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Defining Midwifery-Led Care in the United States Using Concept Analysis.

Katie Page1,2, Julia Phillippi3, Cathy L Emeis4

  • 1Centra Medical Group Women's Center, Centra Health, Lynchburg, Virginia.

Journal of Midwifery & Women'S Health
|December 26, 2024
PubMed
Summary

Midwifery-led care, where midwives lead, partners with patients, and embodies midwifery philosophy, is crucial for improving maternal and infant outcomes. This model offers enhanced patient satisfaction and reduced healthcare costs.

Keywords:
concept analysismidwifery caremidwifery integrationmidwifery‐led careorganizational models

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Area of Science:

  • Health Services Research
  • Nursing
  • Public Health Policy

Background:

  • National health policy advocates for integrating midwifery care to enhance quality and reduce maternal health disparities.
  • The specific service models of midwifery care and their impact on outcomes are not well understood in the U.S.
  • Midwifery-led care models are linked to better outcomes but have been inconsistently studied and narrowly defined.

Purpose of the Study:

  • To conduct a concept analysis of midwifery-led care.
  • To expand the definition of midwifery-led care to encompass a broader scope beyond perinatal care.
  • To provide a refined definition that can guide midwifery practice, research, and health policy.

Main Methods:

  • Utilized Walker and Avant's concept analysis methodology.
  • Identified key attributes, antecedents, and consequences of midwifery-led care.
  • Synthesized existing literature and practice to define the concept.

Main Results:

  • Identified three core attributes: midwife as lead clinician, person-midwife partnership, and care embodying midwifery philosophy.
  • Defined antecedents including licensure, patient need, low-to-moderate risk status, supportive regulations, and reimbursement.
  • Consequences include improved maternal and neonatal outcomes, increased patient satisfaction, and decreased healthcare costs.

Conclusions:

  • The expanded definition of midwifery-led care offers a systems-level approach, centering the patient and midwifery philosophy.
  • This refined definition is essential for consistent application in practice, research, and policy.
  • Further research is needed to classify midwifery-led care models and compare outcomes across different service models.