PONE-D-22-04372A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia.PLOS ONE

Dear Dr. Miller,

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Academic Editor

PLOS ONE

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"We have read the journal's policy and the authors of this manuscript have the following competing interests:YM has previously received funding for the development of patient decision aids, including resources for women to choose between models of maternity care, and for establishing a state-wide survey of recent maternity consumers’ experience of maternity care across different models of care in Queensland, Australia. The funding bodies for that work had no involvement in the research reported here. EM is employed by a health service at which some participants in this study gave birth. EM was not employed by the health service at the time of data collection (2012) and the health service had no involvement or influence in the analysis of the data for the work reported in this manuscript. JT and ST have no competing interests to declare."

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6. Please include a copy of Table 8 which you refer to in your text on page 37.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Abstracts have different wording. Please can they agree? The abstract in the paper is more informative.

Rationale for the study is well argued. The aim of this study was to directly compare women’s pregnancy, labour, birth, and postpartum outcomes and experiences across the major MMC categories offered in Queensland, Australia, using data collected in 2012 from a state-wide sample of women who had given birth in Queensland.

This paper conducts secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in Queensland Australia. Please add to abstract where research is conducted and when.

This retrospective cohort study was conducted using data obtained from the 2012 Having a Baby in Queensland Survey. Please add response rate to abstract.

This data is 10 years old. Please add to limitations and any relevant changes in policy or practice during this time.

Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. Please specify differences between these models.

Logistic regression was used to estimate the odds of 34 outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates.

Line 73. Does private midwifery care provide continuity?

Line 93 Specify which antenatal care providers ?

Table 1 clarify who provides obstetric care if required in each model and who pays for this?

Line 239 Classification of MMC did not capture transitions between models of care during pregnancy. Where women transitioned between models of care during the index pregnancy, women were classified into the final model received in pregnancy to allow comparison of outcomes under a single model of care received. My understanding is that women are not classified by the model they started with, but the model they ended up in. Is this correct? If so, please justify as this is not intention to treat analysis and introduces bias?

Line 304 Low response rate. Comment upon limitations of study. Please add weblink to survey questions if available.

There are many many comparisons in this paper by differing models. Is it possible to produce a diagram/infographic summarising these to help the reader interpret the findings.

Line 618 Please report key infant outcomes here for all models as a balancing measure.

There is little reference to work in the filed in the discussion. What does this work add to this body of international literature?

Reviewer #2: Thank you for the opportunity to review this paper. I found the paper to be very well written and thorough. I preferred the tables in the supplementary that included p values and think this format would be better for the wider readership than the tables in the manuscript that only have OR presented as it helps the reader focus on the statistically significant outcomes. There is also little reference to the CI in the results but the tables include them.

My biggest concern is with the age of the dataset being over 10 years since collection. You haven't mentioned in the limitations the fact that the data is over 10 years old and that there has been development of the PPM and MGP model across Australia and in QLD during that time. When you collated this data the 2010 maternity care changes had just come into effect and there would have been very few endorsed (eligible) midwives at the time, now there are many more and now also with visiting rights, especially in QLD. I think this really needs to be explained in this paper. Otherwise you are suggesting this data is more current and relevant than it is.

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Reviewer #1: Yes: jane sandall

Reviewer #2: No

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A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia.

PONE-D-22-04372R1

Dear Dr. Miller,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Hannah Dahlen, RN, RM, BN (Hons), MCommN, PhD FACM

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Hazel Keedle

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