A new study shows one form of antenatal care provides the best of both worlds

Rosie Russell

Seeing the same midwife throughout pregnancy could not only be easier on the pocket, but also cause less problems than other forms of care, according to new research from the University of Sydney.

The study compared caseload midwifery care to standard antenatal care and private obstetric care at the Royal Hospital for Women. The results revealed that pregnant women with one midwife were less likely to require an episiotomy, caesarean, or analgesia, and cost the public hospital system less.
Australian College of Midwives spokesperson, Professor Hannah Dahlen, believes that caseload midwifery is far superior to other forms of care.

“There is no model on earth that provides more continuity and consistency than caseload midwifery,” Dahlen says.

Caseload midwifery is a system where a woman is looked after by one or a small group of midwifes during pregnancy and for six weeks afterwards so they are very familiar with one another by the time the baby arrives.

Co-author of the study, Professor Sally Tracy, says the research was a cross-sectional study of around 6000 women who gave birth at the Royal Hospital for Women in Randwick.

“The latest findings help to refute misconceptions that one-to-one midwifery care is expensive or unsuitable [for] complex pregnancies,” Tracy says.

Over the course of one financial year, the average woman who chose caseload midwifery care saved over $1000 compared to those that elected for private obstetric or standard hospital care.

“Childbirth is the single most important reason for hospitalisation and accounts for the highest number of occupied bed days for women, however, the current structure of our maternity system makes it challenging to deliver value for money,” Tracy says.

The study found that caseload midwifery patients were 10 times less likely to have an elective caesarean and that first-time low-risk mothers were nearly 60 per cent more likely to have a spontaneous onset of labour and an unassisted vaginal birth.

This is compared to 48.2 per cent who chose standard hospital care and 30.8 per cent with private obstetric care.