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Caseload Midwifery: A Critical Analysis of Evidence-based Practice - Essay Example

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Caseload Midwifery: A Critical Analysis of Evidence-based Practice.
Caseload midwifery is a style of care where a patient is assigned a primary midwife who will secure care from pregnancy, birth, and the days following the delivery (Southern Health, 2011). …
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Caseload Midwifery: A Critical Analysis of Evidence-based Practice
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Download file to see previous pages Any additional tests or care shall be ordered by the midwife, including the need to refer the patient to medical staff where necessary. The primary midwife is available on call and would be supported by caseload midwives where the primary is not available.
Caseload midwifery also seems to be synonymous with midwifery-managed care or one-on-one midwifery care (McCourt and Page, 1996; Farmer and Chipperfield, 1996). In different countries, midwifery care has been based on caseload and sustained care (Newman and Pearse, 2006). For countries like Australia and the UK where this type of care is often applied, caseload midwifery is a coordinated model for care within existing maternity services.
This study now seeks to present a critical literature review of caseload midwifery model compared with standard models of practice. To pursue such goals, various aspects and perspectives in midwifery caseload shall be covered, including clinical outcomes, patient perspectives, midwife perspectives, and efficacy of the model. The Kotter model of change will be considered especially as it covers the leadership elements which can help ensure the effective implementation of change in maternal and child care.
Discussion Clinical outcomes The available evidence from randomized controlled trials (Turnbull, et.al. 1996; Hatem, et.al. 2008) indicates how caseload midwifery is an option which helps decrease obstetric intervention (Hartz, et.al. 2011). It is also an intervention which helps ensure improved levels of satisfaction for women, with less unfavourable effects on mothers and their babies (Hartz, et.al. 2011). However, the randomized controlled trials on caseload midwifery including two comparative studies (Harvey, et.al. 1996; Pankhurst, 1997) did not specify differences in the style of delivery for the women under caseload management. Trends in other comparative cohort studies (Benjamin, et.al. 2001; Pankhurst, 1997) indicate that caseload midwifery may favourably impact on the outcomes of birth. However, no previous studies sought to evaluate the significance in the style of delivery. Comparative cohort studies and descriptive studies for caseload midwifery of care include low risk standards (Nixon, et.al. 2003; Johnson, et.al. 2005; Williams, et.al. 2005), including standards for women with low to moderate risks and women having high levels of risk (Nixon, et.al. 2003; Turnbull, et.al. 2009). There seems to be a contrast in the mode of birth outcomes in terms of comparative cohorts and descriptive Australian standards on caseload midwifery in terms of clinical trials and comparative cohort studies (Harvey, et.al. 1996; Pankhurst, 1997). The issue on why the contrast exists needs to be considered. Methodological differences would be under initial consideration. The levels of evidence relating to the efficacy of clinical remedies is hierarchical in nature with systematic reviews and some randomized controlled trials at the highest level of evidence (National Health and Medical Research Council, 2008). The Cochrane review of midwifery-centric against other interventions for ...Download file to see next pagesRead More
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