title: Changing Childbirth: a pilot project.
abstract: OBJECTIVE
  To compare the outcomes of an adapted pilot Changing Childbirth initiative providing continuity of care by a group of known midwives with traditional maternity care.
  
  
  METHODS
  Between-groups trial to compare levels of satisfaction and clinical outcomes for two groups of women, cared for either under this Changing Childbirth scheme or the traditional model of care.
  
  
  METHODS
  Of the 200 women who agreed to participate in the project, 100 were randomly allocated to the pilot scheme and 100 to the traditional care package. During the postpartum period, information was collected via a questionnaire about participants' levels of satisfaction with a variety of aspects of care provided during the antenatal, delivery and postpartum periods. Data about clinical outcomes for the two groups were also obtained.
  
  
  RESULTS
  Women in the pilot group had significantly more continuity of care throughout each of the three periods, were generally more satisfied with their care, felt that they had more choice over a variety of aspects of care and experienced no compromise in clinical outcomes (P = 0.05 or less in each case).
  
  
  CONCLUSIONS
  Many previous attempts to introduce the Changing Childbirth initiative have revealed significant problems, particularly with regard to the continuity of carer requirement. Taking account of local health care needs and existing provision, the present study adapted this concept to continuity of care. This did not apparently affect any of the guiding principles contained in the original document, and yet enhanced satisfaction. It would appear that the Changing Childbirth agenda can be adapted and integrated with local health care situations without sacrificing any of the overarching principles.
authors.affiliation: School of Health Sciences, The University of Birmingham, Birmingham B15 2TT, UK. c.m.hicks@bham.ac.uk
authors.forename: Carolyn
authors.initials: C
authors.lastname: Hicks
authors.forename: Peter
authors.initials: P
authors.lastname: Spurgeon
authors.forename: Fred
authors.initials: F
authors.lastname: Barwell
mesh_terms: D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration; D036861:Delivery, Obstetric / Q000451:nursing* / Q000523:psychology / Q000592:standards; D004739:England; D005260:Female; D006801:Humans; D009721:Nurse Midwives / Q000458:organization & administration*; D009746:Nursing, Team / Q000458:organization & administration*; D009936:Organizational Innovation; D017060:Patient Satisfaction; D010865:Pilot Projects; D011181:Postnatal Care / Q000458:organization & administration; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration; D011795:Surveys and Questionnaires