Effect of midwife‐led care on birth outcomes of primiparas

Background The high caesarean section rate is a prominent public health problem in China. Aim This study aimed to determine the effects of midwife‐led care during labour on birth outcomes for healthy primiparas. Design Randomized controlled trial. Setting The Obstetrics Department of Fujian Provincial Maternity and Child Health Hospital. Methods A total of 666 primiparas in labour were randomly divided into an intervention and control group (333 in each group). The intervention group received a midwife‐led model of care during labour. Results Data from 648 cases (331 intervention group and 317 control group) were analysed. The intervention group was less likely to experience caesarean section, postpartum haemorrhage, opiate analgesia, vaginal examinations, neonatal asphyxia, and neonatal hospitalization and was more likely to experience shorter length of labour and vaginal birth than the control group (all, P 0.05). Conclusions Midwife‐led care can reduce the caesarean section rate, promote normal birth, improve birth outcomes, and promote maternal and child health. SUMMARY STATEMENT What is already known about this topic? Midwifery is a key element of maternal and newborn health care. Using midwife‐led care for normal labour is a recommended practice in several developed countries, eg, Sweden, New Zealand, the United Kingdom, the Netherlands, and Australia. There are a limited number of Chinese studies that addressed midwife‐led care. What this paper adds? Midwife‐led care during delivery can shorten the length of labour and reduce the caesarean rate and analgesic use. Midwife‐led care during labour significantly reduced the risk of newborn hospitalizations and decreased the rate of postpartum haemorrhage, thus improving delivery outcomes and promoting maternal and child health. The implications of this paper: The findings provide evidence to support the feasibility and the beneficial effect of midwife‐led care during delivery for women in Mainland China.