Midwives found to aid babies' survival

Women who are cared for by midwives rather than GPs or obstetricians are less likely to lose their babies within the first six months of their pregnancies, an international review of maternity services has found.

Researchers gave no reasons for the shock finding, taken from an analysis of 11 trials involving more than 12,200 women in four countries, but a spokeswoman for the Australian College of Midwives, Hannah Dahlen, said women who were seen by the same midwife during pregnancy, labour and birth usually felt more supported and less anxious, leading to reduced risk of miscarriage.

That explanation has frustrated the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, which says its members provide the same level of continuous care to their patients and could not be held accountable for miscarriages or stillbirths that occurred so early in pregnancy.

"One third of women see private obstetricians and we all give continuity of care," the college's president, Christine Tippett, said yesterday.

"I am on call 24 hours a day, seven days a week and I deliver about 90 per cent of my women. I think it is drawing a very long bow to link miscarriages before 24 weeks with continuity of care. Most miscarriages occur because of foetal or chromosomal abnormalities and there is no evidence to suggest the mode of care makes any difference."

The analysis, which is the largest undertaken in the world, also found that women in midwife-led models of care were less likely to be admitted to hospital during pregnancy, have instrumental deliveries, episiotomies or require analgesia and were more likely to have spontaneous vaginal births, feel in control during labour and better able to initiate breastfeeding.

Dr Dahlen said the analysis, published by the Cochrane collaboration, considered the gold standard of assessing medical evidence, proved that midwife-led models of care had no adverse outcomes and many benefits. Continued...