Research into impact of independent midwifery care published

The British Medical Journal this week published research comparing care provided by independent midwives with maternity care within the NHS. The research compared a wide range of ‘outcomes’ including whether mothers started labour spontaneously, whether their birth was spontaneous, without forceps, ventouse or caesarean section,  where drugs were used for pain relief, and breastfeeding rates. It found that women who used an independent midwife (i.e. a midwife registered with the Independent Midwives Association) were more likely to start labour spontaneously, have an unassisted vaginal birth, use fewer pain relieving drugs and were much more likely to establish breastfeeding.
 
For women with a straightforward pregnancy the stillbirth and neonatal death rate was similar to that for women having their baby with NHS care. There appeared to be more baby deaths among women who had a more complex pregnancy with an independent midwife. Unfortunately the methodology used was unable to compare accurately the women having care with an independent midwife with those using NHS services. Although the sample was matched in terms of age, previous children, year of birth and socioeconomic status there are likely to be many other ways in which the two groups differ, including different beliefs and preferences, making it difficult to make meaningful comparisons.