To assess whether infant emergency department (ED) use differs between a midwifery-based and obstetrics-based model of care. Retrospective population-based cohort study. Province of Ontario, Canada. Infants born to low-risk primiparous women in a hospital, 2012-2021. Modified Poisson regression compared ED use between women with midwifery and obstetrics-model care, weighting by propensity-based overlap weights. Any unscheduled infant ED visit after the birth hospitalisation discharge date up to 27 days thereafter. Included were 36 949 livebirths to women receiving care by a midwife and 120 463 to women receiving care by an obstetrician. Median gestational age at birth was 39 weeks; 11.8% and 13.3% were admitted to the NICU, and the median newborn hospital length of stay was 1.3 and 1.8 days, respectively. Midwifery-care mother-child pairs received a median of 6.9 postpartum visits by a midwife. An infant ED visit ≤ 27 days occurred among 1789 (4.8%) midwife-led care patients versus 11 886 (9.9%) obstetrician-led care recipients (relative risk RR 0.51, 95% CI 0.49 to 0.54; absolute risk difference -4.6%, 95% CI -4.9 to -4.3). The corresponding RR was 0.42 (95% CI 0.39 to 0.46) for infant ED visit ≤ 7 days and 0.87 (95% CI 0.86 to 0.89) for infant ED visit ≤ 365 days. Among infants born to low-risk primiparous women, midwifery-model care was associated with less ED use after birth than an obstetrics model of care. Among similar populations, enhanced access to midwifery care might reduce postnatal newborn resource use.
Ray et al. (Wed,) studied this question.