Advanced intrapartum midwifery practice: a scoping review

Area of Science:

• Maternal and Child Health
• Midwifery Practice
• Healthcare Skills Development

Background:

• Advanced practice midwives demonstrate positive impacts on maternal and neonatal outcomes, care access, and efficiency.
• Existing literature lacks specific details on advanced midwifery skills within intrapartum care.

Purpose of the Study:

• To systematically map and identify advanced midwifery skills utilized in intrapartum care.
• To address the lack of international consensus on advanced midwifery practice during childbirth.

Main Methods:

• A comprehensive scoping review was performed, searching multiple electronic databases (Medline, Scopus, CINAHL, Cochrane Library, Google).
• The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.
• Data was collected from inception up to April 2022.

Main Results:

• Out of 6932 identified studies, 17 met the inclusion criteria for the review.
• Identified advanced intrapartum skills include perineal care, instrumental and breech vaginal birth, perineal repair, cesarean section assistance, emergency procedures, intrapartum ultrasound, counseling, labor techniques, advanced assessment, and external cephalic version.
• Key skills also encompass intangible aspects and mediation.

Conclusions:

• Advanced midwifery skills in intrapartum care are evolving, with trends towards promoting physiological childbirth in midwifery-led units.
• In resource-limited settings, advanced midwifery practice often overlaps with medical skill sets.
• Developing advanced skills, particularly in birth physiology and utilizing technological/emotional competencies, is crucial for improving maternal and neonatal outcomes.