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Giving women their own case notes to carry during pregnancyBrown HC, Smith HJ
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SummaryWomen carrying their own case notes improves their sense of control and satisfaction and the availability of antenatal records, but insufficient evidence of additional effectsIn some healthcare systems women are given their own case notes to look after and bring to each antenatal visit. This review suggests that there are both potential benefits (increased availability of antenatal records during hospital attendance, increased maternal control and satisfaction during pregnancy) and harms (more operative deliveries). All the trials reported that more women in the case notes group would prefer to hold their antenatal records in another pregnancy, but there was not enough evidence to determine the effect of women carrying their own case notes on health behaviours such as smoking and breastfeeding and clinical outcomes.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 2, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 19. 2004 AbstractBackgroundIn many countries women are given their own case notes to carry during pregnancy so as to increase their sense of control and satisfaction with their care. ObjectivesTo evaluate the effects of giving women their own case notes to carry during pregnancy. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2007). Selection criteriaRandomised controlled trials of women given their own case notes to carry during pregnancy. Data collection and analysisTwo review authors independently applied the inclusion criteria and assessed study quality. One review author extracted data from the included studies using a standard form (checked by second review author). We assessed estimates of effect using relative risk with 95% confidence intervals. Main resultsThree trials were included (n = 675 women). Women carrying their own notes were more likely to feel in control (relative risk (RR) 1.56, 95% confidence interval (CI) 1.18 to 2.06). Women's satisfaction: one trial reported more women in the case notes group (66/95) were satisfied with their care than the control group (58/102) (RR 1.22, 95% CI 0.99 to 1.52); two trials reported no difference in women's satisfaction (one trial provided no data and one trial used a 17 point satisfaction scale). More women in the case notes group wanted to carry their own notes in a subsequent pregnancy (RR 1.79, 95% CI 1.43 to 2.24). Overall, the pooled estimate of the two trials (n = 347) that reported on the risk of notes lost or left at home was not significant (RR 0.38, 95% CI 0.04 to 3.84). There was no difference for health related behaviours (cigarette smoking and breastfeeding), analgesia needs during labour, miscarriage, stillbirth and neonatal deaths. More women in the case notes group had operative deliveries (RR 1.83, 95% CI 1.08 to 3.12). Authors' conclusionsThe three trials are small, and not all of them reported on all outcomes. The results suggest that there are both potential benefits (increased maternal control and satisfaction during pregnancy, increased availability of antenatal records during hospital attendance) and harms (more operative deliveries). Importantly, all of the trials report that more women in the case notes group would prefer to hold their antenatal records in another pregnancy. There is insufficient evidence on health related behaviours (smoking and breastfeeding) and clinical outcomes. It is important to emphasise that this review shows a lack of evidence of benefit rather than evidence of no benefit. |