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Meta-Analysis
. 2024 Jun;51(2):264-274.
doi: 10.1111/birt.12801. Epub 2023 Nov 30.

Systematic review and meta-analysis examining the effects of midwife care on cesarean birth

Ilir Hoxha  1   2   3 , Krenare Grezda  3 , Anirudh Udutha  4 , Besarta Taganoviq  2 , Riaz Agahi  2 , Naime Brajshori  2 , Sharon Schindler Rising  5
Affiliations
Meta-Analysis

Systematic review and meta-analysis examining the effects of midwife care on cesarean birth

Ilir Hoxha et al. Birth. 2024 Jun.

Abstract

Background: The increasing number of unnecessary cesarean births is a cause for concern and may be addressed by increasing access to midwifery care. The objective of this review was to assess the effect of midwifery care on the likelihood of cesarean births.

Methods: We searched five databases from the beginning of records through May 2020. We included observational studies that reported odds ratios or data allowing the calculation of odds ratios of cesarean birth for births with and without midwife involvement in care or presence at the institution. Standard inverse-variance random-effects meta-analysis was used to generate overall odds ratios (ORs).

Results: We observed a significantly lower likelihood of cesarean birth in midwife-led care, midwife-attended births, among those who received instruction pre-birth from midwives, and within institutions with a midwifery presence.

Conclusions: Care from midwives reduces the likelihood of cesarean birth in all the analyses, perhaps due to their greater preference and skill for physiologic births. Increased use of midwives in maternal care can reduce cesarean births and should be further researched and implemented broadly, potentially as the default modality in maternal care.

Keywords: cesarean birth; health practice variation; midwife‐led care; midwives; physician variation; practice patterns.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three 3 years; and no other relationships or activities that could appear to have influenced the submitted work.

References

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