Midwifery Antenatal Postnatal Service (MAPS): A retrospective cohort study exploring perinatal outcomes and consumer...

Maternity consumer and workforce preference is for continuity of midwifery care, with on-call arrangements identified as a key barrier.

The Midwifery Antenatal Postnatal Service (MAPS) enables midwives to provide antenatal and postnatal continuity without on-call or intrapartum care requirements. High satisfaction has been reported amongst midwives and women. Limited research has explored associated clinical outcomes.

To explore perinatal outcomes of women who received MAPS care against a matched sample who received standard fragmented care, contextualised by qualitative insights into women's perspectives of care.

A retrospective cohort study compared perinatal outcomes of 223 MAPS mother-baby dyads with a matched standard-care cohort. A total 105 consumers participated in a brief online cross-sectional survey. Clinical outcomes were analysed using adjusted logistic regression. Qualitative data underwent inductive content analysis.

Compared with the matched cohort, MAPS was associated with reduced induction of labour (aOR 0.62, 95% CI 0.39-0.97, p = 0.036), increased use of 'other analgesia and comfort measures' (aOR 1.94, 95% CI 1.16-3.25, p = 0.012), increased vaginal birth (aOR 1.53, 95% CI 1.02-2.31, p = 0.041) and reduced breast milk substitute feeding for maternal choice (aOR 0.61, 0.38-0.98, p = 0.041). Consumer satisfaction was high (mean 4.93/5), explored through three themes.

MAPS was associated with select improved maternal outcomes. Qualitative findings highlighted structural elements that supported relational care, and opportunities for improvement.

MAPS offers a positive alternative to standard care. Further research is recommended to strengthen evidence into its impact on clinical outcomes and to optimise continuity and integration within pre-existing services.