Trend Analysis of Primary Midwife-led Delivery Care at a Japanese Perinatal Center

Objective: To perform trend analysis of primary midwife-led delivery care for 'low risk' pregnant women at our hospital. Methods: A retrospective cohort study was performed to examine trends and outcomes of labor under primary midwife-led delivery care at the Japanese Red Cross Katsushika Maternity Hospital between 2008 and 2012. Results: During the study period, the rate of deliveries initially considered 'low risk' decreased from 25 to 22% (p < 0.01). This change was associated with increased cases of previous Cesarean deliveries and preterm delivery. There were no significant changes in the neonatal outcomes; however, the rate of Cesarean delivery and incidence of severe perineal laceration in primary midwife-led delivery care were decreased from 2.1 and 3.3% to 0.3 (p = 0.02) and 1.1% (p = 0.04), respectively due to the close cooperation between midwives and obstetricians. Conclusion: The rate of deliveries initially considered 'low risk' decreased over the last 5-year period. Closer cooperation between midwives and obstetricians is important in primary midwife-led delivery care.