Evaluating midwife-led continuity of care and breastfeeding outcomes: A quasi-experimental study

BACKGROUND: Midwife-led continuity of care is associated with many positive health outcomes for women and babies. However, little is known about the relationship between model of care and breastfeeding rates or duration. AIM: The primary aim of this study was to compare breastfeeding outcomes for women within midwife-led continuity of care and standard care models across postnatal timepoints. The secondary aim was to assess breastfeeding education received during pregnancy between groups. METHODS: A quasi-experimental, prospective longitudinal study was conducted, with women from midwife-led continuity of care and standard care enrolled. Questionnaires were administered at five time points across the pregnancy and postnatal continuum (second trimester, third trimester, and one week, one month, and four months postnatal). RESULTS: In total, 383 women consented to participate, with 214 completing the questionnaire at the final postnatal timepoint (94 in midwife-led continuity of care, 120 in standard care). Across postnatal time points, breastfeeding rates (exclusive and any breastfeeding) were statistically similar between groups. During pregnancy, women who received midwife-led continuity of care reported less comprehensive breastfeeding discussions than those cared for within standard care. DISCUSSION: Breastfeeding support and education are part of a midwife's role and may encourage continuation and exclusivity. However, decisions surrounding breastfeeding are complex and can be influenced by other internal and external factors. CONCLUSION: Midwife-led continuity of care was not associated with a statistically significant difference in breastfeeding rates up to four months postnatal. Further investigation to better understand how midwives can support women to improve breastfeeding outcomes is required.