Satisfaction with midwife-managed care in different time periods: A randomised controlled trial of 1299 women
Abstract
Objective To compare women's satisfaction with midwife-managed care with 'shared care' over three different time periods.Design Randomised controlled trial.Setting Glasgow Royal Maternity Hospital, Glasgow, UK.Participants 1299 women experiencing normal pregnancy (consent rate: 82%). Six hundred and forty-eight women were randomised to midwife-managed care and 651 to 'shared care'.Methods Three self-report questionnaires were sent to women's homes. The questionnaires examined: satisfaction with antenatal care at 34-35 weeks' gestation, and satisfaction with intrapartum, hospital- and home-based postnatal care at seven weeks postnatally. The third questionnaire reviewed satisfaction with intrapartum care seven months after delivery.Findings Women in both groups were satisfied. However, women in the midwife-managed group were more highly satisfied in relation to the dimensions examined: relationships with staff, information transfer, choices and decisions, and social support. The differences between the two groups were evident for all time periods (i.e. antenatal, intrapartum and postnatal periods) and were sustained at seven-month follow-up. This is illustrated in the mean scores for relationships with staff, as measured at 34-35 weeks' gestation (possible range -2; very negative attitudes to 2; very positive attitudes). Women in the midwife-managed group scored a mean of 1.22 compared to 0.74 for the 'shared care' group (mean diff: 0.48; 95% CI: 0.42 to 0.55). While women in both groups were more likely to make positive rather than negative comments in open-ended questions, the midwife-managed group were more likely to make positive comments whereas the 'shared care' group were more likely to make negative comments.Conclusion Midwife-managed care for healthy pregnant women which is integrated into existing services improves satisfaction with antenatal, intrapartum and postnatal care.
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Both team midwifery models and caseload midwifery models have been shown to increase women's satisfaction.
“Both team midwifery models (that include four to 12 midwives) and caseload midwifery models (where women are allocated a primary ‘known’ midwife) have been shown to increase women’s satisfaction [4, 6, 14].”
These findings are in keeping with many of the RCTs, other studies, and the Cochrane review of midwife-led care.
“These findings are in keeping with many of the RCTs [4–6, 14], other studies [4, 6, 8–14], and the Cochrane review of midwife-led care [7].”
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- Authors
- Shields, N., Turnbull, D., Reid, M., Holmes, A., McGinley, M., & Smith, L. N.
- Affiliations
- The University of Adelaide (AU)
- University of Glasgow (GB)
- Princess Royal Maternity Hospital (GB)
- Corresponding author
- Shields, Noreen
- ORCID
- Turnbull, Deborah
- Venue
- Midwifery
- Publisher
- Elsevier BV
- Published
- 1998-06
- Volume
- 14
- Issue
- 2
- Pages
- 85-93
- ISSN
- 0266-6138 (ISSN-L)
- OpenAlex
- W2078098074
- Cited by
- 62
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2016: 6 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 4
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Midwifery (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- shared care, patient satisfaction, prenatal care, intrapartum care, postpartum care, normal pregnancy, staff-patient relationship, social support, information transmission
- MeSH terms
- Adult, Female, Humans, Maternal Health Services, Mothers, Nurse Midwives, Obstetrics, Patient Care Team, Pregnancy, Primary Nursing, Surveys and Questionnaires, Scotland, Nursing Evaluation Research, Patient Satisfaction
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