The results of the COSMOS trial (COmparing standard
maternity care with one to one midwifery support) were published recently in
the British Journal of Obstetrics and Gynaecology.
The results of the trial show improved
outcomes for mothers and babies who received caseload care compared to those
who received standard care.
Women allocated to caseload were:
likely to have a Caesarean section 19.4%compared to 24.9% (receiving
likely to have a spontaneous vaginal birth 63% compared to 55.7%,
likely to have epidural analgesia 30.5% versus 34.6%,
likely to have an episiotomy 23.1% versus 29.4%.
Infants of women allocated to caseload
were less likely to be admitted to special or neonatal intensive care 4.0%
Midwives working in the caseload model at the Women's provide care in accordance with
hospital policies and guidelines and work collaboratively with medical
staff. The hospital management and the parameters of the trial ensured
that midwives did not work greater than 12 hours and had a minimum of 4 days
per fortnight free of call and duty. Caseload midwives are well supported
with back up and support always available.
ANF members and staff have been actively
involved in the trial and remain involved in on-going monitoring and review of
the Women's caseload program.
ANF congratulates all involved, caseload
and standard care midwives, The Women's management and Latrobe University researchers
for this significant contribution to the international evidence base.
Read the research article