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Do women who receive only midwifery care during their pregnancy have a better outcome to those who are cared for by a number of different professionals?
A new study published in the Cochrane Library  has shown that women who receive care from only midwives throughout their pregnancy have better outcomes in terms of complications and premature birth, some of the common causes of cerebral palsy injury in newborn babies.
This study reviewed a large number of other individual research papers in order to try to give an over view as to whether midwifery care alone made any difference as to the outcome. The study reviewed 31 trials involving over 16 thousand woman, who were a mixture of both high and low risk pregnancies. Outcomes were compared in terms of the need for regional analgesia, episiotomy, instrumental birth, need for pain relief during birth, need to be induced, attendance at birth by a known midwife, length of labour, pre term birth or miscarriage before 24 weeks and the need for caesarean section. The outcomes were better for midwife lead care in all of these categories apart from for caesarean section, where the rate was the same.
It was also reported in the study that women felt a higher degree of satisfaction with their care if they received care from a smaller team of midwives rather than care being shared between midwives, GPs and obstetricians.
As medical negligence solicitors we often receive enquiries from parents about possible cerebral palsy claims stemming from poor care and monitoring during pregnancy, and a common concern is lack of continuity of care.
Complications during pregnancy and labour are thankfully usually well managed, however poor communication and continuity of care can lead to misdiagnosis, for example pregnancy related hypertension or diabetes, where trends of test results are established over a period of time. A midwife who gets to know a mother during pregnancy may be less likely to miss key signs of a developing problem, which could lead to complications for both mother and child.
The author of the study stated: “Most women should be offered midwife-led continuity models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications.”
As medical solicitors we would concur with this given the views of our clients, who frequently complain of being seen by a number of different health professionals, which they feel didn’t allow their midwife to get to know them and their baby and lead to a lack of continuity of care. The outcome of poor care in pregnancy can be devastating for mum and baby, with some babies suffering cerebral palsy as a result of injury suffered during their birth. It is vital to seek specialist advice if you have concerns regarding the care you received during your pregnancy or birth.
 DOI: 10.1002/14651858.CD004667.pub3 Midwife-led continuity models versus other models of care for childbearing women. Jane Sandall et al.