Midwifery-led care: finding evidence for an antenatal model

Conducted as the first phase of the Improving Patient Outcomes Project, a structured literature review aimed to determine an evidence base for the development of a midwifery-led antenatal model of care. In particular, evidence was sought for those elements of antenatal care that were proven effective and were valued by women. There is good quality evidence that women are satisfied with receiving antenatal care from midwives and that antenatal visit schedules can be made more flexible. The literature provided practical assistance in defining maternity outcome measures but was not able to provide a strong evidence base for all aspects of antenatal care. This paper reports on a systematic approach to reviewing literature in which the intuitive and practical experience of expert reviewers and clinicians contributes to assessing the overall quality of currently available research evidence. This combined approach ensures a judicious and sensitive application of available evidence to the development of safe and appropriate models of care.