Introduction The role of midwives has changed in providing care for low-risk pregnancies and childbirth. This study explores the perceptions of perinatal care providers and recipients regarding midwifery services. Methods This study used a qualitative content analysis approach. Data were collected through 49 semi-structured in-depth interviews, and analysed with qualitative content analysis. Results The medicalisation of pregnancy and childbirth has marginalised midwifery. Midwifery, which should be at the heart of all low-risk pregnancies and childbirth, has deteriorated such that it has become disempowered in interdisciplinary relations. Conclusions Midwifery is at risk of being totally excluded from low-risk pregnancy care and childbirth.
Background: Although there are studies that suggest a vast expansion of medicalization of pregnancy and birth in Iran, data about the rate of intervention applications caused by the medicalization in low-risk pregnancies and birth is limited. Moreover, there is limited information on the effectiveness of these interventions for different modes of childbirth. Objectives: This study aimed to determine the rate of application of maternal medicalized care in low-risk pregnancies and births and to identify the factors that are associated with type of delivery. Patients and Methods:This cross-sectional study was performed by stratified-cluster sampling on 320 postpartum women from four public and private hospitals in Mashhad, Iran. The data collection instrument was a designed and standardized tool for assessment of medicalized pregnancy and childbirth. Also, descriptive tests and logistic regression were used. A value of P < 0.05 was considered statistically significant for all tests. Results: In this study, the rates of natural vaginal and caesarean birth were 34.7% and 65.3%, respectively. Preconception and prenatal care received from an obstetrician were 72.8% and 51.6%, respectively. The median number of prenatal visits, laboratory examinations and sonography procedures was 12, 3 and 4, respectively. In 49.4% of the cases, the women were hospitalized before the onset of labor. Early admission (OR = 2.40; 95% CI = 1.93 -2.97; P = 0.001) and performing electronic fetal heart monitoring during admission (OR = 2.47; 95% CI = 1.28 -4.73; P = 0.006) were the interventions that the regression logistic analysis identified as associated with a higher rate of caesarean delivery. Conclusions: It seems that obstetric interventions are widely applied in low-risk pregnancies and births. Some of these interventions have the effect of increasing the rate of caesarean delivery. According to the provided information, it seems that it is necessary to adjust health policy to provide appropriate care for low-risk pregnancies and births.
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