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Birth outcome in a caseload study conducted in a rural area of Sweden-a register based study

Hildingsson, Ingegerd ; Karlström, Annika ; Rubertsson, Christine LU and Larsson, Birgitta (2020) In Sexual & Reproductive Healthcare 24.
Abstract

BACKGROUND: Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden.

METHOD: A register-based study of 266 women recruited to the project and a control group of 125 women from the same catchment area. Midwives provided antenatal care and were on-call 7 a.m. to 11 p.m. for birth. Data were collected from the antenatal and birth records. Crude and adjusted odds ratios with 95% confidence intervals were calculated between women in the project and the control group.

RESULTS: There were more primiparous women and highly educated women recruited to the... (More)

BACKGROUND: Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden.

METHOD: A register-based study of 266 women recruited to the project and a control group of 125 women from the same catchment area. Midwives provided antenatal care and were on-call 7 a.m. to 11 p.m. for birth. Data were collected from the antenatal and birth records. Crude and adjusted odds ratios with 95% confidence intervals were calculated between women in the project and the control group.

RESULTS: There were more primiparous women and highly educated women recruited to the project, and fewer foreign-born and single women, compared to the control group. Women in the project met more midwives and were less likely to have a pregnancy complication. During intrapartum care, women recruited to the project were less likely to need labour augmentation and less likely to have an instrumental vaginal birth and elective caesarean section. They had fewer second degree perineal tears and were more likely to fully breastfeed at discharge. No differences were found in neonatal outcome. The continuity of a known midwife at birth was quite low.

CONCLUSION: This study shows that women self-recruited to a continuity of care project in a rural area of Sweden had a higher rate of normal births. There were few differences if having a known midwife or not. Long distances to hospital and lack of staff affected the level of continuity.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Sexual & Reproductive Healthcare
volume
24
article number
100509
publisher
Elsevier
external identifiers
  • pmid:32220783
  • scopus:85082180696
ISSN
1877-5764
DOI
10.1016/j.srhc.2020.100509
language
English
LU publication?
yes
id
187614de-1d7e-44d1-aac2-16ac22cf75b9
date added to LUP
2020-04-01 16:08:44
date last changed
2024-06-27 15:57:29
@article{187614de-1d7e-44d1-aac2-16ac22cf75b9,
  abstract     = {{<p>BACKGROUND: Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden.</p><p>METHOD: A register-based study of 266 women recruited to the project and a control group of 125 women from the same catchment area. Midwives provided antenatal care and were on-call 7 a.m. to 11 p.m. for birth. Data were collected from the antenatal and birth records. Crude and adjusted odds ratios with 95% confidence intervals were calculated between women in the project and the control group.</p><p>RESULTS: There were more primiparous women and highly educated women recruited to the project, and fewer foreign-born and single women, compared to the control group. Women in the project met more midwives and were less likely to have a pregnancy complication. During intrapartum care, women recruited to the project were less likely to need labour augmentation and less likely to have an instrumental vaginal birth and elective caesarean section. They had fewer second degree perineal tears and were more likely to fully breastfeed at discharge. No differences were found in neonatal outcome. The continuity of a known midwife at birth was quite low.</p><p>CONCLUSION: This study shows that women self-recruited to a continuity of care project in a rural area of Sweden had a higher rate of normal births. There were few differences if having a known midwife or not. Long distances to hospital and lack of staff affected the level of continuity.</p>}},
  author       = {{Hildingsson, Ingegerd and Karlström, Annika and Rubertsson, Christine and Larsson, Birgitta}},
  issn         = {{1877-5764}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Elsevier}},
  series       = {{Sexual & Reproductive Healthcare}},
  title        = {{Birth outcome in a caseload study conducted in a rural area of Sweden-a register based study}},
  url          = {{http://dx.doi.org/10.1016/j.srhc.2020.100509}},
  doi          = {{10.1016/j.srhc.2020.100509}},
  volume       = {{24}},
  year         = {{2020}},
}