Midwife led maternity care models: A scoping review

Abstract
Introduction: Midwife led maternity care models focus on normality, continuity of care and being cared for by trusted midwives from preconception throughout pregnancy, labour and the postnatal period. The aim of this model is to provide care either in community or hospital settings, normally to healthy women with uncomplicated pregnancies. Methods: The scoping review used search terms for the PICO components with synonyms, related terms and specialist terms were harvested from the Medical Subject Headings (MeSH)© and Embase© using Rayyan. Database searches were from PubMed, EBSCO-CINAHL, Dimensions, Web of Science, SCOPUS, and the Cochrane Library of Systematic reviews and African Journals Online (AJOL). A total of 17 058 citations were identified and 69 remained for analysis after removing duplicates and others which did not meet the criteria. Results: Of the 69 included studies, 14 were qualitative, 34 were quantitative, 19 were RCTs and 2 were mixed methods. Only 13% of the studies were from Africa and the rest were from the developed world. Six themes emerged as follows: reduced interventions in labour; positive birth outcomes; satisfaction with care; cost effectiveness of services; autonomous practice and quality midwifery services; good woman–midwife relationship and several subthemes. Discussion: Midwife-led care had a significant positive effect on physiological outcomes for women when compared to physician-led care, had reduced surgical interventions and augmentation, as well as less usage of pharmacological analgesia. This may also assist in acceptability, accessibility and availability of such a model in all maternity care units and community settings in LMICs.
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Citation
Danda, G. et al. (2023) Midwife led maternity care models: A scoping review. Discovery 59, e102d1304