Comparing the Implications of Midwifery-Led Care and Standard Model on Maternal and Neonatal Outcomes during Pregnancy, Childbirth and Postpartum

Abstract

Background & aim: Considering importance of developing maternal care, the present study was designed to compare the implications of a midwifery-led care (MLC) and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum. Methods: This clinical trial performed through quasi- experimental method on 200 pregnant women referred to health centers of Kashan, Iran, between 2014 and 2017. Participants were randomly assigned to MLC and standard model of care group (each 100). Data on maternal and neonatal outcomes were collected using self-structured questionnaires and checklists. The validity and reliability of tools were evaluated through content validity and also test-retest and observer reliability. The collected data were analyzed using SPSS version 21 by T test, chi-square and Mann-Whitney. Results: The implementation of MLC resulted in improved outcomes including decrease in cesarean section, increase in spontaneous delivery, increase in physiological delivery, increased participation in preparatory classes for labor, decrease in induction, decrease in hospital stay, decrease in the number of prenatal visits, decrease in ultrasound, and increase in mean gestational age at admission (p <0.05). The results also pointed to increased lactation and decreased hospitalization due to jaundice (p < 0.05). There was no statistically significant difference in terms of anesthesia, narcotic use, postpartum hemorrhage, curettage, episiotomy, postpartum infection and postpartum depression. No maternal mortality was observed in two groups. Conclusion: Midwifery-led care can lead to improved maternal and neonatal outcomes at least in low-risk pregnant women. More chance of physiological delivery, spontaneous labor and less cesarean section, induction and augmentation were significant.