midwiferyled

Midwifery-led care refers to a model of maternity care in which most of the pregnancy, birth, and postpartum care is provided by midwives. This model emphasizes normal physiological birth, continuity of care, and patient-centered decision making. It is commonly delivered in midwifery-led units or birth centers, as well as in home birth programs, and is designed for low-risk pregnancies. When risk factors emerge, care may be transferred to obstetric-led services.

Care principles include comprehensive risk assessment at booking and throughout pregnancy, individualized birth planning, and access to pain relief and emergency support as needed. The care team emphasizes non-pharmacological approaches, informed choice, and minimal unnecessary interventions, with a preference for avoiding routine induction or cesarean sections when not medically indicated.

Outcomes: In many settings, midwifery-led care is associated with lower rates of cesarean section and instrumental births for low-risk pregnancies and higher maternal satisfaction, while maintaining safety comparable to obstetric-led care when appropriately selected and properly integrated with transfer pathways. The model requires reliable triage and transfer protocols for high-risk cases and adequate staffing and training.

Global use and policy: Countries such as the United Kingdom, the Netherlands, and parts of Canada and Australia operate midwifery-led models including birth centers and home birth programs. Guidelines from organizations like NICE and WHO support midwifery-led care as a safe option for eligible pregnancies with appropriate referral and transfer arrangements.