[Benefits and risks of caseload midwifery: continuity of midwifery team during antenatal, intrapartal, and postnatal care]

Wassén L, Borgström Bolmsjö B, Eriksson M, Frantz S, Hagman A, Lindroth M, Rubertsson C, Steen Carlsson K, Strandell A, Svanberg T, Wessberg A, Wallerstedt SM
Record ID 32018011319
Original Title: Nytta och risker med caseload midwifery: samma barnmorske-team genom graviditet, förlossning och eftervård
Authors' objectives: Background In Sweden, about 115,000 children are born every year. Midwives provide care to women throughout their pregnancy, childbirth and the postnatal period, consulting other health professionals when necessary. Usually, the same midwife provides care during pregnancy and postnatal follow-up. During birth and the first week postpartum, other midwives, working at the hospitals, provide intrapartum and postpartum care. It has been suggested that continuity of the midwifery care over the entire process, i.e. caseload midwifery, would improve outcomes for the mother and the child. In this model, a primary midwife, within a small team of midwives, follows a load of cases (about 40 per year per midwife) during pregnancy, childbirth and the postnatal period. Caseload midwives are on a more flexible time plan, including duty on-call about half of their scheduled work hours, to be able to assist the team’s assigned women at birth. Question at issue What are the benefits and risks of caseload midwifery, compared with standard care in Sweden, during pregnancy, birth and postpartum care for women and their children?
Authors' results and conclusions: This systematic review shows that there may be little or no difference between caseload midwifery and Swedish standard care regarding perinatal mortality and neonatal morbidity. No evidence is available regarding severe neonatal morbidity, and no conclusions can be drawn based on available evidence regarding studied critical maternal outcomes. Caseload midwifery may reduce the incidence of caesarean section but the generalisability of these results in the Swedish setting is unclear. The risk of preterm birth, as well as instrumental birth, is probably not affected. RCTs in Swedish health care, or similar settings, would be required to gain important evidence that is currently lacking.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Nurse Midwives
  • Pregnancy
  • Prenatal Care
  • Postnatal Care
  • Labor, Obstetric
  • Continuity of Patient Care
  • Midwifery
  • Caseload midwifery
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
Contact Name: hta-centrum@vgregion.se
Contact Email: hta-centrum@vgregion.se
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