Cited by 906Maternal and Perinatal Health InterventionsMaternal and Neonatal HealthcareBreastfeeding Practices and Influences

Midwife-led continuity models versus other models of care for childbearing women

Open access
Sandall, Jane, Soltani, Hora, Gates, Simon, Shennan, Andrew, Devane, Declan·2016·Cochrane Database of Systematic Reviews

Abstract

Analysis 1.17.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 17 Perineal laceration requiring suturing. . . . . . . . . . . . . . . . . . . . . .Analysis 1.18.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 18 Mean labour length (hrs). . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.19.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 19 Postpartum haemorrhage (as defined by trial authors). . . . . . . . . . . . . . . .Analysis 1.20.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 20 Breastfeeding initiation. . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.21.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 21 Duration of postnatal hospital stay (days). . . . . . . . . . . . . . . . . . . .Analysis 1.22.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 22 Low birthweight (< 2500 g). . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.23.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 23 5-minute Apgar score below or equal to 7. . . . . . . . . . . . . . . . . . . .Analysis 1.24.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 24 Neonatal convulsions (as defined by trial authors). . . . . . . . . . . . . . . . .Analysis 1.25.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 25 Admission to special care nursery/neonatal intensive care unit. . . . . . . . . . . . .Analysis 1.26.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 26 Mean length of neonatal hospital stay (days).. . . . . . . . . . . . . . . . . .Analysis 1.27.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 27 Fetal loss less than 24 weeks and neonatal death. . . . . . . . . . . . . . . . . .Analysis 1.28.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 28 Fetal loss equal to/after 24 weeks and neonatal death. . . . . . . . . . . . . . . .Analysis 2.1.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 1 Regional analgesia (epidural/spinal). . . . . . . . . . . . . . . . .Analysis 2.2.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 2 Caesarean birth. . . . . . . . . . . . . . . . . . . . . . . .Analysis 2.3.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 3 Instrumental vaginal birth (forceps/vacuum). . . . . . . . . . . . . .Analysis 2.4.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 4 Spontaneous vaginal birth (as defined by trial authors). . . . . . . . . .Analysis 2.5.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 5 Intact perineum. . . . . . . . . . . . . . . . . . . . . . . .Analysis 2.6.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 6 Preterm birth (< 37 weeks). . . . . . . . . . . . . . . . . . . .Analysis 2.7.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 7 All fetal loss before and after 24 weeks plus neonatal death. . . . . . . . .Analysis 3.1.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 1 Regional analgesia (epidural/spinal). . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.2.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 2 Caesarean birth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.3.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 3 Instrumental vaginal birth (forceps/vacuum). . . . . . . . . . . . . . . . . . . . . . .Analysis 3.4.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 4 Spontaneous vaginal birth (as defined by trial authors). . . . . . . . . . . . . . . . . . . .Analysis 3.5.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 5 Intact perineum. . . . . . . . . . . . . . . . . . . . . . . . . .

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd004667.pub5

Cites

99 of 99 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Mothers who receive care based on midwife-led continuity models were more satisfied and were less likely to experience intervention and adverse outcomes for themselves or their infants during the postnatal period than women who received other models of care.

    “Mothers who receive care based on these continuity models were more satisfied and were less likely to experience intervention and adverse outcomes for themselves or their infants during the postnatal period than women who received other models of care [5]”

    From Support during the postnatal period: Evaluating new mothers' and midwives' experiences of a new, coordinated postnatal care model in a midwifery clinic in Sweden (2023) · cites this paper as [5]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured
  • Continuity models of midwifery care have clear benefits for the health of the mother and baby, as well as increased satisfaction and lower costs.

    “A Cochrane review of 17,674 women in 15 scientific studies showed clear benefits for the health of the mother and baby, as well as increased satisfaction and lower costs [3].”

    From Fulfilment of expectations on birth and the postpartum period – A Swedish cohort study (2022) · cites this paper as [3]

    The Main results (page not provided) confirm that the review included 15 trials involving 17,674 women and found benefits including fewer preterm births and fewer fetal losses or neonatal deaths. They also report higher maternal satisfaction in most studies. However, the Main results describe only a trend toward cost savings, with inconsistent cost assessment, so the claim of lower costs as a clear benefit overstates the evidence. (LLM, conf=0.89)

    Experimental — accuracy not yet measured
  • Continuity models result in better maternal and foetal outcomes and greater satisfaction compared to standard care.

    “Continuity models not only result in better maternal and foetal outcomes but also a greater satisfaction compared to standard care [3].”

    From Fulfilment of expectations on birth and the postpartum period – A Swedish cohort study (2022) · cites this paper as [3]

    The Authors’ conclusions report fewer interventions and greater satisfaction with midwife-led continuity care, while describing adverse outcomes for women and infants as at least comparable. The Main results report reductions in some fetal outcomes but no difference in several others. Thus, the unqualified claim of better maternal and foetal outcomes overstates the review’s findings; the comparison was with other models of care, not solely standard care. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • The countries that have more than others implemented the midwifery-led care model are Canada, Australia, United Kingdom and Sweden, Netherlands and Norway, and Denmark.

    “The countries that have more than others implemented the midwifery-led care model are Canada (10), Australia (11), United Kingdom and Sweden (12), Netherlands and Norway (13), and Denmark (14).”

    From The midwifery-led care model: a continuity of care model in the birth path (2019) · cites this paper as [11]

    The Background says that midwife-led continuity care is available in the United Kingdom. However, the review does not establish that the United Kingdom and Sweden have implemented it more than other countries; its Included studies section lists trials in four countries and does not include Sweden. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Midwife-led continuity models are associated with a lower frequency of preterm delivery (RR 0.76; RC 96%: 0.64; 8 trials, n=13238).

    “preterm delivery: 8 trials, n= 13238; RR: 0.76; RC 96%: 0.64”

    From The midwifery-led care model: a continuity of care model in the birth path (2019) · cites this paper as [11]

    The Summary of Findings reports fewer preterm births with midwife-led continuity care: RR 0.76 across 8 RCTs and 13,238 participants. It gives a 95% confidence interval of 0.64 to 0.91, not the quoted 96% interval, and the citing sentence omits the upper bound. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

1 retracted

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D.
Affiliations
  • St Thomas' Hospital (GB)
  • Sheffield Hallam University (GB)
  • University of Warwick (GB)
  • Ollscoil na Gaillimhe – University of Galway (IE)
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2016-04-28
Volume
2016
Issue
4
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
OpenAlex
W4296980855
Cited by
906
References
99
Citations by year
2026: 74 · 2025: 79 · 2024: 109 · 2023: 116 · 2022: 110 · 2021: 94 · 2020: 107 · 2019: 77 · 2018: 61 · 2017: 49 · 2016: 20 · 2015: 8 · 2014: 2
FWCI
12.19
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • SHURA (Sheffield Hallam University Research Archive) (Sheffield Hallam University) (acceptedVersion)
Funders
  • World Health Organization
  • UNICEF
  • Sheffield Hallam University
  • King's College Hospital NHS Foundation Trust
  • National Institute for Health and Care Research (NF-SI-0514-10145)
  • King's College London
  • Evidence Synthesis Programme
  • National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
Keywords
models of care, childbirth, perineal tears, postpartum hemorrhage, breastfeeding initiation, low birth weight, Apgar score, neonatal seizures, neonatal intensive care admission, maternal outcomes, infant outcomes, obstetric surgery, cesarean section, episiotomy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review