Observational studyBMJ open2021
Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population? A retrospective cohort study, London, UK.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Interventions to Address Disparities in Perinatal Outcomes by Ethnicity: A Systematic Review.BJOG : an international journal of obstetrics and gynaecology · 2025Pooled it
- Midwife continuity of care models versus other models of care for childbearing women.The Cochrane database of systematic reviews · 2024Pooled it
- Targeted health and social care interventions for women and infants who are disproportionately impacted by health inequalities in high-income countries: a systematic review.International journal for equity in health · 2023Pooled it
- Understanding the implementation of specialist maternity services for pregnant women with FGM/C in Germany: a situation analysis applying normalization process theory.Reproductive health · 2026Article
- The Impact of Community-Based Midwife Continuity of Care Models for Women Living in Areas of Social Disadvantage and Ethnic Diversity in the United Kingdom: A Prospective Cohort Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- The role of poverty-related social determinants in maternal and perinatal health inequities: a cross-sectional study using the eLIXIR born in South London, UK maternity-child data linkage.International journal for equity in health · 2026Article
- Releasing time to deliver care: a mixed methods evaluation of the implementation of enhanced midwifery continuity of carer.BMJ open · 2025Article
- Midwifery Continuity of Care During Pregnancy, Birth, and the Postpartum Period: A Matched Cohort Study.Birth (Berkeley, Calif.) · 2025Article
- When midwife continuity of carer is the policy proposal, what is the problem of perinatal health inequalities represented to be?SN social sciences · 2025Review
- Systematic review of interventions to reduce ethnic health inequalities in maternal and perinatal health in the UK.BMJ public health · 2025Article
- A Comprehensive Review on Social Inequalities and Pregnancy Outcome-Identification of Relevant Pathways and Mechanisms.International journal of environmental research and public health · 2022Review
- Advancing quality and safety of perinatal services in India: opportunities for effective midwifery integration.Health policy and planning · 2022Article
- Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents.Children (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectives(1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women.
designRetrospective observational cohort study.
settingFour council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse.
participantsAll women booked for antenatal care under Guys and St Thomas' National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas.
main outcome measuresTo explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes).
resultsThere was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth.
conclusionThis study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater.
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