Midwifery continuity of care for women with complex pregnancies in Australia: An integrative review

Deborah Fox; Vanessa Scarf; Sabera Turkmani; Chris Rossiter; Rebecca Coddington; Annabel Sheehy; Christine Catling; Allison Cummins; Kathleen Baird

doi:10.1016/j.wombi.2022.07.001

Midwifery continuity of care for women with complex pregnancies in Australia: An integrative review

Women Birth. 2023 Mar;36(2):e187-e194. doi: 10.1016/j.wombi.2022.07.001. Epub 2022 Jul 20.

Authors

Deborah Fox¹, Vanessa Scarf², Sabera Turkmani², Chris Rossiter², Rebecca Coddington², Annabel Sheehy², Christine Catling², Allison Cummins³, Kathleen Baird²

Affiliations

¹ Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia. Electronic address: Deborah.Fox@uts.edu.au.
² Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Australia.
³ School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Australia.

PMID: 35869009
DOI: 10.1016/j.wombi.2022.07.001

Abstract

Background: All women require access to quality maternity care. Continuity of midwifery care can enhance women's experiences of childbearing and is associated with positive outcomes for women and infants. Much research on these models has been conducted with women with uncomplicated pregnancies; less is known about outcomes for women with complexities.

Aim: To explore the outcomes and experiences for women with complex pregnancies receiving midwifery continuity of care in Australia.

Methods: This integrative review used Whittemore and Knafl's approach. Authors searched five electronic databases (PubMed/MEDLINE, EMBASE, CINAHL, Scopus, and MAG Online) and assessed the quality of relevant studies using the Critical Appraisal Skills Programme (CASP) appraisal tools.

Findings: Fourteen studies including women with different levels of obstetric risk were identified. However, only three reported outcomes separately for women categorised as either moderate or high risk. Perinatal outcomes reported included mode of birth, intervention rates, blood loss, perineal trauma, preterm birth, admission to special care and breastfeeding rates. Findings were synthesised into three themes: 'Contributing to safe processes and outcomes', 'Building relational trust', and 'Collaborating and communicating'. This review demonstrated that women with complexities in midwifery continuity of care models had positive experiences and outcomes, consistent with findings about low risk women.

Discussion: The nascency of the research on midwifery continuity of care for women with complex pregnancies in Australia is limited, reflecting the relative dearth of these models in practice.

Conclusion: Despite favourable findings, further research on outcomes for women of all risk is needed to support the expansion of midwifery continuity of care.

Keywords: Australia; Childbirth; Continuity of care; Midwife-led care; Perinatal outcomes; Pregnancy.

Publication types

Review

MeSH terms

Australia
Continuity of Patient Care
Female
Humans
Infant
Infant, Newborn
Maternal Health Services*
Midwifery*
Parturition
Pregnancy
Premature Birth*