Midwifery and quality care

findings from a new evidence-informed framework for maternal and newborn care

Mary J. Renfrew (Lead / Corresponding author), Alison McFadden, Maria Helena Bastos, James Campbell, Andrew Amos Channon, Ngai Fen Cheung, Deborah Rachel Audebert Delage Silva, Soo Downe, Holly Powell Kennedy, Address Malata, Felicia McCormick, Laura Wick, Eugene Declercq

    Research output: Contribution to journalArticle

    353 Citations (Scopus)

    Abstract

    In this first paper in a series of four papers on midwifery, we aimed to examine, comprehensively and systematically, the contribution midwifery can make to the quality of care of women and infants globally, and the role of midwives and others in providing midwifery care. Drawing on international definitions and current practice, we mapped the scope of midwifery. We then developed a framework for quality maternal and newborn care using a mixed-methods approach including synthesis of findings from systematic reviews of women's views and experiences, effective practices, and maternal and newborn care providers. The framework differentiates between what care is provided and how and by whom it is provided, and describes the care and services that childbearing women and newborn infants need in all settings. We identified more than 50 short-term, medium-term, and long-term outcomes that could be improved by care within the scope of midwifery; reduced maternal and neonatal mortality and morbidity, reduced stillbirth and preterm birth, decreased number of unnecessary interventions, and improved psychosocial and public health outcomes. Midwifery was associated with more efficient use of resources and improved outcomes when provided by midwives who were educated, trained, licensed, and regulated. Our findings support a system-level shift from maternal and newborn care focused on identification and treatment of pathology for the minority to skilled care for all. This change includes preventive and supportive care that works to strengthen women's capabilities in the context of respectful relationships, is tailored to their needs, focuses on promotion of normal reproductive processes, and in which first-line management of complications and accessible emergency treatment are provided when needed. Midwifery is pivotal to this approach, which requires effective interdisciplinary teamwork and integration across facility and community settings. Future planning for maternal and newborn care systems can benefit from using the quality framework in planning workforce development and resource allocation.
    Copyright © 2014 Elsevier Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)1129-1145
    Number of pages17
    JournalLancet
    Volume384
    Issue number9948
    Early online date22 Jun 2014
    DOIs
    Publication statusPublished - 20 Sep 2014

    Fingerprint

    Quality of Health Care
    Midwifery
    Mothers
    Newborn Infant
    Preventive Medicine
    Emergency Treatment
    Stillbirth
    Resource Allocation
    Maternal Mortality
    Premature Birth
    Infant Mortality
    Public Health
    Pathology
    Morbidity

    Keywords

    • Midwifery
    • Quality care
    • Maternal and newborn care
    • Midwives

    Cite this

    Renfrew, Mary J. ; McFadden, Alison ; Bastos, Maria Helena ; Campbell, James ; Channon, Andrew Amos ; Cheung, Ngai Fen ; Delage Silva, Deborah Rachel Audebert ; Downe, Soo ; Kennedy, Holly Powell ; Malata, Address ; McCormick, Felicia ; Wick, Laura ; Declercq, Eugene. / Midwifery and quality care : findings from a new evidence-informed framework for maternal and newborn care. In: Lancet. 2014 ; Vol. 384, No. 9948. pp. 1129-1145.
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    Renfrew, MJ, McFadden, A, Bastos, MH, Campbell, J, Channon, AA, Cheung, NF, Delage Silva, DRA, Downe, S, Kennedy, HP, Malata, A, McCormick, F, Wick, L & Declercq, E 2014, 'Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care', Lancet, vol. 384, no. 9948, pp. 1129-1145. https://doi.org/10.1016/S0140-6736(14)60789-3

    Midwifery and quality care : findings from a new evidence-informed framework for maternal and newborn care. / Renfrew, Mary J. (Lead / Corresponding author); McFadden, Alison; Bastos, Maria Helena; Campbell, James; Channon, Andrew Amos; Cheung, Ngai Fen; Delage Silva, Deborah Rachel Audebert ; Downe, Soo; Kennedy, Holly Powell; Malata, Address; McCormick, Felicia; Wick, Laura; Declercq, Eugene.

    In: Lancet, Vol. 384, No. 9948, 20.09.2014, p. 1129-1145.

    Research output: Contribution to journalArticle

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    AU - Campbell, James

    AU - Channon, Andrew Amos

    AU - Cheung, Ngai Fen

    AU - Delage Silva, Deborah Rachel Audebert

    AU - Downe, Soo

    AU - Kennedy, Holly Powell

    AU - Malata, Address

    AU - McCormick, Felicia

    AU - Wick, Laura

    AU - Declercq, Eugene

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