Simulated home delivery in hospital: a randomised controlled trial

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Evidence-Based Midwifery

Background:

• Maternity care models vary, influencing patient experience and outcomes.
• Comparing midwife-led versus consultant-led care is crucial for optimizing antenatal and delivery services.

Purpose of the Study:

• To compare the outcomes and satisfaction levels between midwife-led and consultant-led maternity care models.
• To assess complications and maternal/fetal well-being in two distinct care settings.

Main Methods:

• A randomized controlled trial involving 3510 women at Leicester Royal Infirmary Maternity Hospital.
• Women were allocated to either midwife-led care (simulated home environment) or consultant-led care (delivery suite with advanced equipment).
• Key outcome measures included antenatal, intrapartum, and postpartum complications, maternal morbidity, fetal mortality/morbidity, and patient satisfaction.

Main Results:

• No significant differences were observed in antepartum, intrapartum, or postpartum events between the two groups.
• The percentage of mothers and babies discharged home healthy was comparable across both care models.
• Women in the midwife-led care group reported generally higher satisfaction with antenatal and delivery care.

Conclusions:

• Midwife-led care, particularly in a home-like setting, enhances patient satisfaction without compromising safety or clinical outcomes.
• Both models of maternity care are effective in ensuring the well-being of mothers and newborns.
• Findings support the integration of midwife-led care models to improve the overall patient experience in maternity services.