Midwifery Continuity of Care during Pregnancy, Birth and the Postpartum
period: a matched cohort study.
Abstract
Objective: To compare labour outcomes in a midwifery continuity of care
(MCoC) model to standard midwifery care. Design: Matched cohort study.
Setting: Public healthcare during pregnancy and childbirth, Stockholm,
Sweden. Population: Women giving birth at Karolinska University Hospital
site Huddinge in Stockholm between January 1st, 2019 to August 31st,
2021. Methods: Propensity score matching was applied to obtain a matched
set from the standard care group for every woman in the MCoC model.
Based on the matched cohort, we estimated risk ratios (RR) for binary
outcomes with 95% confidence intervals (CI). Main Outcome Measures:
Interventions during labor, mode of birth, and preterm birth
(<37 gestational weeks). Results: Compared with standard care,
women in the MCoC model were more likely to give birth spontaneously (RR
1.06 95% CI 1.02-1.10), and less likely to have an elective caesarean
section on maternal request (RR 0.24 95% CI 0.11-0.51). The risk of
preterm birth was reduced in the MCoC group (RR 0.51 95% CI 0.32-0.82).
Conclusions: The MCoC model was associated with fewer medical
interventions and improved maternal and neonatal outcomes.