Clinical evaluation of the implementation outcomes of the maternity care program for low-risk pregnant women
Objective To implement a midwife-led maternity care program and to evaluate its effectiveness for low-risk pregnant women.Methods Low-risk pregnant women who made an appointment at a tertiary obstetrics and gynecology hospital in Shanghai were selected as the study objects,and were randomly divided into an intervention group(n=485)and a control group(n=499).The control group received routine prenatal health services led by obstetricians,and routine obstetric care services were performed during intrapartum and postpartum periods,while the intervention group additionally received a midwife-led maternity care pro-gram,including eight antenatal contacts in the midwife's outpatient clinic,WeChat group intervention and telephone visits,conti-nuous labor support and postpartum visits.Results In the intervention group,the median number of antenatal contacts with mid-wives was 7 times.The rate of birth plan making and its implementation rate were 76.70％and 84.68％,respectively.Women in the intervention group experienced lower cesarean section rate(27.68％)than that in the control group(35.25％)(P＜0.05).Women in the intervention group experienced lower chances of epidural analgesia,amniotomy,episiotomy and NICU admission,less amount of bleeding in the third stage of labor and 2 hours postpartum,and less amount of total bleeding(all P＜0.05).The total scores of women's antenatal care experience,childbirth experience,postnatal care experience,reproductive health literacy in late trimester,antenatal breast-feeding self-efficacy,childbirth self-efficacy,and the rate of exclusive breastfeeding before dis-charge were all significantly higher in the intervention group than those in the control group(all P＜0.05).Conclusion The imple-mentation of the midwife-led maternity care program can promote low-risk women s normal pregnancy and childbirth,improve women's ante-,intra-,and postnatal care experience,and achieve the two-way empowerment between women and midwives.
low-risk pregnant womenmaternity caremidwifechildbirth self-efficacyreproductive health literacybreastfeedingchildbirth experienceobstetric nursing
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