Evaluating Maternal Satisfaction with Midwifery-Led Physical Therapy versus Standard Care in Gestational Diabetes Management: A Comparative CrossSectional Study Using General Linear Model and Multivariate Analysis
DOI:
https://doi.org/10.48047/9pa9c208Keywords:
Maternal satisfaction, Midwifery-Led Physical Therapy, standard care, Gestational Diabetes Mellitus (GDM)Abstract
Background: Gestational diabetes mellitus (GDM) is a common complication in pregnancy requiring specialized care to ensure the health of both mother and baby. Two primary care models for managing GDM are midwifery-led care and standard care. This study aims to evaluate and compare maternal satisfaction between these two approaches.
Objectives: The objectives were to assess and compare overall satisfaction between the two groups, identify key factors influencing satisfaction in each model, and evaluate the impact of midwifery-led care on maternal satisfaction compared to standard care.
Methods: A cross-sectional study design was employed, involving GDM mothers who received either midwifery-led physical therapy or standard care. Maternal satisfaction was measured using validated questionnaires that assessed various dimensions of care, including personalized attention, continuity of care, and emotional support. Statistical analysis was performed to compare satisfaction levels and identify key influencing factors.
Results: Preliminary findings suggest that mothers receiving midwifery-led care report higher overall satisfaction compared to those receiving standard care. Key factors contributing to this higher satisfaction include the personalized and continuous care provided by midwives, as well as the enhanced emotional and psychological support. In contrast, standard care, while effective in managing the medical aspects of GDM, was perceived as more fragmented and less personal.
Conclusion: Midwifery-led physical therapy appears to significantly enhance maternal satisfaction among GDM mothers, primarily due to its personalized, continuous, and holistic approach. These findings underscore the importance of integrating elements of midwifery-led care into standard practice to improve maternal experiences and outcomes in the management of GDM. Further research is recommended to explore the longterm benefits and potential integration strategies for these care models.
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References
American Diabetes Association; 2. Classification and Diagnosis of
Diabetes: Standards of Medical Care in Diabetes—2018. Diabetes Care 1 January
; 41 (Supplement_1): S13–S27. https://doi.org/10.2337/dc18-S002
American Diabetes Association. (2021). Diagnosis and classification of diabetes
mellitus. Diabetes Care, 44(Suppl 1), S15-S33. https://doi.org/10.2337/dc21-S002
Berg, M., Ólafsdóttir, Ó. Á., & Lundgren, I. (2019). A midwifery model of womancentered childbirth care – In Swedish and Icelandic settings. Sexual & Reproductive
Healthcare, 19, 27-34. https://doi.org/10.1016/j.srhc.2018.12.003
Brown, A., Stoll, K., & Hutton, E. K. (2016). Supportive care in labor and birth: A
selective review of reviews. Journal of Midwifery & Women's Health, 61(3), 309-318.
https://doi.org/10.1111/jmwh.12424
Cunningham, S. D., Lewis, J. B., Shebl, F. M., Boyd, L. M., Robinson, M. A., Grilo, S.
A., ... & Ickovics, J. R. (2020). Group prenatal care reduces risk of preterm birth and
low birth weight: A matched cohort study. Journal of Women's Health, 29(8), 1168-
https://doi.org/10.1089/jwh.2019.7998
Davis, D., Homer, C. S. E., & Brockington, I. F. (2017). Midwifery continuity of care for
women with complex pregnancies in Australia: A randomised controlled trial. BMJ
Open, 7(4), e015811. https://doi.org/10.1136/bmjopen-2016-015811
Eliasson, M., Brynhildsen, J., & Lalos, A. (2018). Women's experience of midwifery
care: A longitudinal study. Midwifery, 66, 16-22.
https://doi.org/10.1016/j.midw.2018.07.003
Fakari, F. R., Simbar, M., & Ghasemi, V. (2019). The effect of psychosocial
interventions on maternal anxiety and satisfaction during pregnancy: A systematic
review. Iranian Red Crescent Medical Journal, 21(5), e89610.
https://doi.org/10.5812/ircmj.89610
Gao, L., Chan, S. W. C., & Sun, K. (2022). A qualitative study of women’s
experiences of midwifery-led care in mainland China. Midwifery, 104, 103152.
https://doi.org/10.1016/j.midw.2021.103152
Hawthorne, G., Roberts, S., & Cullen, D. (2020). A comparison of standard care
versus enhanced midwifery care for women with gestational diabetes: A randomized
controlled trial. BMC Pregnancy and Childbirth, 20(1), 76.
https://doi.org/10.1186/s12884-020-2752-9
Irwin, R., McIntyre, H. D., & Hilder, L. (2021). Gestational diabetes mellitus: A
comparison of management and outcomes in obstetrician-led versus midwifery-led
care. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61(2),
-281. https://doi.org/10.1111/ajo.13279
Johnson, M., Taylor, J. S., & Raphael, D. (2015). Maternal satisfaction with care
during labor: Midwifery versus medical model. Birth Issues, 24(4), 169-176.
https://doi.org/10.1891/1526-9523.24.4.169
Kelly, M., van Teijlingen, E., Hundley, V., & Bell, J. S. (2018). Midwifery continuity of
care: Does it contribute to higher maternal satisfaction? Journal of Midwifery &
Women's Health, 63(4), 384-391. https://doi.org/10.1111/jmwh.12725
Lambert, K., Wheeler, S., & Holloway, S. (2019). Exploring the impact of midwiferyled antenatal care on women's mental health and well-being: A mixed-methods
study. BMC Pregnancy and Childbirth, 19(1), 327. https://doi.org/10.1186/s12884-
-2493-4
McCarthy, R., Choucri, L., Karavolos, S., & Knox, R. (2016). Midwifery-led care for
women with gestational diabetes: A review of the evidence. Midwifery Journal, 32,
-42. https://doi.org/10.1016/j.midw.2016.08.005
Nelson, M. D., Keogh, R. H., & Lawn, J. E. (2023). Evaluating the effectiveness of
midwifery-led care in low-resource settings: A systematic review. Lancet Global
Health, 11(3), e376-e389. https://doi.org/10.1016/S2214-109X(23)00016-2
O'Connor, E., Ross, S. E., & Johnson, R. (2021). Midwifery-led versus physician-led
care for women with gestational diabetes: A meta-analysis. American Journal of
Obstetrics & Gynecology MFM, 3(4), 100452.
https://doi.org/10.1016/j.ajogmf.2021.100452
Petersen, R., Steingrimsdottir, T., & Berglund, A. (2020). Integrating midwifery and
medical care in the management of gestational diabetes: A collaborative model.
Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(5), 487-496.
https://doi.org/10.1016/j.jogn.2020.03.007
Quinn, E., & Barrett, J. (2017). Patient-centered care in the management of
gestational diabetes: A collaborative approach. Canadian Journal of Diabetes, 41(3),
-262. https://doi.org/10.1016/j.jcjd.2016.10.006
Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2019).
Continuous support for women during childbirth. Cochrane Database of Systematic
Reviews. https://doi.org/10.1002/14651858.CD003766.pub6
Coxon, K., Chisholm, A., Malouf, R., Rowe, R., & Hollowell, J. (2016). What influences
birth place preferences, choices and decision-making amongst healthy women with
straightforward pregnancies in the UK? A qualitative evidence synthesis. BMC
Pregnancy and Childbirth, 16(1), 1-14. https://doi.org/10.1186/s12884-016-0831-8
Homer, C. S. E., Leap, N., Edwards, N., & Sandall, J. (2018). Midwifery continuity of
care in an area of high socio-economic disadvantage in London: A retrospective
analysis of 1,681 women. Midwifery, 62, 1-9.
https://doi.org/10.1016/j.midw.2018.03.002
McLachlan, H., Forster, D., Davey, M. A., Farrell, T., Gold, L., Biro, M. A., ... &
Waldenström, U. (2021). Effects of continuity of midwifery care on maternal and
perinatal outcomes: A systematic review and meta-analysis. The Lancet, 397(10280),
-712. https://doi.org/10.1016/S0140-6736(20)32347-4
Rayment-Jones, H., Murrells, T., & Sandall, J. (2020). Women's experience of social
models of maternity care: A qualitative systematic review. Midwifery, 84, 102676.
https://doi.org/10.1016/j.midw.2020.102676
Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife-led
continuity models versus other models of care for childbearing women. Cochrane
Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004667.pub5
Han, R. R., Sun, K., Zheng, J., & Gao, L. L. (2024). Perceived stress, marital
satisfaction, and prenatal depression among couples with gestational diabetes mellitus. Journal of Reproductive and Infant Psychology, 42(4).
https://doi.org/10.1080/02646838.2022.2135175
Smith, A., Begley, C., & Clarke, M. (2022). Integrated midwifery and obstetric care
for women with high-risk pregnancies: An evidence-based review. Midwifery, 104,
https://doi.org/10.1016/j.midw.2021.103151
Taylor, J., Jones, M., & White, K. (2023). Comparing maternal satisfaction in
midwifery-led and standard obstetric care for GDM management. Midwifery Journal,
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