Australian caseload midwifery: the exception or the rule

Area of Science:

• Maternal Health
• Midwifery Care Models
• Public Health Outcomes

Background:

• Caseload midwifery models emerged in Australia during the late 1990s and early 2000s.
• Previous studies, primarily from the UK, yielded mixed results on caseload midwifery's effectiveness.
• A need exists for robust evidence on Australian caseload midwifery models.

Purpose of the Study:

• To review clinical outcomes of Australian caseload midwifery models.
• To compare caesarean section and intervention rates with national data.
• To identify the need for further high-quality research.

Main Methods:

• Review of descriptive and comparative cohort studies on Australian caseload midwifery.
• Analysis of reported clinical outcomes, focusing on caesarean section rates.
• Comparison of Australian findings with international studies and national rates.

Main Results:

• Australian caseload midwifery models consistently show lower caesarean section rates.
• Reduced rates observed irrespective of maternal obstetric risk.
• Findings contrast with some earlier international randomized controlled trials.

Conclusions:

• Australian caseload midwifery is associated with decreased caesarean section and intervention rates.
• Existing evidence highlights the need for a large-scale randomized controlled trial.
• An ongoing Australian randomized controlled trial aims to provide definitive evidence.