Cargando…

A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia

We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in...

Descripción completa

Detalles Bibliográficos
Autores principales: Miller, Yvette D., Tone, Jessica, Talukdar, Sutapa, Martin, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275696/
https://www.ncbi.nlm.nih.gov/pubmed/35819947
http://dx.doi.org/10.1371/journal.pone.0271105
_version_ 1784745544496709632
author Miller, Yvette D.
Tone, Jessica
Talukdar, Sutapa
Martin, Elizabeth
author_facet Miller, Yvette D.
Tone, Jessica
Talukdar, Sutapa
Martin, Elizabeth
author_sort Miller, Yvette D.
collection PubMed
description We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in Queensland (response rate = 30.4%). Logistic regression was used to estimate the odds of outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates. Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. There were minimal differences for women in GP Shared Care. Women in Public Midwifery Continuity Care were less likely to have a scheduled caesarean and more likely to have an unassisted vaginal birth, experience freedom of mobility during labour and informed consent processes for inducing labour, vaginal examinations, fetal monitoring and receiving Syntocinon to birth their placenta, and report highest quality interpersonal care. They had fewer vaginal examinations, lower odds of perineal trauma requiring sutures and anxiety after birth, shorter postpartum hospital stays, and higher odds of a home postpartum care visit. Women in Private Obstetric Care were more likely to have their labour induced, a scheduled caesarean birth, experience informed consent processes for caesarean, and report highest quality interpersonal care, but less likely to experience unassisted vaginal birth and informed consent for Syntocinon to birth their placenta. There is an urgent need to communicate variations between maternity models across the range of outcome and experiential measures that are important to women; build more rigorous comparative evidence for Private Midwifery Care; and prioritise experiential and out-of-pocket cost comparisons in further research to enable woman-centred informed decision-making.
format Online
Article
Text
id pubmed-9275696
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-92756962022-07-13 A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia Miller, Yvette D. Tone, Jessica Talukdar, Sutapa Martin, Elizabeth PLoS One Research Article We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in Queensland (response rate = 30.4%). Logistic regression was used to estimate the odds of outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates. Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. There were minimal differences for women in GP Shared Care. Women in Public Midwifery Continuity Care were less likely to have a scheduled caesarean and more likely to have an unassisted vaginal birth, experience freedom of mobility during labour and informed consent processes for inducing labour, vaginal examinations, fetal monitoring and receiving Syntocinon to birth their placenta, and report highest quality interpersonal care. They had fewer vaginal examinations, lower odds of perineal trauma requiring sutures and anxiety after birth, shorter postpartum hospital stays, and higher odds of a home postpartum care visit. Women in Private Obstetric Care were more likely to have their labour induced, a scheduled caesarean birth, experience informed consent processes for caesarean, and report highest quality interpersonal care, but less likely to experience unassisted vaginal birth and informed consent for Syntocinon to birth their placenta. There is an urgent need to communicate variations between maternity models across the range of outcome and experiential measures that are important to women; build more rigorous comparative evidence for Private Midwifery Care; and prioritise experiential and out-of-pocket cost comparisons in further research to enable woman-centred informed decision-making. Public Library of Science 2022-07-12 /pmc/articles/PMC9275696/ /pubmed/35819947 http://dx.doi.org/10.1371/journal.pone.0271105 Text en © 2022 Miller et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Miller, Yvette D.
Tone, Jessica
Talukdar, Sutapa
Martin, Elizabeth
A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title_full A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title_fullStr A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title_full_unstemmed A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title_short A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia
title_sort direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in queensland, australia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275696/
https://www.ncbi.nlm.nih.gov/pubmed/35819947
http://dx.doi.org/10.1371/journal.pone.0271105
work_keys_str_mv AT milleryvetted adirectcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT tonejessica adirectcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT talukdarsutapa adirectcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT martinelizabeth adirectcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT milleryvetted directcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT tonejessica directcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT talukdarsutapa directcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia
AT martinelizabeth directcomparisonofpatientreportedoutcomesandexperiencesinalternativemodelsofmaternitycareinqueenslandaustralia