Sharon Hall MD
Purpose: The purpose of this article is to compare midwife and obstetrician led labor and delivery and to ascertain if cesarean section rate changes with provider.
Method: A PubMed literature search was conducted with search terms: midwife, obstetrician, labor and delivery, cesarean section rate. Seven pertinent articles were retrieved and served as the basis for this clinical review.
Results: Midwife led labor and delivery decreases surgical delivery rate.
Conclusion: There is evidence that midwifes’ work contributes to lowering cesarean section rate in uncomplicated pregnancies. However, further research is needed to establish a stronger evidence of lower surgical delivery rate with midwife led labor and delivery
Keywords: Midwife, obstetrician, surgical delivery rate, midwife assisted labor and delivery, obstetrician led labor and delivery.
SIGNIFICANCE TO OBSTETRICS Surgical delivery is associated with increased pain, longer recovery and even quicker onset of postpartum depression¹. It can affect breastfeeding and overall wellbeing of a new mother². It is important to find the variable that may decrease the incidence of surgical delivery
TARGET AUDIENCE The target audience for this proposal will be advanced practice providers practicing in obstetrics, and physicians. Women and pregnant women may benefit from the findings of this review.
PURPOSE This proposal will enlighten the audience to the risks of surgical delivery. With the advent of improvements in fetal monitoring and advances in fetal-maternal medicine, cesarean section may appear as more controlled, predicted mode of delivery. However, there are clear benefits to vaginal delivery, and it should be preferred to surgical delivery if circumstances permit.
1.Monari F, Di Mario S, Facchinetti F, Basevi V. Obstetricians' and midwives' attitudes toward cesarean section. Birth. 2008;35(2):129-135. doi:10.1111/j.1523-536X.2008.00226.x3.
2. Betrán AP, Temmerman M, Kingdon C, et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. doi:10.1016/S0140-6736(18)31927-5
3. Journal of the American Academy of Physician Assistants. The Journal of the American Academy of Physician Assistants website. Published 2017. Accessed March 3, 2022. https://journals.lww.com/jaapa/pages/default.aspx
4. Journal of the American Academy of Physician Assistants. Information for authors and peer reviewers. The Journal of the American Academy of Physician Assistants website. Published 2018. Accessed March 10, 2022. https://journals.lww.com/jaapa/Pages/authorguidelines.aspx 5. 5. Amin P, Zaher S, Penketh R, et al. Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study. J Matern Fetal Neonatal Med. 2019;32(15):2475-2480. doi:10.1080/14767058.2018.1439006
6. Kobayashi S, Hanada N, Matsuzaki M, et al. Assessment and support during early labour for improving birth outcomes. Cochrane Database Syst Rev. 2017;4(4):CD011516. Published 2017 Apr 20. doi:10.1002/14651858.CD011516.pub2
7. King TL. The Effectiveness of Midwifery Care in the World Health Organization Year of the Nurse and the Midwife: Reducing the Cesarean Birth Rate. J Midwifery Womens Health. 2020;65(1):7-9. doi:10.1111/jmwh.13089
Szczepanska A. Midwife Or Obstetrician Led Labor And Delivery: Does Cesarean Section Rate Change. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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