To determine whether experience of midwife-only and nurse-midwife lead maternity carers (LMCs) is related to perinatal mortality.
In a retrospective analysis, routinely collected data were obtained for all pregnancies resulting in live births (or stillbirth at ≥20weeks or weighing >400g) in New Zealand in 2005-2009. An anonymized dataset of date of midwife registration was used. The main outcome measure was perinatal mortality (fetal deaths and neonatal deaths ≤27days).
Among 233215 eligible births, 84043 were linked to a midwife-only LMC and 150172 to a nurse-midwife LMC. Among pregnancies with midwife-only LMCs, perinatal mortality was higher when the midwife had less than 1year of experience than when the midwife had 5-9years' experience (rate ratio 1.33; 95% confidence interval 1.02-1.73), an absolute difference of two additional deaths per 1000 births. There was a decreasing rate of perinatal mortality with increasing experience (P=0.031). Perinatal mortality rates did not differ by experience in the nurse-midwife group.
Pregnancies cared for by early-career (<1year) midwife-only LMCs were associated with a 33% increase in perinatal mortality. No association between experience and perinatal mortality was found for nurse-midwives. Midwife-only trained LMCs could require additional training and/or supervision in their first year of practice.
This research output has an Altmetric Attention Score of 47. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 February 2019.
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Altmetric has tracked 31,978,644 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
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