de Wolff Mie G, Ladekarl Monica, Pagh Nanna B, Overgaard Charlotte
Copenhagen University Hospital, Hvidovre, Department of Obstetrics and Gynocology, Kettegaards Allé 34, 2650 Hvidovre, Denmark; University of Southern Denmark, Unit for Health Promotion Research, Degnevej 14, 6705 Esbjerg, Denmark.
Copenhagen University Hospital, Hvidovre, Department of Obstetrics and Gynocology, Kettegaards Allé 34, 2650 Hvidovre, Denmark.
Midwifery. 2025 Mar;142:104301. doi: 10.1016/j.midw.2025.104301. Epub 2025 Jan 21.
Despite solid evidence and national recommendations supporting midwife-led continuity-of-care models, Danish women's access to such programs remains limited.
A public birth facility introduced a midwife-led continuity-of-care model, targeting a subset of women receiving antenatal and intrapartum care.
To compare care satisfaction during pregnancy and birth and birth experience between women receiving midwife-led continuity of care and those receiving standard midwifery care.
This cross-sectional study used convenience sampling, with data collected via an online questionnaire distributed 4-6 weeks postpartum. Participants were recruited during antenatal visits. Birth experience and care satisfaction were assessed using the WOCCA and Pregnancy and Childbirth Questionnaires (PCQ). Domain scores of the PCQ were compared using linear regression to compare adjusted mean differences (aMD). Single items were compared with Mann-Whitney U-tests for non-normally distributed variables.
Between October 2022 and September 2023, 563 women were enrolled, with 368 responding. The midwife-led continuity of care group reported significantly higher satisfaction in both pregnancy domains than standard midwifery care (Personal Treatment: aMD 3.0 points; CI 1.7-4.3 and Education and Information: aMD 2.1 points; CI 0.9-3.3). Additionally, they reported a significantly more positive birth experience (p = 0.010), with 88.5 % (vs. 74.4 %) rating it very positive or outstanding. Also, overall care satisfaction during birth was higher, with 96.2 % (vs. 84.8 %) reporting being very or extremely satisfied (p = 0.021).
Women receiving midwife-led continuity of care reported more positive birth experiences and higher care satisfaction levels than women receiving standard midwifery care. The findings add to the evidence of the benefits of midwife-led continuity of care models. More comprehensive access to this model of care could enhance the pregnancy and birth experiences of more women, also in settings already offering midwifery-led care.
尽管有确凿证据和国家建议支持由助产士主导的连续性照护模式，但丹麦女性获得此类项目的机会仍然有限。
一家公立分娩机构引入了由助产士主导的连续性照护模式，目标是部分接受产前和产时护理的女性。
比较接受助产士主导的连续性照护的女性与接受标准助产护理的女性在孕期和分娩期间的护理满意度及分娩体验。
本横断面研究采用便利抽样，通过产后4 - 6周发放的在线问卷收集数据。参与者在产前检查时招募。使用WOCCA和《妊娠与分娩问卷》（PCQ）评估分娩体验和护理满意度。使用线性回归比较PCQ的领域得分，以比较调整后的平均差异（aMD）。对于非正态分布变量，单项采用Mann-Whitney U检验进行比较。
在2022年10月至2023年9月期间，共招募了563名女性，368人做出回应。助产士主导的连续性照护组在两个孕期领域的满意度均显著高于标准助产护理（个人治疗：aMD 3.0分；CI 1.7 - 4.3；教育与信息：aMD 2.1分；CI 0.9 - 3.3）。此外，她们报告的分娩体验明显更积极（p = 0.010），88.5%（相比74.4%）将其评为非常积极或出色。而且，分娩期间的总体护理满意度更高，96.2%（相比84.8%）报告非常或极其满意（p = 0.021）。
与接受标准助产护理的女性相比，接受助产士主导的连续性照护的女性报告了更积极的分娩体验和更高的护理满意度。这些发现进一步证明了助产士主导的连续性照护模式的益处。更全面地获得这种照护模式可以改善更多女性的孕期和分娩体验，在已经提供助产士主导护理的环境中亦是如此。
