Costs cut by continuity of midwife care

The research led by Sally Tracy, professor of midwifery at the University of Sydney, randomly allocated 1748 pregnant women of varying risk into two groups to receive either caseload care from a named midwife, or standard public hospital maternity care with rostered midwives and shared care with medical practitioners.

While there was no significant difference in the overall rate of caesarean section between the two groups, women in the caseload group were more likely to have an unassisted birth without pharmacological analgesia and were less likely to have an elective caesarean (8%) than the standard care group (11%).

The overall median cost of birth per woman was $566.74 less for caseload midwifery than standard care.

Neonatal outcomes did not differ between the two groups. However, women in the caseload group were more likely (30%) to experience spontaneous onset of labour and more likely to breastfeed at discharge from hospital.