Impact of midwife-led continuous support during childbirth on maternal outcomes, psychological resilience, and labor pain in primiparas: a retrospective study.

چکیده اصلی

OBJECTIVE: To evaluate the association between integrated midwife-led continuous labor support with postpartum care and maternal and neonatal outcomes, psychological resilience, and labor pain in primiparous women. METHODS: Medical records of 150 nulliparous women who delivered at Beijing Ditan Hospital between October 2023 and July 2025 were retrospectively reviewed. The observation group received continuous midwife-led support during labor with extended postpartum care, while the control group received standard obstetric care. Outcomes were assessed using the Labor and Delivery Efficiency and Quality Index (LBDI), Connor-Davidson Resilience Scale (CD-RISC), Delivery Pain Assessment System (DPAS), and Pain Tolerance-Recovery Response Index (PTRR). Relevant clinical data were analyzed to explore associated factors. Data were analyzed using SPSS 26.0 and AMOS 24.0. RESULTS: Compared with the control group, the observation group showed higher composite LBDI scores (8.43 ± 0.57 vs. 7.77 ± 0.65, p < 0.001, Cohen's d = 1.09), higher spontaneous vaginal delivery rates (95% vs. 76%, p < 0.001), and higher 5-minute Apgar scores (9.4 ± 0.4 vs. 8.8 ± 0.6, p < 0.001), along with reduced postpartum hemorrhage and lower incidence of fetal distress (all p < 0.05). Psychological resilience and labor pain responses were better in the observation group (p < 0.05). CONCLUSION: Integrated midwife-led labor support with postpartum continuity of care was associated with better delivery outcomes and higher psychological resilience scores in primiparous women. Prospective studies are needed to confirm causality.

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