Caseload midwifery for women at low risk of medical complications: a randomised controlled trial

医疗并发症风险低的女性的助产病例数：一项随机对照试验

• 批准号: nhmrc : 433040
• 负责人: Dr Mary-Ann Davey
• 金额: $ 40.31万
• 依托单位: La Trobe University
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2007
• 资助国家: 澳大利亚
• 起止时间: 2007-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/caseload-midwifery-women-controlled-trial/94661
• 关键词: Caseload; midwifery; women; low; risk

In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing caseload care. Studies of continuity of midwifery teams have reported reduced caesareans and other interventions in labour. They have also found increased satisfaction, with no statistically significant differences in health outcomes for babies. Women who are identified at low medical risk will be recruited from the antenatal clinic of a large, tertiary, public maternity hospital. Women will be randomly allocated to caseload midwifery or standard low risk care. Those allocated to caseload will receive pregnancy, birth and postnatal care from a primary midwife with one or two pregnancy visits to be conducted by a 'back-up' midwife. The midwife will collaborate with obstetricians and other health professionals as necessary. This will be the first RCT of caseload midwifery care in Australia and only the third one conducted anywhere. It is a unique opportunity to provide a rigorous evaluation of a model that is beginning to be implemented widely in Australia. The trial will provide much needed information regarding the outcomes of caseload midwifery including interventions in childbirth, safety, costs, women's satisfaction with care and impact on the midwifery workforce. The study will provide data that will inform clinical practice and guide service providers involved in the organisation of maternity services.

2004年6月，维多利亚州人类服务部发布了一份政策文件《维多利亚州孕产妇服务的未来方向》。该文件批准扩大提供“一对一”助产护理（病例）的公共产妇护理模式。该模型的安全性和有效性在很大程度上未知，评价有限。在英国和澳大利亚进行的研究在很大程度上衡量了护理提供者团队（通常为6-12名助产士）的效果，在英国只有两个测试案例护理。对助产队连续性的研究报告说，剖腹产和其他分娩干预减少了。他们还发现满意度有所提高，婴儿的健康结果没有统计学显着差异。将从一家大型三级公立妇产医院的产前诊所招募被确定为医疗风险低的妇女。女性将被随机分配到助产士或标准低风险护理。那些被分配到工作量的人将接受初级助产士的怀孕、分娩和产后护理，并由“后备”助产士进行一次或两次怀孕检查。必要时，助产士将与产科医生和其他保健专业人员合作。这将是澳大利亚第一个案例助产护理RCT，也是在任何地方进行的第三个RCT。这是一个独特的机会，可以对澳大利亚开始广泛实施的模式进行严格的评估。该试验将提供急需的信息，包括分娩干预措施，安全，成本，妇女对护理的满意度和对助产士的影响。该研究将提供数据，为临床实践提供信息，并指导参与组织孕产妇服务的服务提供者。