(Press-News.org) 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.
### END
Women who receive midwife care throughout their pregnancy and birth have better outcomes
2013-08-21
ELSE PRESS RELEASES FROM THIS DATE:
Peering into the heart of aquatic embryo development
2013-08-21
Scientists using a pioneering bio-imaging system to record simultaneously the development of hundreds of aquatic embryos have discovered significant parent-offspring similarities in the timing and sequence of that development.
Researchers at Plymouth University have found the timing of key developmental milestones – such as the first beating of the heart, formation of the eyes and movement – differs markedly between individuals in a species of aquatic snail, but also that these timings appear to be heritable, i.e. they are passed from mother to offspring.
The study, made ...
Frontiers news briefs: August 20
2013-08-21
Frontiers in Plant Science
Transgenic bacteria shed light on symbiotic exchanges within the soil
Adding light-producing bacteria to soil can be a powerful method for tracking in real time how plant roots provide soil bacteria with carbohydrates, according to a new study in Frontiers in Plant Science.
Soil bacteria rely for their growth on compounds released from plant roots in the form of excretions and sloughed-off cells, while bacteria often make scarce nutrients available to roots in exchange. For the first time, researchers from Woods Hole Marine Biological Laboratory ...
First pre-clinical gene therapy study to reverse Rett symptoms
2013-08-21
The concept behind gene therapy is simple: deliver a healthy gene to compensate for one that is mutated. New research published today in the Journal of Neuroscience suggests this approach may eventually be a feasible option to treat Rett Syndrome, the most disabling of the autism spectrum disorders. Gail Mandel, Ph.D., a Howard Hughes Investigator at Oregon Health and Sciences University, led the study. The Rett Syndrome Research Trust, with generous support from the Rett Syndrome Research Trust UK and Rett Syndrome Research & Treatment Foundation, funded this work through ...
Honeyguide birds destroy own species' eggs to eliminate competition
2013-08-21
Like cuckoos, honeyguides are parasitic birds that lay their eggs in other birds' nests and dupe them into raising their young. Now scientists reveal that, unlike in cuckoos, the resemblance between honeyguide eggs and those of their bee-eater bird hosts hasn't evolved to trick hosts into accepting the imposter egg as one of their own. Rather, it appears to have evolved to trick other honeyguides who would otherwise destroy the eggs because of fierce competition for host nests. The new research is published today, 21 August, in the journal Biology Letters.
Honeyguides ...
Study implicates dopamine in food restriction, drug abuse
2013-08-21
SAN ANTONIO (Aug. 20, 2013) — Scientists today reported a possible basis for why food-restricted animals show increased susceptibility to drugs of abuse. This association has puzzled researchers since it was first observed more than three decades ago.
Senior author Michael Beckstead, Ph.D., from the School of Medicine at The University of Texas Health Science Center San Antonio, said the team found that dopamine neurons in a brain region called the substantia nigra fire bursts more than twice as frequently in chronically food-restricted mice. Cocaine significantly enhanced ...
Social giving makes us happier
2013-08-21
People usually feel good when they make a charitable donation, but they feel even better if they make the donation directly to someone they know or in a way that builds social connection. Research to be published in the International Journal of Happiness and Development investigates for the first time how social connection helps turn generous behavior into positive feelings on the part of the donor.
Lara Aknin of Simon Fraser University, in Burnaby, British Columbia, Canada, and colleagues at the University of British Columbia, Vancouver and Harvard Business School, Massachusetts, ...
3D graphene: Solar cells' new platinum?
2013-08-21
One of the most promising types of solar cells has a few drawbacks. A scientist at Michigan Technological University may have overcome one of them.
Dye-sensitized solar cells are thin, flexible, easy to make and very good at turning sunshine into electricity. However, a key ingredient is one of the most expensive metals on the planet: platinum. While only small amounts are needed, at $1,500 an ounce, the cost of the silvery metal is still significant.
Yun Hang Hu, the Charles and Caroll McArthur Professor of Materials Science and Engineering, has developed a new, inexpensive ...
Epic ocean voyages of coral larvae revealed
2013-08-21
MIAMI – August 20, 2013 -- A new computer simulation conducted at the University of Bristol (UB) and University of Miami (UM) Rosenstiel School of Marine & Atmospheric Science has revealed the epic, ocean-spanning journeys travelled by millimetre-sized coral larvae through the world's seas.
The study, published in Global Ecology and Biogeography, is the first to recreate the oceanic paths along which corals disperse globally, and will eventually aid predictions of how coral reef distributions may shift with climate change.
Coral reefs are under increasing threat ...
Multiple genes manage how people taste sweeteners
2013-08-21
Genetics may play a role in how people's taste receptors send signals, leading to a wide spectrum of taste preferences, according to Penn State food scientists. These varied, genetically influenced responses may mean that food and drink companies will need a range of artificial sweeteners to accommodate different consumer tastes.
"Genetic differences lead to differences in how people respond to tastes of foods," said John Hayes, assistant professor, food science and director of the sensory evaluation center.
Based on the participants' genetic profile, researchers were ...
Chromosome 21 abnormality tells oncologists to treat pediatric ALL more aggressively
2013-08-21
A recent study by members of the Children's Oncology Group reports results of a large trial showing that children whose leukemia cells have amplification of a portion of chromosome 21 may require more aggressive treatment for Acute Lymphoblastic Leukemia (ALL) than children without this gene amplification.
"This helps identify patients who need more therapy than they may otherwise get," says Stephen Hunger, MD, investigator at the University of Colorado Cancer Center, professor of pediatrics at the University of Colorado School of Medicine, and director of the Center ...