An evaluation of Midwifery Group Practice. Part I: clinical effectiveness.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
MGP is clinically effective when practiced in a routine setting.
Turnbull
Deborah
D
School of Psychology, Faculty of Health Sciences, The University of Adelaide, North Terrace Campus, South Australia, Australia. deborah.turnbull@adelaide.edu.au
Baghurst
Peter
P
Collins
Carmel
C
Cornwell
Chris
C
Nixon
Anne
A
Donnelan-Fernandez
Roslyn
R
Antoniou
Georgia
G
D001315:Australia / Q000453:epidemiology; D005260:Female; D006123:Group Practice / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000458:organization & administration*; D016294:Models, Nursing; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000451:nursing; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000458:organization & administration*