Validation of a Midwifery Model in Palestine 2

Study Overview
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Brief Summary
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A midwife-led continuity model of care was implemented in governmental maternal facilities in Palestine. Midwives from the hospitals provided outreaching caseload ante- and postnatal care to women in rural villages clinics and homes. This study investigated if the model had impact on important maternal and neonatal health outcomes. A retrospective cohort design was used.

Detailed Description
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Background: A midwife-led continuity model of care was implemented in governmental maternal facilities in Palestine. Midwives from the hospitals provided outreaching caseload ante- and postnatal care to women in rural villages clinics and homes. This study investigated if the model had impact on important maternal and neonatal health outcomes. Method: A retrospective cohort design was used. Nablus governmental hospital, Rafidia's medical records were reviewed and data extracted involving 2199 women with singleton pregnancies, residing in rural villages, and their new-born babies born between January 2016 and February 2017. Outcomes were limited to the available information in the hospital's birth registry. Important maternal outcomes were postpartum anaemia (Hb <11), mode of delivery and induction of labour. Important outcomes for new-borns were premature delivery < 37 weeks, birth weight < 2500g and 1500g and referral to neonatal intensive care unit. Outcomes were compared between women receiving the midwife-led continuity model of antenatal care and women receiving regular care.

Official Title
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The Palestinian Midwifery-led Continuity Model's Effect on Mothers' and Babies' Health Outcomes

Conditions
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Prenatal Care

Intervention / Treatment
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* Other: Midwife led continuity model of care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women with singleton pregnancies residing in rural areas giving birth at Nablus governmental hospital, Palestine Exclusion Criteria: Multiple pregnancies Women residing in urban areas

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 44 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Midwife led continuity model of care<br>Women who received antenatal care from midwives from the hospital reaching out to the rural villages | Other: Midwife led continuity model of care<br>* Midwives from the hospitals provided outreaching caseload ante- and postnatal care to women in rural villages clinics and homes<br>|
| Regular care group<br>Women who received care from doctors, nurses or midwives employed at primary Health care centres in rural villages | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emergency Caesarean section rate | Percentage of women undergoing emergency Caesarean section | 17 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Premature birth rate | Babies born before 37 weeks gestational age | 17 months | 
| Post partum anaemia in the mother | Low Hb Level at discharge from hospital | 17 months | 
| Induction of Labour rate | The rate of women in each group who received induction of labour | 17 months | 
| Birth weight | Weight immediately post partum: Low (<2500g) Very low (<1500) | 17 months | 
| APGAR score 5 minutes post partum | APGAR score | 17 months | 
| Referral to neonatal intensive care | Rate of babies that were referred to neonatal intensive care during hospital stay | 17 months | 
| Blood transfusion rate post partum | Rate of women receiving blood tranfusion during the hospital stay | 17 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Midwifery-led continuity of care, Birth complications