Labour outcomes in caseload midwifery and standard care: a register-based cohort study

Ingrid Jepsen; Svend Juul; Maralyn Foureur; Erik Elgaard Sørensen; Ellen Ågaard Nøhr

doi:10.1186/s12884-018-2090-9

Labour outcomes in caseload midwifery and standard care: a register-based cohort study

Bidragets oversatte titel: Et register baseret kohorte studie om fødselsudfald i kendt jordemoder ordning sammenlignet med konventionel omsorg

Ingrid Jepsen, Svend Juul, Maralyn Foureur, Erik Elgaard Sørensen, Ellen Ågaard Nøhr

Jordemoderuddannelsen

Publikation: Bidrag til tidsskrift › Tidsskriftsartikel › Forskning › peer review

Abstract

Background:
Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and standard midwifery care.

Methods:
A historical register-based cohort study was carried out using routinely collected data about all singleton births
2013–2016 in two maternity units in the North Denmark Region. In this region, women are geographically allocated to
caseload midwifery or standard care, as caseload midwifery is only available in some towns in the peripheral part of the
uptake areas of the maternity units, and it is the only model of care offered here. Labour outcomes of 2679 all-risk
women in caseload midwifery were compared with those of 10,436 all-risk women in standard midwifery care using
multivariate linear and logistic regression analyses.

Bidragets oversatte titel	Et register baseret kohorte studie om fødselsudfald i kendt jordemoder ordning sammenlignet med konventionel omsorg
Originalsprog	Engelsk
Tidsskrift	BMC Pregnancy and Childbirth
Vol/bind	18
Udgave nummer	1
Antal sider	11
ISSN	1471-2393
DOI	https://doi.org/10.1186/s12884-018-2090-9
Status	Udgivet - 6 dec. 2018

Emneord

Sygdom, sundhedsvidenskab og sygepleje
Jordemoder
evaluering
kendt jordemoderordning
kohorte studie

Adgang til dokumentet

10.1186/s12884-018-2090-9

Andre filer og links

Link to publication in Scopus

2 Bidrag til bog/antologi
2 Paper/skriftligt oplæg
2 Tidsskriftsartikel
1 Bog
Mere
- 1 Podcast, musik- og lydproduktion

Identitetens konstruktion i mødet med kvinden og institutionen
Knudsen, M. L. M., 19 apr. 2022, Jordemoder: Profession, identitet og fortællinger. Schrøder, K., Vilhelmsen, A.-M. R. & Knudsen, M. L. M. (red.). København: Akademisk Forlag, s. 73-85 13 s.
Publikation: Bidrag til bog/antologi/rapport › Bidrag til bog/antologi › Formidling
Kendt Jordemoderordning – en særlig arbejdsform
Jepsen, I., 19 apr. 2022, Jordemoder: Profession, identitet og fortællinger. Schrøder, K., Vilhelmsen, A.-M. R. & Knudsen, M. L. M. (red.). København: Akademisk Forlag, s. 251-261 11 s.
Publikation: Bidrag til bog/antologi/rapport › Bidrag til bog/antologi › Formidling
Experiences and outcome of caseload midwifery - a mixed methods study
Bidragets oversatte titel: Kendt jordemoderordning: oplevelser og resultater - et mixed metode studieJepsen, I., 24 aug. 2018.
Publikation: Konferencebidrag uden forlag/tidsskrift › Paper/skriftligt oplæg › Formidling
Kendt jordemoderordning
Jepsen, I. (Udøver), 27 dec. 2018
Publikation: Ikke-skriftlig produktion › Podcast, musik- og lydproduktion › Formidling

Åben adgang
A qualitative study of how caseload midwifery is constituted and experienced by Danish midwives
Bidragets oversatte titel: Et kvalitativt studie om, hvordan jordemødre oplever at arbejde som kendt jordemoderJepsen, I., Sørensen, E. E., Nøhr, E. Å. & Mark, E., 19 jun. 2017.
Publikation: Konferencebidrag uden forlag/tidsskrift › Paper/skriftligt oplæg › Forskning › peer review
A qualitative study of how caseload midwifery is experienced by couples in Denmark
Jepsen, I., Mark, E., Foureur, M., Nøhr, E. A. & Sørensen, E. E., 2017, I: Women and Birth. 30, 1, s. e61-e69 9 s.
Publikation: Bidrag til tidsskrift › Tidsskriftsartikel › Forskning › peer review
Caseload midwifery: a mixed methods study : Ph.d.-afhandling
Bidragets oversatte titel: Kendt jordemoderordning: et mixed metode studieJepsen, I., 2017, Aalborg Universitetsforlag. 93 s.
Publikation: Bog/antologi/rapport/Ph.d. afhandling › Bog › Forskning › peer review

Åben adgang
Is caseload midwifery a healthy work-form? - A survey of burnout among midwives in Denmark
Jepsen, I., Juul, S., Foureur, M., Sørensen, E. E. & Nøhr, E. A., 2017, I: Sexual & Reproductive HealthCare. 11, s. 102-106 5 s.
Publikation: Bidrag til tidsskrift › Tidsskriftsartikel › Forskning › peer review

1 Foredrag eller oplæg

Fremtidig organisering for Kendt Jordemoderordning og Kendt Jordemoderteam
Jepsen, I. (Oplægsholder)
10 okt. 2022
Aktivitet: Tale eller præsentation - typer › Foredrag eller oplæg

Citationsformater

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title = "Labour outcomes in caseload midwifery and standard care: a register-based cohort study",

abstract = "Background: Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and standard midwifery care. Methods: A historical register-based cohort study was carried out using routinely collected data about all singleton births 2013-2016 in two maternity units in the North Denmark Region. In this region, women are geographically allocated to caseload midwifery or standard care, as caseload midwifery is only available in some towns in the peripheral part of the uptake areas of the maternity units, and it is the only model of care offered here. Labour outcomes of 2679 all-risk women in caseload midwifery were compared with those of 10,436 all-risk women in standard midwifery care using multivariate linear and logistic regression analyses. Results: Compared to women in standard care, augmentation was more frequent in caseload women (adjusted odds ratio (aOR) 1.20; 95% CI 1.06-1.35) as was labour duration of less than 10 h (aOR 1.26; 95% CI 1.13-1.42). More emergency caesarean sections were observed in caseload women (aOR 1.17; 95% CI 1.03-1.34), but this might partly be explained by longer distance to the maternity unit in caseload women. When caseload women were compared to women in standard care with a similar long distance to the hospital, no difference in emergency caesarean sections was observed (aOR 1.04; 95% CI 0.84-1.28). Compared to standard care, infants of caseload women more often had Apgar ≤7 after 5 min. (aOR 1.57; 95% CI 1.11-2.23) and this difference remained when caseload women were compared to women with similar distance to the hospital. For elective caesarean sections, preterm birth, induction of labour, dilatation of cervix on admission, amniotomy, epidural analgesia, and instrumental deliveries, we did not obseve any differences between the two groups. After birth, caseload women more often experienced no laceration (aOR 1.17; 95% CI 1.06-1.29). Conclusions: For most labour outcomes, there were no differences across the two models of midwifery-led care but unexpectedly, we observed slightly more augmentation and adverse neonatal outcomes in caseload midwifery. These findings should be interpreted in the context of the overall low intervention and complication rates in this Danish setting and in the context of research that supports the benefits of caseload midwifery. Although the observational design of the study allows only cautious conclusions, this study highlights the importance of monitoring and evaluating new practices contextually.",

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author = "Ingrid Jepsen and Svend Juul and Maralyn Foureur and S{\o}rensen, {Erik Elgaard} and N{\o}hr, {Ellen {\AA}gaard}",

note = "Publisher Copyright: {\textcopyright} 2018 The Author(s).",

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doi = "10.1186/s12884-018-2090-9",

language = "English",

volume = "18",

journal = "BMC Pregnancy and Childbirth",

issn = "1471-2393",

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TY - JOUR

T1 - Labour outcomes in caseload midwifery and standard care

T2 - a register-based cohort study

AU - Jepsen, Ingrid

AU - Juul, Svend

AU - Foureur, Maralyn

AU - Sørensen, Erik Elgaard

AU - Nøhr, Ellen Ågaard

PY - 2018/12/6

Y1 - 2018/12/6

N2 - Background: Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and standard midwifery care. Methods: A historical register-based cohort study was carried out using routinely collected data about all singleton births 2013-2016 in two maternity units in the North Denmark Region. In this region, women are geographically allocated to caseload midwifery or standard care, as caseload midwifery is only available in some towns in the peripheral part of the uptake areas of the maternity units, and it is the only model of care offered here. Labour outcomes of 2679 all-risk women in caseload midwifery were compared with those of 10,436 all-risk women in standard midwifery care using multivariate linear and logistic regression analyses. Results: Compared to women in standard care, augmentation was more frequent in caseload women (adjusted odds ratio (aOR) 1.20; 95% CI 1.06-1.35) as was labour duration of less than 10 h (aOR 1.26; 95% CI 1.13-1.42). More emergency caesarean sections were observed in caseload women (aOR 1.17; 95% CI 1.03-1.34), but this might partly be explained by longer distance to the maternity unit in caseload women. When caseload women were compared to women in standard care with a similar long distance to the hospital, no difference in emergency caesarean sections was observed (aOR 1.04; 95% CI 0.84-1.28). Compared to standard care, infants of caseload women more often had Apgar ≤7 after 5 min. (aOR 1.57; 95% CI 1.11-2.23) and this difference remained when caseload women were compared to women with similar distance to the hospital. For elective caesarean sections, preterm birth, induction of labour, dilatation of cervix on admission, amniotomy, epidural analgesia, and instrumental deliveries, we did not obseve any differences between the two groups. After birth, caseload women more often experienced no laceration (aOR 1.17; 95% CI 1.06-1.29). Conclusions: For most labour outcomes, there were no differences across the two models of midwifery-led care but unexpectedly, we observed slightly more augmentation and adverse neonatal outcomes in caseload midwifery. These findings should be interpreted in the context of the overall low intervention and complication rates in this Danish setting and in the context of research that supports the benefits of caseload midwifery. Although the observational design of the study allows only cautious conclusions, this study highlights the importance of monitoring and evaluating new practices contextually.

AB - Background: Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and standard midwifery care. Methods: A historical register-based cohort study was carried out using routinely collected data about all singleton births 2013-2016 in two maternity units in the North Denmark Region. In this region, women are geographically allocated to caseload midwifery or standard care, as caseload midwifery is only available in some towns in the peripheral part of the uptake areas of the maternity units, and it is the only model of care offered here. Labour outcomes of 2679 all-risk women in caseload midwifery were compared with those of 10,436 all-risk women in standard midwifery care using multivariate linear and logistic regression analyses. Results: Compared to women in standard care, augmentation was more frequent in caseload women (adjusted odds ratio (aOR) 1.20; 95% CI 1.06-1.35) as was labour duration of less than 10 h (aOR 1.26; 95% CI 1.13-1.42). More emergency caesarean sections were observed in caseload women (aOR 1.17; 95% CI 1.03-1.34), but this might partly be explained by longer distance to the maternity unit in caseload women. When caseload women were compared to women in standard care with a similar long distance to the hospital, no difference in emergency caesarean sections was observed (aOR 1.04; 95% CI 0.84-1.28). Compared to standard care, infants of caseload women more often had Apgar ≤7 after 5 min. (aOR 1.57; 95% CI 1.11-2.23) and this difference remained when caseload women were compared to women with similar distance to the hospital. For elective caesarean sections, preterm birth, induction of labour, dilatation of cervix on admission, amniotomy, epidural analgesia, and instrumental deliveries, we did not obseve any differences between the two groups. After birth, caseload women more often experienced no laceration (aOR 1.17; 95% CI 1.06-1.29). Conclusions: For most labour outcomes, there were no differences across the two models of midwifery-led care but unexpectedly, we observed slightly more augmentation and adverse neonatal outcomes in caseload midwifery. These findings should be interpreted in the context of the overall low intervention and complication rates in this Danish setting and in the context of research that supports the benefits of caseload midwifery. Although the observational design of the study allows only cautious conclusions, this study highlights the importance of monitoring and evaluating new practices contextually.

KW - disease, health science and nursing

KW - Jordemoder

KW - evaluering

KW - kendt jordemoderordning

KW - kohorte studie

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U2 - 10.1186/s12884-018-2090-9

DO - 10.1186/s12884-018-2090-9

M3 - Journal article

C2 - 30522453

SN - 1471-2393

VL - 18

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

IS - 1

ER -

Labour outcomes in caseload midwifery and standard care: a register-based cohort study

Abstract

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