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Many many thanks for this work!! Marianne Prins Van: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] Namens Soo Downe Verzonden: woensdag 21 augustus 2013 15:11 Aan: [log in to unmask] Onderwerp: Re: Cochrane News: Women Who Receive Midwife Care Throughout Their Pregnancy and Birth Have Better Outcomes Yes, fab to have this Jane, and all involved! All the best soo From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Denis Walsh Sent: 21 August 2013 12:42 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: Cochrane News: Women Who Receive Midwife Care Throughout Their Pregnancy and Birth Have Better Outcomes The most important systematic review for midwives – congratulations to all. Best wishes, Denis Dr Denis Walsh Associate Professor in Midwifery Postgraduate Director of Research & Knowledge Transfer Academic Division of Midwifery University of Nottingham A Floor Medical School Queens Medical Centre Derby Rd Nottingham NG7 2UH Tel: +44(0)115 8230987 Mobile: 07905735777 Email: [log in to unmask]<mailto:[log in to unmask]> From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Sandall, Jane Sent: 21 August 2013 12:14 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Cochrane News: Women Who Receive Midwife Care Throughout Their Pregnancy and Birth Have Better Outcomes From: Wiley Science Newsroom [mailto:[log in to unmask]] Sent: 19 August 2013 11:00 To: Beal, Jennifer - Chichester Subject: Cochrane News: Women Who Receive Midwife Care Throughout Their Pregnancy and Birth Have Better Outcomes To view this email as a webpage click here<http://dmmsclick.wiley.com/view.asp?m=6iz29deyg6svb5ymgpsg&u=22624725&f=h> [cid:image002.jpg@01CE9E82.5B996640]<http://dmmsclick.wiley.com/click.asp?p=22624725&m=77372&u=2058454> Women Who Receive Midwife Care Throughout Their Pregnancy and Birth Have Better Outcomes Maternity care that involves a midwife as the main care provider leads to better outcomes for most women, according to a systematic review published in The Cochrane Library. Researchers found that women who received continued care throughout pregnancy and birth from a small group of midwives were less likely to give birth pre-term and required fewer interventions during labour and birth than when their care was shared between different obstetricians, GPs and midwives. In many countries, including the UK and Australia, midwives act as the main providers of care for women throughout pregnancy, labour and birth. In midwife-led care, there is an emphasis on normality, continuity of care and being cared for by a known, trusted midwife during labour. Midwife-led continuity of care is provided in a multi-disciplinary network of consultation and referral with other care providers. This contrasts with medical-led models of care, where an obstetrician or family physician is primarily responsible for care, and with shared-care, where responsibility is shared between different healthcare professionals. There has been some debate about whether the midwife-led model of care is more effective. The researchers reviewed data from 13 trials involving a total of 16,242 women. Eight trials included women at low risk of complications and five trials included women at high risk of complications. They looked at outcomes for mothers and babies when midwives were the main providers of care, compared to medical-led or shared care models. When midwives were the main providers of care throughout, women were less likely to give birth before 37 weeks or lose their babies before 24 weeks. Women were happier with the care they received, had fewer epidurals, fewer assisted births, and fewer episiotomies. An episiotomy involves making a surgical incision to reduce the risk of a tear. In addition, women who received midwife-led care were no more likely to have a caesarean birth, but they were in labour for about half an hour longer on average. Based on these results, the researchers conclude that all women should be offered midwife-led continuity of care unless they have serious medical or obstetric complications. “Women should be encouraged to ask for this option,” said lead researcher Jane Sandall of the Division of Women’s Health at King’s College London in London, UK, who led an interdisciplinary team of researchers from Sheffield Hallam University, The University of Warwick and National University of Ireland Galway. “Policymakers in areas of the world where health systems do not provide midwife-led care should consider the importance of midwives in improving maternity care and how financing of midwife-led services can be reviewed to support this.” Five studies considered the cost of midwife-led compared to shared care. While care provided by midwives was more cost-effective during labour, the results for postnatal care were inconclusive. “There was a lack of consistency in the way that maternity care cost was estimated in the studies, but there seemed to be a trend towards a cost-saving effect of midwife-led care,” said Sandall. Full citation: Sandall J, Soltani H, Gates S, Shennan A, Devane D.; Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub3. About The Cochrane Library The Cochrane Library contains high quality health care information, including the Cochrane Database of Systematic Reviews, from the Cochrane Collaboration. Cochrane Systematic Reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration (http://www.cochrane.org) is a UK registered international charity and the world's leading producer of systematic reviews. It has been demonstrated that Cochrane Systematic Reviews are of comparable or better quality and are updated more often than the reviews published in print journals (Wen J et al; The reporting quality of meta-analyses improves: a random sampling study. Journal of Clinical Epidemiology 2008; 61: 770-775). In June 2013, the Cochrane Database of Systematic Reviews received an impact factor of 5.703, from Thomson ISI. The Cochrane Library is published by Wiley on behalf of The Cochrane Collaboration. The Cochrane Library Podcasts: a collection of podcasts on a selection of Cochrane Reviews by authors of reviews in this issue will be available from www.cochrane.org/podcasts<http://dmmsclick.wiley.com/click.asp?p=22624725&m=77372&u=2058459>. Accessing The Cochrane Library The Cochrane Library can be accessed at www.thecochranelibrary.com<”http:/www.thecochranelibrary.com”>. Guest users may access abstracts and plain language summaries for all reviews in the database, and members of the media may request full access to the contents of the Library. For further information, see contact details below. A number of countries, including countries in the World Bank’s list of low- and low- middle income economies (countries with a gross national income (GNI) per capita of less than $4700), have national provisions by which some or all of their residents are able to access The Cochrane Library for free. To find out more, please visit www.thecochranelibrary.com/FreeAccess<http://dmmsclick.wiley.com/click.asp?p=22624725&m=77372&u=2058460>. ________________________________