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Impact of the midwife-led care model on mode of birth: a systematic review and meta-analysis

02 July 2024
Volume 32 · Issue 7



Increased rates of caesarean sections globally have potential short- and long-term impacts for mothers and babies. Research on models of care and mode of birth has reported varied results. The aim of this study was to analyse the relationship between the midwife-led model of care and mode of birth.


This systematic review and meta-analysis searched PubMed, Scopus and Web of Science. Quantitative full-text open access research articles published between 2010 and 2023 in Indonesian or English were included. Research that assessed the relationship between the model and birth planning were excluded.


A total of 16 articles were included. Two were experimental, and the remaining 14 were observational, with a total sample of 125 201 people. The midwife-led model supported spontaneous vaginal birth (odds ratio: 1.64, P=0.01) when compared to other models.


Implementing the midwife-led model of care may increase the likelihood of physiological birth and reduce the incidence of caesarean section, especially in low-risk pregnancies.

According to the World Health Organization (WHO, 2021), the number of caesarean section births continues to increase globally, accounting for more than one in five (21%) of all births (Betran et al, 2021). This proportion is expected to increase over the next decade, with almost a third (29%) of all births likely to occur via caesarean section by 2030 (Betran et al, 2021).

A caesarean section can be crucial in situations such as prolonged or obstructed labour, fetal distress or when the fetus is in an abnormal position; however, not all caesarean sections performed are necessary for medical reasons (WHO, 2021). Unnecessary surgical procedures can be dangerous, both for the woman and her baby. As for all types of surgery, caesarean sections can have risks, including the potential for severe bleeding or infection, slower recovery time after birth, delays in breastfeeding and early breastfeeding initiation and increased chances of complications in subsequent pregnancies (WHO, 2021).

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