Background Experts in many countries are recommending a scaling up midwifery-led care as a model to improve maternal and newborn outcomes, reduce rates of unnecessary interventions, realise cost savings, and facilitate normal spontaneous vaginal birth. Objective The aim of this study was to compare midwifery-led and obstetrician-gynaecologist-led care-related vaginal birth outcomes. Participants Pregnant women in Kaunas city maternity care facilities. Methods A propensity score-matched case–control study of midwifery-led versus physician-led low-risk birth outcomes. Patient characteristics and outcomes were compared between the groups. Continuous variables are presented as mean ± standard deviation and analysed using the Mann–Whitney U test. Categorical and binary variables are presented as frequency (percentage), and differences were analysed using the chi-square test. Analyses were conducted separately for the unmatched (before propensity score matched [PSM]) and matched (after PSM) groups. Results After adjusting groups for propensity score, postpartum haemorrhage differences between physician-led and midwifery-led labours were significantly different (169.5 and 152.6 mL; p = 0.026), same for hospital stay duration (3.3 and 3.1 days, p = 0.042). Also, in matched population, significant differences were seen for episiotomy rates (chi2 = 4.8; p = 0.029), newborn Apgar 5 min score (9.58 and 9.76; p = 0.002), and pain relief (chi2 = 14.9; p = 0.002). Significant differences were seen in unmatched but not confirmed in matched population for obstetrical procedures used during labour, breastfeeding, birth induction, newborn Apgar 1 min scores, and successful vaginal birth as an overall spontaneous vaginal birth success measure. Conclusion The midwifery-led care model showed significant differences from the physician-led care model in episiotomy rates, hospital stay duration and postpartum haemorrhage, and newborn Apgar 5 min scores. Midwifery-led care is as safe as physician-led care and does not influence the rate of successful spontaneous vaginal births.

According to the World Health Organization, midwife-led care is the most appropriate and cost-effective type of perinatal care. As the Covid-19 pandemic with its drastic changes and challenges for the health systems and the medical staff made large adjustments to the healthcare delivery system, midwife-led care became an even more important supportive tool in maintaining unnecessary interventions. This retrospective cohort study aims to compare the outcomes of midwife-led care and team-led care in low-risk births between the Covid-19 pandemic and non-Covid-19 pandemic period. The total studied population was 1,185 singleton births and consisted of 727 births during the non-Covid-19 period and 458 births from the Covid-19 period. The study revealed the safety of low-risk birth care during the first wave of the Covid-19 pandemic in both groups. The maternal and perinatal outcomes remained stable without an increased rate of unsuccessful vaginal births and newborn asphyxia; moreover, birth care of low-risk women provided by midwives preserved autonomy, integrity, and resistance to responding to a disaster. The aforementioned results exhibit that high-quality, safe supervision by midwives in low-risk births can be provided even in high-stress circumstances.

Tyrimo tikslas. Išanalizuoti pirmą kartą ir pakartotinai besilaukiančių moterų žinias apie seksualinį gyvenimą po gimdymo. Tyrimo metodai. Anoniminė anketinė nėščių moterų apklausa vykdyta 2020 m. lapkričio–2021 m. vasario mėn. internetiniame socialiniame tinkle „Facebook“, grupėje „Nėštumas, Nėštukės ir Mamytės“. Iš viso tyrime dalyvavo 190 nėščių moterų. Rezultatai. Tiek pirmą kartą, tiek pakartotinai besilaukiančios moterys žinojo daugelį seksualinio gyvenimo gerinimo metodų. Didelė dalis pirmą kartą besilaukiančių moterų nežinojo, kad, žindant krūtimi, dažnai jaučiamas sausumo, skausmo pojūtis lytinių santykių metu, kad tiek po natūralaus gimdymo, tiek po CPO moteris gali patirti sunkumų seksualiniame gyvenime. Didžioji dalis pakartotinai besilaukiančių moterų nežinojo, kad, žindant krūtimi, gali sumažėti lytinis potraukis. Išvados. Pirmą kartą ir pakartotinai besilaukiančių moterų žinios apie seksualinį gyvenimą po gimdymo statistiškai reikšmingai nesiskyrė, tačiau pirmą kartą besilaukiančios moterys dažniau žinojo, kad lubrikantas gali pagerinti seksualinį gyvenimą po gimdymo.