Donna L Hartz

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BACKGROUND Women at low risk of pregnancy complications benefit from continuity of midwifery care, but no trial evidence exists for women with identified risk factors. We aimed to assess the clinical and cost outcomes of caseload midwifery care for women irrespective of risk factors. METHODS In this unblinded, randomised, controlled, parallel-group trial,(More)
The aim of this paper is to review the clinical outcomes of descriptive and comparative cohort studies of the Australian caseload midwifery models of care that emerged during the late 1990s and early 2000s. These models report uniformly a decrease in caesarean section operation rates when compared to local, state and national rates, irrespective of the(More)
Maternity services in Australia are in urgent need of change. During the last 10 years several reviews have highlighted the need to provide more continuity of care for women in conjunction with the rationalisation of services. One solution may lie in the development of new integrated systems of care where primary-level maternity units offer midwifery-led(More)
BACKGROUND Australia has an enviable record of safety for women in childbirth. There is nevertheless growing concern at the increasing level of intervention and consequent morbidity amongst childbearing women. Not only do interventions impact on the cost of services, they carry with them the potential for serious morbidities for mother and infant.Models of(More)
BACKGROUND In many countries midwives act as the main providers of care for women throughout pregnancy, labour and birth. In our large public teaching hospital in Australia we restructured the way midwifery care is offered and introduced caseload midwifery for one third of women booked at the hospital. We then compared the costs and birth outcomes(More)
The current Australian national maternity reform agenda focuses on improving access to maternity care for women and their families while preserving safety and quality. The caseload midwifery model of care offers the level of access to continuity of care proposed in the reforms however the introduction of these models in Australia continues to meet with(More)
UNLABELLED Despite low rates of home birth throughout most Western countries, the topic generates considerable debate. This is reflected by the differing positions on home birth adopted by professional colleges representing obstetricians and midwives. We reviewed position statements of midwifery and obstetric colleges in the UK, USA, Australia, New Zealand,(More)
Specialist, for their assistance with this project. We are grateful to them for taking time out of their busy schedules to accommodate the numerous meetings necessary for gathering the city data. The authors appreciate the support provided by staff of Decision Theater at Arizona State University (ASU), particularly in the use of their computers for the(More)
OBJECTIVE to explore whether women allocated to caseload care characterise their midwife differently to those allocated to standard care. DESIGN multi-site unblinded, randomised, controlled, parallel-group trial. SETTING the study was conducted in two metropolitan teaching hospitals across two Australian cities. POPULATION women of all obstetric risk(More)
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