Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study

Abstract Introduction Globally, the management of low-risk pregnancies by midwives often leads to a more natural childbirth process, which enhances physical and psychological outcomes for mothers and their babies. Midwives implement various models of maternal care in practice. This study investigate...

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Main Authors: Shirin Shahbazi Sighaldeh, Elaheh Eskandari, Shahla Khosravi, Elham Ebrahimi, Shima Haghani, Fatemeh Shateranni
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-02789-4
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author Shirin Shahbazi Sighaldeh
Elaheh Eskandari
Shahla Khosravi
Elham Ebrahimi
Shima Haghani
Fatemeh Shateranni
author_facet Shirin Shahbazi Sighaldeh
Elaheh Eskandari
Shahla Khosravi
Elham Ebrahimi
Shima Haghani
Fatemeh Shateranni
author_sort Shirin Shahbazi Sighaldeh
collection DOAJ
description Abstract Introduction Globally, the management of low-risk pregnancies by midwives often leads to a more natural childbirth process, which enhances physical and psychological outcomes for mothers and their babies. Midwives implement various models of maternal care in practice. This study investigates and compares maternal and neonatal outcomes associated with midwifery-led care versus routine midwifery care in private hospitals in Iran. Methods This retrospective cohort study was conducted in Iran in 2022. The study population consisted of two groups including 387 women in the Routine Care Group (RCG) and 397 women in the Private Care Group (PCG). Participants were selected through continuous sampling in accordance with the inclusion criteria. The two groups were compared in terms of some maternal and neonatal outcomes. The research data collection tool was a researcher-made checklist with variables adjusted according to the ‘Iman’ system of the Iran Ministry of Health. Based on this tool, the data were extracted from the mentioned system and analyzed with SPSS software. Findings The results indicated no significant difference between the two groups in terms of the type of delivery (p = 0.999), the use of forceps or vacuum (P = 0.5) and transferring the mother to the operating room (OR) or the intensive care unit (ICU) immediately after delivery (P = 0.744). However, there was a statistically significant difference between the two groups in terms of labor pain control (P < 0.001), induction of labor (P < 0.001), and the use of episiotomy (P < 0.001). Regarding neonatal outcomes, there was no statistically significant difference between the two groups in relation to the average infant weight (P = 0.46), Apgar score (P = 0.75), need for resuscitation (P = 0.999), skin-to-skin contact (P = 0.626), initiation of breastfeeding (P = 0.241) and admission to the neonatal intensive care units (NICU) (P = 0.66). Conclusion Given the positive impact of private care on key maternal outcomes, it is recommended that health policymakers create the conditions necessary for establishing a continuous midwifery care model in both governmental and private hospitals. Besides, more quantitative, qualitative, and especially mixed methods research should be conducted to explore the challenges and facilitators of this model across various settings.
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spelling doaj-art-41560614703d4c8aad8331d8bb54d4822025-08-20T02:13:06ZengBMCBMC Nursing1472-69552025-02-012411910.1186/s12912-025-02789-4Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort studyShirin Shahbazi Sighaldeh0Elaheh Eskandari1Shahla Khosravi2Elham Ebrahimi3Shima Haghani4Fatemeh Shateranni5Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical SciencesMidwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical SciencesDepartment of Community Medicine, Faculty Member of Medicine School, Tehran University of Medical SciencesMidwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical SciencesNursing Care Research Center, Iran University of Medical SciencesMidwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical SciencesAbstract Introduction Globally, the management of low-risk pregnancies by midwives often leads to a more natural childbirth process, which enhances physical and psychological outcomes for mothers and their babies. Midwives implement various models of maternal care in practice. This study investigates and compares maternal and neonatal outcomes associated with midwifery-led care versus routine midwifery care in private hospitals in Iran. Methods This retrospective cohort study was conducted in Iran in 2022. The study population consisted of two groups including 387 women in the Routine Care Group (RCG) and 397 women in the Private Care Group (PCG). Participants were selected through continuous sampling in accordance with the inclusion criteria. The two groups were compared in terms of some maternal and neonatal outcomes. The research data collection tool was a researcher-made checklist with variables adjusted according to the ‘Iman’ system of the Iran Ministry of Health. Based on this tool, the data were extracted from the mentioned system and analyzed with SPSS software. Findings The results indicated no significant difference between the two groups in terms of the type of delivery (p = 0.999), the use of forceps or vacuum (P = 0.5) and transferring the mother to the operating room (OR) or the intensive care unit (ICU) immediately after delivery (P = 0.744). However, there was a statistically significant difference between the two groups in terms of labor pain control (P < 0.001), induction of labor (P < 0.001), and the use of episiotomy (P < 0.001). Regarding neonatal outcomes, there was no statistically significant difference between the two groups in relation to the average infant weight (P = 0.46), Apgar score (P = 0.75), need for resuscitation (P = 0.999), skin-to-skin contact (P = 0.626), initiation of breastfeeding (P = 0.241) and admission to the neonatal intensive care units (NICU) (P = 0.66). Conclusion Given the positive impact of private care on key maternal outcomes, it is recommended that health policymakers create the conditions necessary for establishing a continuous midwifery care model in both governmental and private hospitals. Besides, more quantitative, qualitative, and especially mixed methods research should be conducted to explore the challenges and facilitators of this model across various settings.https://doi.org/10.1186/s12912-025-02789-4MidwiferyDoulasLabor painEpisiotomyLabor inductionNursing care
spellingShingle Shirin Shahbazi Sighaldeh
Elaheh Eskandari
Shahla Khosravi
Elham Ebrahimi
Shima Haghani
Fatemeh Shateranni
Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
BMC Nursing
Midwifery
Doulas
Labor pain
Episiotomy
Labor induction
Nursing care
title Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
title_full Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
title_fullStr Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
title_full_unstemmed Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
title_short Comparison of maternal and neonatal outcomes of midwifery-led care with routine midwifery care: a retrospective cohort study
title_sort comparison of maternal and neonatal outcomes of midwifery led care with routine midwifery care a retrospective cohort study
topic Midwifery
Doulas
Labor pain
Episiotomy
Labor induction
Nursing care
url https://doi.org/10.1186/s12912-025-02789-4
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