Validation of a Midwifery Model in Palestine 2

Completed

• Conditions: Prenatal Care
• Interventions: Other: Midwife led continuity model of care

• Registration Number: NCT03640663
• Lead Sponsor: Oslo University Hospital

Brief Summary

A midwife-led continuity model of care was implemented in governmental maternal facilities in Palestine. Midwives from the hospitals provided outreaching caseload ante- and postnatal care to women in rural villages clinics and homes. This study investigated if the model had impact on important maternal and neonatal health outcomes. A retrospective cohort design was used.

Detailed Description

Background: A midwife-led continuity model of care was implemented in governmental maternal facilities in Palestine. Midwives from the hospitals provided outreaching caseload ante- and postnatal care to women in rural villages clinics and homes. This study investigated if the model had impact on important maternal and neonatal health outcomes.

Method: A retrospective cohort design was used. Nablus governmental hospital, Rafidia's medical records were reviewed and data extracted involving 2199 women with singleton pregnancies, residing in rural villages, and their new-born babies born between January 2016 and February 2017. Outcomes were limited to the available information in the hospital's birth registry. Important maternal outcomes were postpartum anaemia (Hb \<11), mode of delivery and induction of labour. Important outcomes for new-borns were premature delivery \< 37 weeks, birth weight \< 2500g and 1500g and referral to neonatal intensive care unit. Outcomes were compared between women receiving the midwife-led continuity model of antenatal care and women receiving regular care.

Study Timeline

• Study Start: 2016-01-01
• Primary Completion: 2017-02-28
• Study First Submitted: 2018-08-07
• Study First Submitted QC: 2018-08-17
• Study First Posted: 2018-08-21
• Study Completion: 2018-08-30
• Status Verified: 2019-02
• Last Update Submitted: 2019-02-26
• Last Update Posted: 2019-02-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 2199

Inclusion Criteria

• Women with singleton pregnancies residing in rural areas giving birth at Nablus governmental hospital, Palestine

Exclusion Criteria

• Multiple pregnancies
• Women residing in urban areas

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Midwife led continuity model of care	Midwife led continuity model of care	Women who received antenatal care from midwives from the hospital reaching out to the rural villages

Primary Outcome Measures

Name	Time	Method
Emergency Caesarean section rate	17 months	Percentage of women undergoing emergency Caesarean section

Secondary Outcome Measures

Name	Time	Method
Birth weight	17 months	Weight immediately post partum: Low (\<2500g) Very low (\<1500)
Post partum anaemia in the mother	17 months	Low Hb Level at discharge from hospital
Premature birth rate	17 months	Babies born before 37 weeks gestational age
Induction of Labour rate	17 months	The rate of women in each group who received induction of labour
APGAR score 5 minutes post partum	17 months	APGAR score
Referral to neonatal intensive care	17 months	Rate of babies that were referred to neonatal intensive care during hospital stay
Blood transfusion rate post partum	17 months	Rate of women receiving blood tranfusion during the hospital stay

Trial Locations

Locations (1)

Palestinian Ministry of Health; 🇵🇸 Nablus, West Bank, Palestinian Territory, occupied