title: An evaluation of Midwifery Group Practice. Part I: clinical effectiveness.
abstract: 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.
authors.affiliation: School of Psychology, Faculty of Health Sciences, The University of Adelaide, North Terrace Campus, South Australia, Australia. deborah.turnbull@adelaide.edu.au
authors.forename: Deborah
authors.initials: D
authors.lastname: Turnbull
authors.forename: Peter
authors.initials: P
authors.lastname: Baghurst
authors.forename: Carmel
authors.initials: C
authors.lastname: Collins
authors.forename: Chris
authors.initials: C
authors.lastname: Cornwell
authors.forename: Anne
authors.initials: A
authors.lastname: Nixon
authors.forename: Roslyn
authors.initials: R
authors.lastname: Donnelan-Fernandez
authors.forename: Georgia
authors.initials: G
authors.lastname: Antoniou
mesh_terms: 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*