Midwife-Led Vaginal Births as Safe as Physician-Led Ones

A new study shows that for vaginal births with a low risk of complications, midwifery outcomes are equal to those of physician-guided births.

Researchers at the Lithuanian University of Health Sciences (Kaunas, Lithuania) and the Institute of Pharmacoeconomics (Kaunas, Lithuania) conducted a study comparing outcomes of 348 low-risk singleton pregnancies. The researchers matched vaginal, low-risk births, of which 174 were led by an obstetrician/gynecologist, and another 174 were led by midwives. Patient characteristics and outcomes were compared between the groups.

The results showed significant postpartum differences in hemorrhage between physician-led (169.5 mL) and midwifery-led labors (152.6 mL), hospital stay duration (3.3 and 3.1 days), Apgar five minute score (9.58 and 9.76), episiotomy rates, and pain relief. Significant differences were seen, but not confirmed, in obstetrical procedures used during labor, breastfeeding, birth induction, Apgar one minute scores, and successful vaginal birth. The study was published on October 15, 2021, in Open Medicine.

“Midwives are independent healthcare professionals, and not just assistants to the obstetrician-gynecologist,” said lead author Ingrida Poškienė, MD, of the Lithuanian University of Health Sciences. “We would like to make expectant mothers aware that low-risk births supervised by a midwife are as safe as those under supervision of a gynecologist, and we hope the study will encourage midwives to have more confidence in their competence and to take more responsibility for working independently.”

In contrast to the physician-led medical model, midwifery focuses on the normal biological processes of pregnancy and birth. Midwifery-led care can help improve quality of care, outcomes, and provide a more efficient distribution of health care resources by reducing maternal and neonatal mortality and morbidity, stillbirth and preterm birth, decreasing unnecessary interventions, and improving psychosocial and public health outcomes. As a result, many countries are recommending a scaling up of midwifery-led care.

Related Links:
Lithuanian University of Health Sciences
Institute of Pharmacoeconomics