Primiparous women’s experiences of midwife-led continuous labor support in Ethiopia: a qualitative study

BACKGROUND: Midwife-led continuous labour support is a woman-centered approach that has been shown to improve childbirth outcomes. Despite strong global recommendations, it has yet been implemented in Ethiopia. OBJECTIVE: This study aimed to explore the experiences of primiparous women with midwife-led continuous labour support in northwest Ethiopia. METHODS: A qualitative exploratory design was used from July to December 2024. In-depth interviews were conducted with 16 primiparous women who received midwife-led continuous labour support in four primary hospitals. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using latent content analysis. RESULTS: Four sub-categories emerged: emotional empowerment and mindset transformation; compassionate, respectful, and welcoming care; physical and informational support enabling coping and comfort; and a desire for expanded support and system strengthening. Participants considered this model superior to routine care for achieving a positive birth experience, and they advocated its wider adoption, family involvement, and investment in midwives. CONCLUSION: Midwife-led continuous labour support fostered positive birth experiences and strengthened relationships between women and midwives. As the mothers reported, the support enhanced their confidence, emotional empowerment, and development of strategies to cope with labor pain. This approach has clear clinical and policy implications for improving maternal and newborn care. This approach is superior to routine care and is strongly recommended by these mothers as standard practice, offering opportunities for family involvement and institutional investment in midwives.