2024 Volume 38 Issue 2 Pages 188-201
Purpose
The development and utilization of in-hospital midwifery and outpatient midwifery care have been promoted since around 2008 to address the diverse needs of pregnant women and postpartum mothers, improve the quality of care, and redistribute tasks due to the shortage and uneven distribution of obstetricians. Therefore, we conducted a literature review on the current status of in-hospital midwifery and outpatient midwifery care in Japan, assessing their safety and user satisfaction; this endeavor was aimed at further promoting in-hospital midwifery and outpatient midwifery care.
Methods
We conducted a literature review on the safety and user satisfaction of in-hospital midwifery and outpatient midwifery care in Japan over the past 10 years. We extracted 20 articles from the Japan Medical Abstracts Society Web using keywords such as “in-hospital midwifery system.” These articles were analyzed for the descriptions of the safety of in-hospital midwifery, including specific data on delivery outcomes; we also analyzed 15 articles that provided qualitative insights and satisfaction surveys from expectant mothers who had used in-hospital midwifery and outpatient midwifery care.
Results
Regarding the safety of in-hospital midwifery, the rate of medical intervention tended to be higher in the physician-controlled group than in the in-hospital midwifery group (e.g., 52.8% vs. 75.8%); however, there were no significant differences between the two groups in clinically significant delivery outcomes such as neonatal asphyxia and atonic bleeding. Satisfaction with in-hospital midwifery and outpatient midwifery care was high, exceeding 80% in both groups. Advantages highlighted by participants included feeling more relaxed and having extra time during visits, alongside increased peace of mind due to the trust established with the midwife.
Conclusion
The safety of in-hospital midwifery was not significantly different from that of non-in-hospital midwifery, and satisfaction with both in-hospital and outpatient midwifery care was consistently high. In the future, it will be necessary to collect information on the quality of midwives who are in charge of in-hospital midwifery and outpatient midwifery care, as well as on how to inform users of such services, and to study the detailed requirements for the diffusion of safe and highly satisfactory in-hospital midwifery and outpatient midwifery care.
