Effects of midwife-led maternity services on postpartum wellbeing and clinical outcomes in primiparous women under China’s one-child policy

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Hua, J, Zhu, L, Du, L, Li, Y, Wu, Z, Wo, D and Du, W ORCID: https://orcid.org/0000-0002-5115-7214, 2018. Effects of midwife-led maternity services on postpartum wellbeing and clinical outcomes in primiparous women under China’s one-child policy. BMC Pregnancy and Childbirth, 18: 329. ISSN 1471-2393

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Official URL: http://doi.org/10.1186/s12884-018-1969-9

Abstract

Background:

The Midwife-led maternity services have been implemented in China in response to the high rates of primiparous women and Caesarean Sections (CS) which may be related to China’s one-child policy. However, few studies in China have been reported on the effectiveness of Midwife-led Care at Delivery (MCD) and the Continuity of Midwife-led Care (CMC) on postpartum wellbeing and other clinical outcomes. Therefore, evidence-based clinical validation is needed to develop an optimal maternity service for childbearing women in China.

Methods:

A concurrent cohort study design was conducted with 1730 pregnant women recruited from 9 hospitals in Shanghai. Among the 1730 participants at baseline, 1568 participants completed the follow-up questionnaire, with a follow-up rate of 90.6%.

Results:

Compared with the routine Obstetrician-led Maternity Care (OMC), Midwife-led Care at Delivery (MCD) was associated with CS rate (OR were 0.16; 95%CI: 0.11 to 0.25) and a higher total score of postpartum wellbeing (βwere 2.70; 95%CI: 0.70 to 4.70) when adjusting for the baseline differences and other confounders during delivery or postpartum period. Moreover, continuity of Midwife-led Care (CMC) was associated with CS rate (OR were 0.30; 95%CI: 0.23 to 0.41), as well as increased rate of breastfeeding within the first 24 h (OR were 2.49; 95% CI: 1.47 to 4.23), higher postpartum satisfaction (β = 4.52; 95% CI: 1.60 to 12.68), lower anxiety (βwere 0.66; 95% CI: 0.16 to 1.17), increased self-control (βwere 0.39; 95% CI: 0.02 to 0.76) and a higher total score of postpartum wellbeing (βwere 3.14; 95% CI: 1.54 to 4.75).

Conclusion:

CMC is the optimal service for low-risk primiparous women under China’s one-child policy, and is worthwhile for a general implementation across China.

Item Type:	Journal article
Publication Title:	BMC Pregnancy and Childbirth
Creators:	Hua, J., Zhu, L., Du, L., Li, Y., Wu, Z., Wo, D. and Du, W.
Publisher:	BioMed Central Ltd.
Date:	13 August 2018
Volume:	18
ISSN:	1471-2393
Identifiers:	Number Type 10.1186/s12884-018-1969-9 DOI 1969 Publisher Item Identifier
Rights:	© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Divisions:	Schools > School of Social Sciences
Record created by:	Jill Tomkinson
Date Added:	15 Jul 2019 15:52
Last Modified:	15 Jul 2019 15:52
URI:	https://irep.ntu.ac.uk/id/eprint/37080