Mothers-to-be who have their prenatal and childbirth care are led by a midwife have better outcomes compared with those whose care is led by a physician or shared among disciplines, according to a systematic review of 13 trials involving 16,242 women published August 22 in the Cochrane Database of Systematic Reviews.
Pregnancy care that was led or entirely provided by hospital- or community-based midwives was linked to fewer epidurals, episiotomies and use of instruments like forceps or vacuums during delivery.
Risk of losing the baby during the first two trimesters was also significantly lower, UK researchers found.
"Every woman should be aware of the benefits of midwifery-led care compared to obstetrician- or family physician-led care," said Maureen Corry, executive director of Childbirth Connection, a national nonprofit focused on maternal care, who did not work on the paper. "This new Cochrane review is full of good news for women and babies."
The study noted that higher-risk women who saw a midwife as their point-person did not have worse outcomes than low-risk women -- a discovery the researchers interpreted with cautious optimism.
"This is an important finding, because it means that midwives have something to offer women who are not low-risk, when they are coordinating care with a primary care physician or an OBGYN," argued review author Jane Sandall, with the division of women's health at Kings College, London.
