A journey to evidence based practice
Midwives, obstetricians and other professionals make arrangements for obstetric care which are recorded in guidelines, protocols and care pathways. These agreements are, where possible, based on scientific research, now mostly generated from data of high-risk /mixed low or high-risk populations. The use of this evidence can lead to overestimation of risk.
Start date: 2011
Data to get better insight into the progress and outcomes of healthy pregnant women are basically available. Primary care midwives collect data of each woman about pregnancy, childbirth and postnatal period and register these data into a digital registration program. To make appropriate guidelines and protocols for pregnant women, it is necessary to use practice-based evidence. That means collecting data from daily practice systematically and interpreting these date to use the results in determining appropriate care.
The VeCaS project (Obstetric Case Registration System), led by the Research Centre of Midwifery Science, aims to realise a system to collect data on the normal course of pregnancy and childbirth. Midwives affiliated with the VeCaS project ask women to give informed consent for the anonymous use of their medical records for research. This leads to a continuous stream of data from patient records to a VeCaS database. An extraction in August 2016 resulted in a data file of more than 25,000 cases. To promote the validity of the data, a consensus manual has been developed which is used by the midwives.
Currently, midwives register their data into a digital client report. Most of these data will not be used for research and guideline development. When these data are recorded unambiguously and reliably, they can provide valuable insights into the course of pregnancy and childbirth.