Obstetric Team Care by a Private Midwife and Obstetrician—A Pilot Trial

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Abstract
Autonomous obstetric care by either midwife or doctor excludes the complementary expertise of each other. However, in the present Australian hospital system midwives are usually unable to provide continuity of antepartum, intrapartum and postpartum care to the individual patient and thus are less able to accept ongoing clinical responsibilities or provide satisfactory psychological support to the patient. A pilot trial was instituted to assess the practicality of team care by an obstetrician and a midwife where the midwife, having joined with the obstetrician in the care of the patient at all antenatal visits, attended the patient on her admission to the labour ward until 1 hour after her delivery. This personalized midwifery service did not, in this trial, involve the midwife in duties or responsibilities greater than those of the normal labour ward staff but provided the patient with continuity of care and support by a midwife known to the patient throughout her labour and delivery. The midwife visited the patient twice postnatally. Sixty private patients entered the trial and 56 were attended by the midwife in labour. The mean length of attendance of the midwife in the labour ward was 6.6 hours (range 2-14 hours). The mean length of labour in the hospital was 5.2 hours. There was an apparent reduction in analgesic requirements in the trial patients compared to the concurrent rates in the hospital. All patients in the trial were very enthusiastic about the service, the words 'confidence' and 'security' recurring in their later comments. The service was well accepted by the rostered labour suite staff after an initial orientation programme.(ABSTRACT TRUNCATED AT 250 WORDS)

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