None listed
Conditions
Brief summary
Pregnancy and birth directly affect almost 300,000 families in Australia each year. A key concern is that the caesarean section rate in Australia is higher than similar countries with a lack of support for women to have a vaginal birth after caesarean section. We plan to undertake a trial to determine whether midwifery continuity of care increases the rate of vaginal birth in women who have had a previous caesarean section. This trial could significantly alter the way maternity care is provided.
Interventions
Intervention–Midwifery continuity of care: Women allocated to the intervention group will receive midwifery continuity of care from a small group of midwives. The midwives will provide care during the antenatal, labour and birth, and postnatal periods (to two weeks postnatally). Midwives will adhere to The National Midwifery Guidelines for Consultation & Referral. All women will have an appointment with an obstetric consultant at 36 weeks gestation (to re-assess VBAC suitability and discuss the
Intervention–Midwifery continuity of care: Women allocated to the intervention group will receive midwifery continuity of care from a small group of midwives. The midwives will provide care during the antenatal, labour and birth, and postnatal periods (to two weeks postnatally). Midwives will adhere to The National Midwifery Guidelines for Consultation & Referral. All women will have an appointment with an obstetric consultant at 36 weeks gestation (to re-assess VBAC suitability and discuss the birth plan). If a woman develops complications during pregnancy and requires additional care, she will continue with the midwifery continuity of care model while also attending obstetric or other consultations (this is the same for both groups). Labour and birth care will be provided at Gosford Hospital Birth Unit and postnatal care will be provided in the woman’s own home for a period of two weeks postpartum, following discharge from hospital.
Sponsors
University of Technology Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
Booking-in visit attended no later than 20 weeks; most recent birth was by lower-segment CS; no more than one previous CS; considered low risk, other than a history of previous CS; no other previous uterine incision; no previous uterine rupture; no contraindications for vaginal birth at the time of enrolment; English proficiency (spoken and written); public patient; and, no known preference for a certain model of care, such as GP-shared care
Exclusion criteria
Contraindications for vaginal birth at the time of enrolment Not willing to receive model of care
Outcome results
None listed