someone I felt I knew or could trust to ask questions and discuss my concerns. I can understand why mothers who have the option to have their own obstetrician, even with a low-risk pregnancy, would choose to have their pregnancy and labour monitored by the same person throughout, though hopefully this review means that more women will have midwife-led continuity models of care offered to them.
I would also hope that they would include VBAC as an option for midwife led care, with a caseload midwife, even if they can’t offer delivery in a birth centre. It doesn’t make sense to me that women with medium risk pregnancies are offered less continued care than those with low risk pregnancies. It’s something I found incredibly frustrating and disheartening while planning my own VBAC.
Overall I think that women need to be given options and better care in Australia when it comes to birthing our babies.
If you could choose what would be your preferred model of care for pregnancy and birthing?