Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Oct 14;2015(10):CD002856.
doi: 10.1002/14651858.CD002856.pub3.

Giving women their own case notes to carry during pregnancy

Heather C Brown  1 , Helen J Smith, Rintaro Mori, Hisashi Noma
Affiliations
Meta-Analysis

Giving women their own case notes to carry during pregnancy

Heather C Brown et al. Cochrane Database Syst Rev. .

Abstract

Background: In many countries women are given their own case notes to carry during pregnancy to increase their sense of control over, and satisfaction with, their care.

Objectives: To evaluate the effects of giving women their own case notes to carry during pregnancy.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2015) and reference lists of retrieved studies.

Selection criteria: Randomised controlled trials of women given their own case notes to carry during pregnancy.

Data collection and analysis: Two 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 risk ratio (RR) with 95% confidence intervals (CI). The quality of the evidence was assessed using the GRADE approach.

Main results: Four trials were included (n = 1176 women). Overall, the quality of the evidence was graded as low to moderate mainly due to the nature of the intervention not allowing blinding. The updated search identified one cluster-randomised trial, which was included.Women carrying their own notes were more likely to feel in control (two trials, RR 1.56, 95% CI 1.18 to 2.06; 450 women; moderate quality evidence), although there is no evidence of difference in women's satisfaction (two trials, average RR 1.09, 95% CI 0.92 to 1.29); 698 women; low quality evidence). More women in the case notes group wanted to carry their own notes in a subsequent pregnancy (three trials, RR 1.79, 95% CI 1.57 to 2.03; 552 women; low quality evidence). 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 (average RR 0.38, 95% CI 0.04 to 3.84). There was no evidence of difference for health-related behaviours (cigarette smoking and breastfeeding (moderate quality evidence)), analgesia needs during labour (low quality evidence), maternal depression, miscarriage, stillbirth and neonatal deaths (moderate quality evidence). More women in the case notes group had operative deliveries (one trial, RR 1.83, 95% CI 1.08 to 3.12; 212 women), and caesarean sections (one trial, average RR 1.51, 95% CI 1.10 to 2.08; 501 women; moderate quality evidence).

Authors' conclusions: The four 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 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 carry their antenatal records in another pregnancy. There is insufficient evidence on health-related behaviours (smoking and breastfeeding), women's satisfaction, and clinical outcomes. It is important to emphasise that this review shows a lack of evidence of benefit rather than evidence of no benefit.

PubMed Disclaimer

Conflict of interest statement

Rintaro Mori is the lead author of one of the included studies (Mori 2015) and this was assessed by Erika Ota and Nancy Medley. No other conflicts of interest noted.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Case notes versus control, Outcome 1 Women who felt in control.
1.2
1.2. Analysis
Comparison 1 Case notes versus control, Outcome 2 Women's satisfaction with antenatal care ‐ inverse variance.
1.3
1.3. Analysis
Comparison 1 Case notes versus control, Outcome 3 Women who wanted to carry case notes in subsequent pregnancy.
1.4
1.4. Analysis
Comparison 1 Case notes versus control, Outcome 4 Notes lost or left at home.
1.5
1.5. Analysis
Comparison 1 Case notes versus control, Outcome 5 Breastfeeding ‐ inverse variance.
1.6
1.6. Analysis
Comparison 1 Case notes versus control, Outcome 6 Epidural analgesia used in labour.
1.7
1.7. Analysis
Comparison 1 Case notes versus control, Outcome 7 Assisted delivery (forceps and caesarean section).
1.8
1.8. Analysis
Comparison 1 Case notes versus control, Outcome 8 Assisted vaginal delivery (forceps and vacuum extraction) ‐ inverse variance.
1.9
1.9. Analysis
Comparison 1 Case notes versus control, Outcome 9 Caesarean section ‐ inverse variance.
1.10
1.10. Analysis
Comparison 1 Case notes versus control, Outcome 10 Stillbirth or neonatal death ‐ inverse variance.
1.11
1.11. Analysis
Comparison 1 Case notes versus control, Outcome 11 Admission to NICU ‐ inverse variance.
1.12
1.12. Analysis
Comparison 1 Case notes versus control, Outcome 12 Miscarriage.
1.13
1.13. Analysis
Comparison 1 Case notes versus control, Outcome 13 Maternal admission to ICU during pregnancy ‐ inverse variance.
1.14
1.14. Analysis
Comparison 1 Case notes versus control, Outcome 14 Maternal depression (EPDS cut off 12 points) ‐ inverse variance.
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Elbourne 1987 {published data only}
    1. Elbourne D, Richardson M, Chalmers I, Waterhouse I, Holt E. The Newbury Maternity Care Study: a randomized controlled trial to assess a policy of women holding their own obstetric records. British Journal of Obstetrics and Gynaecology 1987;94:612‐9. - PubMed
Homer 1999 {published data only}
    1. Homer CSE, Davis GK, Everitt LS. The introduction of a woman‐held record into a hospital antenatal clinic: the bring your own records study. Australian and New Zealand Journal of Obstetrics and Gynaecology 1999;39(1):54‐7. - PubMed
Lovell 1987 {published data only}
    1. Lovell A, Zander LI, James CE, Foot S, Swan AV, Reynolds A. St. Thomas' Maternity Case Notes Study: Why not give mothers their own case notes?. London: Cicely Northcote Trust, 1986.
    1. Lovell A, Zander LI, James CE, Foot S, Swan AV, Reynolds A. The St. Thomas's Hospital maternity case notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes. Paediatric and Perinatal Epidemiology 1987;1:57‐66. - PubMed
Mori 2015 {published data only}
    1. Mori R, Yonemoto N, Noma H, Ochirbat T, Barber E, Soyolgerel G, et al. The Maternal and Child Health (MCH) Handbook in Mongolia: a cluster‐randomized, controlled trial. Plos One 2015;10(4):e0119772. - PMC - PubMed

References to studies excluded from this review

Aarts 1997 {published data only (unpublished sought but not used)}
    1. Aarts FV. Trial to determine the value of introducing a "state of pregnancy" passport on Curacao. Personal communication 1997.
Draper 1986 {published data only}
    1. Draper J, Field S, Thomas H, Hare M. Should women carry their antenatal records?. BMJ 1986;292(6520):603. - PMC - PubMed
Jenkinson 1989 {published data only}
    1. Jenkinson SD, House MJ. The entire computerised antenatal record collected prospectively and stored on patient held optical memory. Proceedings of Silver Jubilee British Congress of Obstetrics and Gynaecology; 1989 July 4‐7; London, UK. 1989.
Phipps 2001 {published data only}
    1. Phipps H. Carrying their own medical records: the perspective of pregnant women. Australian and New Zealand Journal of Obstetrics and Gynaecology 2001;41(4):398‐401. [MEDLINE: ] - PubMed
Webster 1996 {published data only}
    1. Webster J, Foster S, Thomas I, Griffin A, Timms H. Sharing antenatal care: client satisfaction and use of 'patient held' record. Australian and New Zealand Journal of Obstetrics and Gynaecology 1996;36(1):11‐4. - PubMed

Additional references

Backe 1993
    1. Backe B, Nakling J. Effectiveness of antenatal care: a population based study. British Journal of Obstetrics and Gynaecology 1993;100:727‐32. - PubMed
DoH 1993
    1. Expert Maternity Group, Department of Health. Changing Childbirth. London: HMSO, 1993.
Donald 1984
    1. Donald PR, Hesseling PB. The 'Road to Health' card ‐ a cornerstone of preventative and promotive paediatrics. South African Medical Journal 1984;65:423‐5. - PubMed
Dowswell 2015
    1. Dowswell T, Carroli G, Duley L, Gates S, Gülmezoglu AM, Khan‐Neelofur D, Piaggio G. Alternative versus standard packages of antenatal care for low‐risk pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 7. [DOI: 10.1002/14651858.CD000934] - DOI - PMC - PubMed
Harrison 1998
    1. Harrison D, V Heese H, Harker H, Mann MD. An assessment of the 'Road to Health' card based on perceptions of clinic staff and mothers. South African Medical Journal 1998;88:1424‐7. - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hofmeyr 1994
    1. Hofmeyr GJ, Pattinson RC, Nikodem VC, Gulmezoglu AM. Charting fetal growth. Journal of Comprehensive Health 1994;5:62‐7.
Munjanja 1996
    1. Munjanja SP, Lindmark G, Nystrom L. Randomised controlled trial of a reduced visits programme of antenatal care in Harare, Zimbabwe. Lancet 1996;348:364‐9. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.

References to other published versions of this review

Brown 2004
    1. Brown HC, Smith HJ. Giving women their own case notes to carry during pregnancy. Cochrane Database of Systematic Reviews 2004, Issue 2. [DOI: 10.1002/14651858.CD002856.pub2] - DOI - PubMed
Hodnett 1995
    1. Hodnett ED. Women carrying their own case‐notes during pregnancy. [revised 12 May 1993]. In: Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database [database on disk and CDROM]. The Cochrane Collaboration; Issue 2, Oxford: Update Software; 1995.

Publication types