مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
Impact of Midwifery-Led Care on Maternal Mental Health: A Systematic Review
Impact of Midwifery-Led Care on Maternal Mental Health: A Systematic Review
Zahra Ramezani,1,*Atefeh Khezari,2Zeynab Mahdavi,3Zeynab Mohammadzade,4
1. Undergraduate Student of Midwifery, Faculty of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran 2. Undergraduate Student of Midwifery, Faculty of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran 4. Undergraduate Student of Midwifery, Faculty of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
Introduction: Maternal mental health is a fundamental component of reproductive health, directly influencing mothers, infants, and families. Common psychological disorders such as antenatal anxiety, postpartum depression, and fear of childbirth can negatively affect maternal well-being, mother-infant bonding, and family stability. Midwifery-led care, which emphasizes continuity, individualized support, and a woman-centered approach, has been introduced as an effective model for improving women’s reproductive and mental health outcomes. However, existing evidence regarding its impact on maternal mental health remains fragmented and sometimes inconsistent. This systematic review aimed to synthesize the available evidence on the effects of midwifery-led care on maternal mental health during the perinatal period.
Methods: This systematic review was conducted in accordance with the PRISMA guidelines. Comprehensive searches were performed in PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar up to March 2025. The following keywords were applied: midwifery-led care, continuity of care, maternal mental health, perinatal depression, postpartum depression, and anxiety.
Initially, 1,200 articles were identified. After removing duplicates and screening titles and abstracts, 43 articles were considered for full-text review. Based on inclusion criteria (studies comparing midwifery-led care with standard care and reporting maternal mental health outcomes) and exclusion criteria (non-English studies, non-systematic reviews, case reports), 10 eligible studies were included in the final analysis. The quality of the included studies was assessed using the CASP checklist. Given the heterogeneity of study designs and outcome measures, a qualitative synthesis (narrative review) was performed rather than a meta-analysis.
Results: The findings indicated that midwifery-led care, compared with standard care, was consistently associated with lower levels of antenatal anxiety and reduced rates of postpartum depression.
• Seven out of ten studies reported significant improvements in maternal psychological outcomes.
• Three studies found that women receiving midwifery-led care experienced lower anxiety levels and greater feelings of safety and confidence during pregnancy.
• Four studies reported reduced prevalence and severity of postpartum depression among women receiving midwifery-led care.
• Two studies highlighted improvements in maternal self-confidence in infant care and higher satisfaction with reproductive health services.
Nevertheless, two studies did not find significant differences, which may be attributed to variations in study design, sample size, and the measurement tools used for assessing mental health. Furthermore, evidence on the long-term effects of midwifery-led care in the postnatal period remains limited.
Conclusion: This systematic review suggests that midwifery-led care has a beneficial impact on maternal mental health, particularly in reducing antenatal anxiety and postpartum depression. These findings support the potential of midwifery-led care as an effective and sustainable model to enhance maternal well-being during the perinatal period. However, further high-quality studies are needed, with standardized mental health assessment tools, longer follow-up periods, and exploration of cultural and social contexts. Strengthening midwifery-led models of care could play a crucial role in shaping reproductive health policies and promoting comprehensive support for women during pregnancy and the postpartum period.