Women's health care providers answer questions about giving birth during coronavirus

Midwife- and doctor-led care equally safe during low-risk births


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If you or your partner were scheduled to give birth soon, would you have a preference for who delivered your baby: a midwife or a doctor? A new study of maternity care facilities in Lithuania suggests that for births with a low risk of complications, there is no difference in terms of safety.

The study, “Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis” published in the journal Open Medicine, also revealed that midwife-led births were associated with a significantly lower risk of postpartum hemorrhage, shorter hospital stays and less medical intervention, including pain relief and birth induction.

Safety is paramount while giving birth, and some people may assume that it is best to give birth under the supervision of a doctor. However, for births with a low risk of complications, could a midwife-led birth be just as safe?

The question is an important one, as more midwife-led care could have numerous benefits, including more efficient use of healthcare resources, a reduction in unnecessary medical interventions and greater support for mothers. Midwives have also traditionally provided personalized care for mothers during their pregnancy, birth and during the transition to parenthood, in addition to looking after their safety.

This study, conducted in Lithuania, aimed to investigate differences in the safety of midwife-led births compared with doctor-led births in low-risk pregnancies. In Lithuania, midwives can perform various medical procedures during a birth, and are increasingly recognized as highly trained healthcare professionals.

To investigate these issues, the researchers compared the outcomes of 348 low-risk births in maternity care units in Kaunas city in Lithuania, half of which were led by midwives and half by doctors. The researchers made sure that the births were carefully matched in terms of maternal health and characteristics and the risk of complications, so that the comparisons would be meaningful.

They found no significant difference in safety between midwife- and doctor-led births, with the midwife-led births demonstrating some advantages, including reduced hospital stays and reduced postpartum hemorrhage.

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


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More information:
Ingrida Poškienė et al, Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis, Open Medicine (2021). DOI: 10.1515/med-2021-0373

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Delivering during delivery: Midwife- and doctor-led care equally safe during low-risk births (2021, November 19)
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