Comparing midwife-led and doctor-led maternity care: A systematic review of reviews

Katy Sutcliffe, Jenny Caird, Josephine Kavanagh, Rebecca Rees, Kathryn Oliver, Kelly Dickson, Jenny Woodman, Elaine Barnett-Paige, James Thomas

Research output: Contribution to journalArticlepeer-review


Aims. A report of a systematic review of reviews which examines the impact of having midwives-led maternity care for low-risk women, rather than physicians. Background. A rising birth rate, increasing complexity of births, and economic constraints pose difficulties for maternity services in the UK. Evidence about the most effective, cost-effective, and efficient ways to give maternity services is needed. Data sources. Searches were carried out in August-September 2009 of ten electronic databases, 16 key nursing and research websites, and reference lists of 56 relevant reviews. We also contacted 38 experts for information. No date restrictions were employed. Review methods. A narrative review of systematic reviews or 'meta review' was conducted using transparent and systematic procedures to limit bias at all stages. Systematic reviews that compared midwife-led care during pregnancy and birth with physician-led care were eligible for inclusion. Results. Three meta-analytic reviews were included. Midwife-led care for low-risk women was found to be better for a range of maternal outcomes, reduced the number of procedures in labour, and increased satisfaction with care. For some maternal, foetal, and neonatal outcomes reviews found no evidence that care led by midwives is different to that led by physicians. No adverse outcomes associated with midwife-led care were identified. Conclusions. For low-risk women, health and other benefits can result from having their maternity care led by midwives rather than physicians. Moreover, there appear to be no negative impacts on mothers and infants receiving midwife-led care. © 2012 Blackwell Publishing Ltd.
Original languageEnglish
Pages (from-to)2376-2386
Number of pages10
JournalJournal of Advanced Nursing
Issue number11
Publication statusPublished - Nov 2012


  • Literature review
  • Maternity care
  • Meta-review
  • Midwifery
  • Nursing
  • Systematic review


Dive into the research topics of 'Comparing midwife-led and doctor-led maternity care: A systematic review of reviews'. Together they form a unique fingerprint.

Cite this