loading page

Midwifery Continuity of Care during Pregnancy, Birth and the Postpartum period: a matched cohort study.
  • +6
  • Mia Ahlberg,
  • Katarina Aberg,
  • Louise Lundborg,
  • Xingrong Liu,
  • Mikael Norman,
  • Olof Stephansson,
  • Karin Pettersson,
  • Marie Ekborn,
  • Sven Cnattingius
Mia Ahlberg
Karolinska Institutet
Author Profile
Katarina Aberg
Karolinska Institutet
Author Profile
Louise Lundborg
Karolinska Institute
Author Profile
Xingrong Liu
Author Profile
Mikael Norman
Karolinska Institutet
Author Profile
Olof Stephansson
Clinical Epidemiology Unit
Author Profile
Karin Pettersson
Author Profile
Marie Ekborn
Author Profile
Sven Cnattingius
Karolinska Institutet
Author Profile

Abstract

Objective: To compare labour outcomes in a midwifery continuity of care (MCoC) model to standard midwifery care. Design: Matched cohort study. Setting: Public healthcare during pregnancy and childbirth, Stockholm, Sweden. Population: Women giving birth at Karolinska University Hospital site Huddinge in Stockholm between January 1st, 2019 to August 31st, 2021. Methods: Propensity score matching was applied to obtain a matched set from the standard care group for every woman in the MCoC model. Based on the matched cohort, we estimated risk ratios (RR) for binary outcomes with 95% confidence intervals (CI). Main Outcome Measures: Interventions during labor, mode of birth, and preterm birth (<37 gestational weeks). Results: Compared with standard care, women in the MCoC model were more likely to give birth spontaneously (RR 1.06 95% CI 1.02-1.10), and less likely to have an elective caesarean section on maternal request (RR 0.24 95% CI 0.11-0.51). The risk of preterm birth was reduced in the MCoC group (RR 0.51 95% CI 0.32-0.82). Conclusions: The MCoC model was associated with fewer medical interventions and improved maternal and neonatal outcomes.