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Midwifery continuity of care vs standard maternity care for women at increased risk of preterm birth: A hybrid implementation–effectiveness, randomised controlled pilot trial in the UK

PLoS Medicine Oct 11, 2020

Turienzo CF, Bick D, Briley AL, et al. - Researchers conducted a hybrid randomized controlled pilot trial with the aim to determine if a model of midwifery continuity of care linked with a specialist obstetric clinic is feasible for women considered at increased risk for preterm birth (PTB). In addition, they examined fidelity, and clinical outcomes of the model. From May 9, 2017 to September 30, 2018, they performed random assignment of 334 pregnant women identified at raised risk of PTB (1:1) to either midwifery continuity of antenatal, intrapartum, and postnatal care (Pilot study Of midwifery Practice in Preterm birth Including women’s Experiences [POPPIE] group) or standard care group (maternity care by different midwives working in designated clinical areas). A named/partner midwife provided more than 75% of antenatal and postnatal visits, and presence of a midwife from the POPPIE team was evident at 80% of births. No statistically significant difference was evident between groups (POPPIE group 83.3% versus standard group 84.7%). Infants in the POPPIE group significantly more frequently had skin-to-skin contact after birth, had it for a longer time, and were breastfeed immediately following birth and at hospital discharge. Per overall observations, it is feasible to set up and attain fidelity of a model of midwifery continuity of care associated with specialist obstetric care for women at raised risk of PTB in an inner-city maternity service in London (UK), however, no impact was evident on most outcomes for this population group.

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