The researchers found that with midwife care women were less likely to give birth pre-term and had fewer interventions during labor than when their pregnancy and post delivery care was shared between obstetricians, GPs and midwives.
Midwife care throughout pregnancy is a common norm followed in many countries such as UK and Australia. The emphasis is to be constantly cared by a known, trusted midwife who is aware of a women’s pregnancy and the problems she faced if any.
Midwife-led continuity of care is provided in a multi-disciplinary network of consultation and referral with other care providers. On the other hand the shared way of pregnancy care is when the family GP takes care of the expectant mom for the first half of the pregnancy and then the obstetricians takes over when the mother passes 24 weeks.
The researchers reviewed data from 13 trials involving a total of 16,242 women. Of these eight were those women with low risk of complications and five were those with high risk of complication.
They found that when midwives were the main providers of care throughout, women were less likely to give birth before 37 weeks or lose their babies before 24 weeks. These women were also happier with the care they received had fewer epidurals, fewer assisted births, and fewer episiotomies. The researchers also found that the ceasearean section births were no more likely and labour was about half an hour longer than when the women were being cared by shared experts.
The researchers believe this strongly shows that women need midwife care and should be given such care all through their pregnancy unless there is some complication involved.
“Women should be encouraged to ask for this option,” said lead researcher Jane Sandall of the Division of Women’s Health at King’s College London in London, UK, who led an interdisciplinary team of researchers from Sheffield Hallam University, The University of Warwick and National University of Ireland Galway.
“Policymakers in areas of the world where health systems do not provide midwife-led care should consider the importance of midwives in improving maternity care and how financing of midwife-led services can be reviewed to support this.”
The researchers also reviewed the studies that compared the cost of midwife led care with shared care. They found during labor, midwife care was more cost-effective.
“There was a lack of consistency in the way that maternity care cost was estimated in the studies, but there seemed to be a trend towards a cost-saving effect of midwife-led care,” said Sandall.
The present research comes at a time when another study finds that in UK the NHS will experience shortage of midwives in the coming years and this shortage may last till the mid 2020s because of the baby boom.
The calculations, by the Royal College of Midwives (RCM), suggest that the gap between the number of midwives the NHS in England needs and the number it now has will not be closed until 2026.
Belinda Phipps, chief executive of the parenting charity the National Childbirth Trust, said women giving birth between now and 2026 would be let down as a result of the shortfall. “It’s extremely frustrating to think that we’ll have to wait 13 years before mothers are getting the level of support they need. Childbirth is so important that they shouldn’t have to wait that long. A whole generation of mothers and babies will not get the support they need.”
While the present review identifies the important role of midwives during a crucial time in an expectant mom’s life, it also highlights that the shortage if any, has to be met at an urgent basis so that more women can take the advantage of a constant midwife support throughout their pregnancy.