Maternal and perinatal outcomes based on the planned birthplace for women with low-risk pregnancies: the German model

Background: In Germany, midwifery care has a long-standing tradition and history of providing high-quality services to women, particularly during the critical periods of pregnancy and childbirth. Midwives play a pivotal role, which has evolved to meet the demands of modern maternity care, focusing on prevention, accurate information, comprehensive care during pregnancy, monitoring foetal development, and supporting natural childbirth. Aim: This cohort study examines the data collected from the midwife-led delivery room at the maternity clinic of Hochwald Hospital, with the aim of promoting natural birth-centres around the world. Methodology: The study is based on a retrospective evaluation of data from the maternity clinic at Hochwald Hospital in Bad Nauheim. The data were retrieved from the hospital's electronic patient records Management system to the use of midwife-led delivery rooms. Results: In total during the study period, 748 women were initially admitted to the midwifery led unit/delivery room. Of these, 163 women did not meet the criteria for midwife-led care during labour and were referred for alternative care/ OBGYN led delivery room, escalated to contraindications or complications. Of the remaining 585 women who proceeded to deliver in the midwife-led room, 259 required medical intervention during childbirth. Ultimately, 326 women delivered successfully in the midwife-led delivery room without complications. Conclusion: This cohort study underlines the importance of midwife-led delivery rooms as a vital model of care that promotes and enhances natural childbirth. It also highlights the need for continuous improvement in maternity care services through evidence-based practices and women-centred approach during pregnancy, labour and birth. By strengthening these values, we can manage to improve women's experiences during the perinatal period and contribute to reducing any unnecessary medical interventions.