Australian research published today in the Lancet Medical Journal, has found that caseload midwifery could save the Australian medical system more than 500-dollars per birth.
The researchers say it's information the Australian health system -- and new Federal health minister -- should take on board.
Presenter: Lucy Carter
Speakers: Professor Alec Welsh, University of New South Wales, and obstetrician at the Royal Hospital for Women in Sydney; Professor Sally Tracy, Professor in Midwifery at the University of Sydney and conjoint Professor, School of Women's and Children's Health
LUCY CARTER: For decades, midwifery - or personalised nursing care before, during and after birth - has been considered a boutique service. One's that's too expensive for standard national health care systems.
However the results of a new University of Sydney study may alter that perception.
Led by Professor Sally Tracy, the study examined close to 1,800 women over three years.
SALLY TRACY: The women who had one-to-one midwifery care had 30 per cent less induction of labour. They had less severe blood loss. They were more likely to be breastfeeding on discharge from hospital. And probably the most exciting finding was that it actually cost less by more than $500 per woman.
LUCY CARTER: Study co-author Professor Alec Welsh is a University of New South Wales academic, and obstetrician at the Royal Hospital for Women in Sydney.
ALEC WELSH: One of the new things from this study is that, in this particular study, women of all risk categories are looked after by the midwives. Whereas a lot of Australia's midwifery-led care have focused on purely low risk, however that's being defined.
So I think this says that if, whatever your risk you come under the care of a midwife, you will have a safe outcome.
LUCY CARTER: Professor Welsh says that of particular note is the saving of an average of $566 per birth.
ALEC WELSH: Because of the perception of the amount of time that midwives spend with their clients on each visit, there's been a perception that, well surely that must be more expensive because it takes so many hours.
The interesting thing though is that if you are under the midwifery group practice you are less likely to have medical intervention, less likely to have a caesarean section, less likely to have an epidural. Your hospital stay is likely to be shorter.
So actually, when you factor in those costs, it actually works out as cost effective.
LUCY CARTER: He says it's a saving that could have enormous repercussions for the health industry.
ALEC WELSH: If we look at our hospital here that delivers 4,000 women a year. If one were to say, for example, that even half those women were eligible, then you've got 2,000 women at $500 each. So you've got significant savings in every hospital that can set this up.
LUCY CARTER: Professor Sally Tracy says the study should be closely examined by the incoming Federal Health Minister, Peter Dutton.
SALLY TRACY: The exciting thing about this is that it's probably been a 10 to 15 year project, really, to get the funding, to set up a randomised control trial, to conduct that in a really good way. And then now to have the results published in the Lancet and having been peer-reviewed, very significantly peer-reviewed, I think now this is really time for the Health Minister and for the health system to really look closely at the way this care can be offered.
LUCY CARTER: Both experts say that regardless of the cost, midwifery is a profession that should be taken more seriously in Australia.
SALLY TRACY: There's a really full scope of practice that the midwives who have worked through this trial really, really enjoy. And I think it's time that we recognised that.
ALEC WELSH: Without revealing too much, my wife and I have had two babies looked after by the midwifery group practice in our hospital. It's a fantastic service. It's a very personalised service where you really get to know your midwife well during the pregnancy. There is only a small number who work together, so you know who those people might be. They understand you, have an idea of your wishes etc. So it's a very good form of care.
Keywords:midwifery, birth, health, Lancet, maternity, Professor Alec Welsh, Professor Sally Tracy,Community and Society:Family and Children:Babies - Newborns Health:Medical Research Health:Reproduction and Contraception:Pregnancy and Childbirth Health:Women's Health