midwifeled

Midwifeled care is a model in which a trained midwife leads the care of a woman with a low-risk pregnancy, coordinating assessment, education, birth planning and support, with emphasis on normal physiological birth and avoiding unnecessary interventions. It contrasts with obstetric-led care, in which a physician leads, and with shared-care arrangements.

Prenatal care in this model focuses on risk assessment, education and planning for labor. Intrapartum care aims for continuity with the same midwife or team, and postpartum care supports early breastfeeding and recovery.

Settings include midwife-led units in hospitals, stand-alone birth centers, and some home-visit programs. The model targets low-risk pregnancies, with higher-risk cases managed by obstetric-led care or transferred if needed.

Evidence generally links midwifeled care to lower intervention rates (cesarean, analgesia, instrumental delivery) and high maternal satisfaction, with similar perinatal outcomes for low-risk pregnancies. Transfer to obstetric-led care is available if risk factors arise.

Limitations include the need for rapid transfer protocols, staffing to support continuity, and variability in availability and funding. Successful implementation requires integration with broader maternity services and clear risk-communication pathways.

The development of midwife-led care grew in the late 20th century, with midwife-led units established in several countries as part of reforms to maternity services.