MMRC Speaker Series 2024 - 2025
Wednesday, November 27, 2024, 1230-1330h EST
Postpartum Emergency Department Use Following Midwifery Vs. Obstetrical Prenatal Care: A Population-Based Cohort Study Using Propensity Score-Based Overlap Weights
Carla Sorbara, RM, BA, BHSc, MSc (Public Policy), MSc (Clinical Epidemiology)
Carla Sorbara has worked as a registered midwife since 2006 at North York General Hospital and is currently a full-time midwife at Uptown Midwives and Family Wellness. She has worked with BORN, PCMCH and OMAMA on several quality initiatives.
Emergency Department (ED) use postpartum is a common, and often-preventable, event. The current study helps to resolve an important clinical question: Can postpartum ED use be reduced in low-risk women? Our findings provide important insights into the care of the postpartum woman, both in terms of the coordination and provision of clinical care, and in terms of public health policy for new mothers. Comparisons of women in midwifery vs conventional obstetrical care have been challenging due to unmeasured confounders. We used a propensity-score based overlap weights study design to compare ED use in an unbiased fashion, and observed differences in rates of ED use between midwife and obstetrical populations. The findings help to resolve known gaps in early postpartum care typically seen in women who receive obstetrical care, suggesting that a midwifery approach of early postpartum can alleviate some ED visits.