The Effect of Midwife-Led Practices on Birth Expectancy and Experience Outcomes: Systematic Review and Meta-Analysis

Aim: The objective of this study was to conduct a systematic review of the birth expectations and experiences associated with midwife-led interventions, and to perform a meta-analysis of the existing evidence. Method: The literature review was carried out between November and December 2024 across four electronic databases: PubMed, Cochrane Library, Web of Science, and ULAKBIM. Articles were identified using MeSH-based keywords. Only Randomized Controlled Trials (RCTs) were included in this unrestricted search. The data were analyzed using the Review Manager software. Results: A total of seven studies, involving 936 women, were included in the analysis. According to the results of the random effects model, significant differences in birth expectations were observed between the groups in the post-test (MD: -15.58, 95% CI: -30.74 to -0.42, Z = 2.01, p = 0.04). Additionally, the results showed significant differences in childbirth self-efficacy values between the groups in the post-test (MD: 43.60, 95% CI: 24.53 to 62.67, Z = 4.48, p < 0.00001). Conclusions: Consistent with the findings of the studies included in the review, midwife-led interventions were shown to reduce childbirth-related fear and stress in pregnant women and during the puerperium, while also enhancing their perception of self-efficacy for childbirth. These interventions contribute to low-quality evidence.