Midwifery Antenatal Postnatal Service (MAPS): A retrospective cohort study exploring perinatal outcomes and consumer satisfaction

PROBLEM: Maternity consumer and workforce preference is for continuity of midwifery care, with on-call arrangements identified as a key barrier. BACKGROUND: The Midwifery Antenatal Postnatal Service (MAPS) enables midwives to provide antenatal and postnatal continuity without on-call or intrapartum care requirements. High satisfaction has been reported amongst midwives and women. Limited research has explored associated clinical outcomes. AIM: To explore perinatal outcomes of women who received MAPS care against a matched sample who received standard fragmented care, contextualised by qualitative insights into women's perspectives of care. METHODS: A retrospective cohort study compared perinatal outcomes of 223 MAPS mother-baby dyads with a matched standard-care cohort. A total 105 consumers participated in a brief online cross-sectional survey. Clinical outcomes were analysed using adjusted logistic regression. Qualitative data underwent inductive content analysis. FINDINGS: Compared with the matched cohort, MAPS was associated with reduced induction of labour (aOR 0.62, 95% CI 0.39-0.97, p = 0.036), increased use of 'other analgesia and comfort measures' (aOR 1.94, 95% CI 1.16-3.25, p = 0.012), increased vaginal birth (aOR 1.53, 95% CI 1.02-2.31, p = 0.041) and reduced breast milk substitute feeding for maternal choice (aOR 0.61, 0.38-0.98, p = 0.041). Consumer satisfaction was high (mean 4.93/5), explored through three themes. DISCUSSION: MAPS was associated with select improved maternal outcomes. Qualitative findings highlighted structural elements that supported relational care, and opportunities for improvement. CONCLUSION: MAPS offers a positive alternative to standard care. Further research is recommended to strengthen evidence into its impact on clinical outcomes and to optimise continuity and integration within pre-existing services.