The effectiveness of a Chinese midwives’ antenatal clinic service on childbirth outcomes for primipare: A randomised controlled trial

Gu, Chunyi; Wu, Xiaodan; Ding, Yan; Zhu, Xinli; Zhang, Xinyuan

doi:10.1016/j.ijnurstu.2013.05.001

Cited by 34 publications

(30 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this has rarely been achieved in the area of maternity service provision, either in Australia or elsewhere . Promising outcomes have been reported in other countries for newer models of care that lead to improved experiences for mothers, as well as better birth outcomes, particularly in relation to midwifery‐led care . This is consistent with other studies of antenatal care; however, these studies are few in number.…”

Section: Discussionsupporting

confidence: 59%

Identification and evaluation of models of antenatal care in Australia – A review of the evidence

Brock

Charlton

Yeatman

2014

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 59%

Identification and evaluation of models of antenatal care in Australia – A review of the evidence

Brock

Charlton

Yeatman

2014

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

show abstract

“…Quality scores for the models ranged from 9 to 25 for the midwifery-led interventions (out of a possible 32), with the majority of models reporting fewer than half the characteristics associated with quality maternity care (Table 1 ). Overall our scoring system found little temporal association with scores, although the two highest scoring studies were published recently [ 29 , 32 ]. Two other recent studies with low scores were from China and Mexico [ 33 , 34 ].…”

Section: Resultsmentioning

confidence: 80%

“…Most of the studies (11/17) were restricted to women categorised as ‘low risk’, although the definition of low risk varied between studies. Those not focussed exclusively on ‘low risk’ women were from Australia [ 26 – 28 ], the UK [ 29 ], China [ 30 ] and Mexico [ 31 ]. Our assessment of the presence or absence of reporting of the components and characteristics from the QMNC framework [ 5 ] is shown in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…low risk) Midwifery-led care by same small team of midwives (7 midwives in one unit/team, 12 in the other unit) for the antenatal period, intra-partum and up to 7 days post-partum ✓ ✓ ✓(7 days) 2.Biro et al 2003 [ 26 ] (+Biro 2000) [ 41 ] Data collection 1996–98 Australia; one medical centre (Melbourne) n = 502; Pregnant women of any risk status Team midwifery provided by 7 midwives for antenatal, intra-partum and the immediate post-partum period (1 day) ✓ ✓ ✓(1 day) 3.Flint et al 1989 [ 27 ] Data collection 1983–85 UK (England); one maternity hospital (London) n = 503; Low risk pregnant women Team of 4 midwives offering continuity of care for antenatal, labour and immediate post-partum period (exact period not specified) ✓ ✓ ✓(unspecified) 4.Giles et al 1992 [ 28 ] Data collection 1989–90 Australia; one teaching hospital (Sydney) n = 43; Low risk pregnant women Midwife-led care from team of 4 midwives throughout pregnancy (labour and post-partum care was provided by other staff/midwives) ✓ ??? 5.Gu et al 2013 [ 29 ] Data collection 2011 China; one obstetric hospital (Fudan) n = 55; Low risk, first pregnancy/birth Midwife-led antenatal, intra-partum care, and for first two hours post-partum provided by one of 10 midwives (or an associate) ✓ ✓ 6.Harvey et al 2002 [ 30 ] Data collection period not stated Canada; one tertiary referral centre (Alberta) n = 101; Low risk women/pregnancies Midwife-led care by team of 7 midwives, from booking visit through to intra-partum and post-partum, plus a 6 week follow-up clinic visit ✓ ✓ ✓(one 6 week follow-up visit) 7.Hicks 2003 [ 31 ] Data collection period not stated UK (England); antenatal clinics in study area (location not stated) n = 200; First 200 low risk women to book in study area once study began Team midwifery (eight midwives) providing continuity of care ✓ ✓ ✓ 8. Homer et al 2001a [ …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care

Symon

Pringle

Cheyne

et al. 2016

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundImplementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation. Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care.MethodsA systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models’ characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria.ResultsFrom 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0–32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported.ConclusionsThe QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised.

show abstract

“…The Chinese study [44] took place in an environment without a strong tradition of midwifery care, differing, for example, from Australia and the UK. There was one economic analysis of a ‘midwife-led’ hospital antenatal clinic ([45]); the others all evaluated continuity intervention.…”

Section: Resultsmentioning

confidence: 99%

Antenatal care trial interventions: a systematic scoping review and taxonomy development of care models

Symon

Pringle

Downe

et al. 2017

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundAntenatal care models vary widely around the world, reflecting local contexts, drivers and resources. Randomised controlled trials (RCTs) have tested the impact of multi-component antenatal care interventions on service delivery and outcomes in many countries since the 1980s. Some have applied entirely new schemes, while others have modified existing care delivery approaches. Systematic reviews (SRs) indicate that some specific antenatal interventions are more effective than others; however the causal mechanisms leading to better outcomes are poorly understood, limiting implementation and future research. As a first step in identifying what might be making the difference we conducted a scoping review of interventions tested in RCTs in order to establish a taxonomy of antenatal care models.MethodsA protocol-driven systematic search was undertaken of databases for RCTs and SRs reporting antenatal care interventions. Results were unrestricted by time or locality, but limited to English language. Key characteristics of both experimental and control interventions in the included trials were mapped using SPIO (Study design; Population; Intervention; Outcomes) criteria and the intervention and principal outcome measures were described. Commonalities and differences between the components that were being tested in each study were identified by consensus, resulting in a comprehensive description of emergent models for antenatal care interventions.ResultsOf 13,050 articles retrieved, we identified 153 eligible articles including 130 RCTs in 34 countries. The interventions tested in these trials varied from the number of visits to the location of care provision, and from the content of care to the professional/lay group providing that care. In most studies neither intervention nor control arm was well described. Our analysis of the identified trials of antenatal care interventions produced the following taxonomy: Universal provision model (for all women irrespective of health state or complications); Restricted ‘lower-risk’-based provision model (midwifery-led or reduced/flexible visit approach for healthy women); Augmented provision model (antenatal care as in Universal provision above but augmented by clinical, educational or behavioural intervention); Targeted ‘higher-risk’-based provision model (for woman with defined clinical or socio-demographic risk factors). The first category was most commonly tested in low-income countries (i.e. resource-poor settings), particularly in Asia. The other categories were tested around the world. The trials included a range of care providers, including midwives, nurses, doctors, and lay workers.ConclusionsInterventions can be defined and described in many ways. The intended antenatal care population group proved the simplest and most clinically relevant way of distinguishing trials which might otherwise be categorised together. Since our review excluded non-trial interventions, the taxonomy does not represent antenatal care provision worldwide. It offers a stable and reproduc...

show abstract

The effectiveness of a Chinese midwives’ antenatal clinic service on childbirth outcomes for primipare: A randomised controlled trial

Cited by 34 publications

References 39 publications

Identification and evaluation of models of antenatal care in Australia – A review of the evidence

Identification and evaluation of models of antenatal care in Australia – A review of the evidence

Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care

Antenatal care trial interventions: a systematic scoping review and taxonomy development of care models

Contact Info

Product

Resources

About