What Elements Can Be Considered Midwifery Care Sensitive Outcomes? A Single-center Prospective Observational Cohort Study

Background The evidence suggests that the midwifery care model is associated with better outcomes in the labour and birth process, although the debate is already heated. Aim To verify the variation in the duration of the labour process among low-risk pregnant women cared for within different assistance midwifery models and to measure any variation in maternal and neonatal outcomes. Methods A single-centre cross-sectional observational study was conducted in a second-level hospital (hub) in accordance with the STROBE guidelines (Strengthening the Reporting of OBservational studies in Epidemiology), including 272 pregnant women. Findings The standard care with ‘regional analgesia’ and ‘one-to-one with regional analgesia’ models are linked to longer labour durations, identifying analgesia as a variable that affects both assistance types. The ‘one-to-one’ model and the ‘one-to-one’ model with water were correlated with a reduction in gynaecologist consultations due to unexpected worsening in the clinical labour conditions compared to the ‘standard’ model, while being multiparous, age group and birth weight were not related to an increased risk. Discussion When midwifery care during labour was prolonged, as in the ‘one-to-one’ model, some outcomes, such as lacerations, episiotomies, postpartum haemorrhage and gynaecologist consultation, improved. These outcomes can be considered midwifery-sensitive outcomes . Conclusion The ‘midwifery care-led’ model promotes the personalisation of assistance, allowing the woman to have the birth experience she prefers, guaranteeing safety.