Published 11 June 2009, doi:10.1136/bmj.b2210
Cite this as: BMJ 2009;338:b2210

Editorials

Independent midwifery care versus NHS care in the UK

A need to balance risks, benefits, and choice

The first 150 words of the full text of this article appear below.

A commitment to quality and safety, together with choice and continuity of care, underpins current directions for the reform of maternity services in the United Kingdom and Australia.^{1 2} Recognition that midwifery-led care will be central to these changes, with options for women to give birth at home, has stimulated research about the safest and most effective models of care. Symon and colleagues (doi:10.1136/bmj.b2060) compare clinical outcomes between pregnant women accessing an independent midwife and women using the National Health Service (NHS).³ They found that obstetric risk factors were an important predictor of perinatal outcomes. Unwittingly the authors illustrate pitfalls involved in attempting to match disparate datasets. Nevertheless, they confirm some of what we already know about the benefits of continuity models of midwifery care and the important role of risk selection in achieving good perinatal outcomes.

Symon and colleagues attempted to match two groups of women, which is . . . [Full text of this article]

¹ School of Nursing, Midwifery and Indigenous Health, Faculty of Health and Behavioural Sciences, University of Wollongong, NSW, Australia 2522, ² Informed Health Choices Trust, NSW, Australia

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Outcomes for births booked under an independent midwife and births in NHS maternity units: matched comparison study

Andrew Symon, Clare Winter, Melanie Inkster, and Peter T Donnan
BMJ 2009 338: b2060. [Abstract] [Full Text] [PDF]

Outcomes of planned home births with certified professional midwives: large prospective study in North America

Kenneth C Johnson and Betty-Anne Daviss
BMJ 2005 330: 1416. [Abstract] [Full Text] [PDF]

Perinatal death associated with planned home birth in Australia: population based study

Hilda Bastian, Marc J N C Keirse, and Paul A L Lancaster
BMJ 1998 317: 384-388. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Independent midwives

Emma A Mahony
bmj.com, 16 Jun 2009 [Full text]

Acknowledgement

Allison Shorten, et al.
bmj.com, 22 Jun 2009 [Full text]

The Value of Independent Midwifery Care

Pauline Elizabeth Dawkins
bmj.com, 22 Jun 2009 [Full text]

demand all you like, but........

Bob Bury
bmj.com, 24 Jun 2009 [Full text]

Online poll

Find out more >>