{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:38:51Z","timestamp":1792449531414,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP2009326"],"award-info":[{"award-number":["APP2009326"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1159536"],"award-info":[{"award-number":["APP1159536"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to compare health outcomes and costs in standard public maternity care compared to private obstetric\u2010led maternity care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study with linked administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Australian maternity care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>867\u2009334 births, covering all births in three states of Australia between 2016 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Standard public care involved mainly fragmented midwifery, obstetric and General Practitioner provider care, with birth in a public hospital. Private obstetric\u2010led care was led by a personally selected obstetrician, with midwifery involvement and birth in a private hospital. We analysed outcomes from pregnancy onset to 4\u2009weeks post\u2010birth. Matching was utilised to account for demographic, socio\u2010economic and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Stillbirths or neonatal deaths; neonatal intensive care admissions; APGAR score &lt;\u20097 at 5\u2009min; 3rd or 4th degree perineal tears; maternal haemorrhages; mean cost per pregnancy episode.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher adverse outcomes in standard public maternity care compared to private obstetric\u2010led care, including 778 more stillbirths or neonatal deaths (OR 2.0, 95% CI: 1.8\u20132.1), 2747 more APGAR score &lt;\u20097 at 5\u2009min (OR 2.0, 95% CI: 2.0\u20132.1), 3273 more 3rd or 4th degree perineal tears (OR 2.9, 95% CI: 2.7\u20133.1) and 10 627 additional maternal haemorrhages (OR 2.7, 95% CI: 2.6\u20132.8). Mode of birth correlated with neonatal death. Mean cost to all funders in Australian dollars per pregnancy episode was $5929 higher in standard public maternity care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We have shown significantly lower adverse health outcomes and costs in private obstetric\u2010led care compared to standard public maternity care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.18286","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T08:14:12Z","timestamp":1752480852000},"page":"72-82","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Maternal and Neonatal Outcomes and Health System Costs in Standard Public Maternity Care Compared to Private Obstetric\u2010Led Care: A Population\u2010Level Matched Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7233-6804","authenticated-orcid":false,"given":"Emily J.","family":"Callander","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation Monash University  Melbourne Australia"},{"name":"School of Public Health University of Technology Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Enticott","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, School of Clinical Sciences Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakila","family":"Thangaratinam","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Liverpool Women's National Health Service Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Gamble","sequence":"additional","affiliation":[{"name":"Centre for Healthcare and Communities Coventry University  Coventry UK"},{"name":"School of Nursing and Midwifery Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Robson","sequence":"additional","affiliation":[{"name":"College of Health and Medicine Australia National University  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102264"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12684"},{"key":"e_1_2_11_4_1","unstructured":"D.Ockenden \u201cIndependent Review of Maternity Services at Shrewsbury and Telford Hospital NHS Trust\u201d(2019)."},{"key":"e_1_2_11_5_1","volume-title":"Mackay HHS Obstetrics and Gynaecology Investigation Report","author":"Duncombe G.","year":"2022"},{"key":"e_1_2_11_6_1","unstructured":"B.Kirkup \u201cReading the Signals Maternity and Neonatal Services in East Kent\u2014The Report of the Independent Investigation\u201d(2022)."},{"issue":"4","key":"e_1_2_11_7_1","article-title":"Midwife Continuity of Care Models Versus Other Models of Care for Childbearing 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