title: A comparison of midwife-led care versus obstetrician-led care for low-risk women in Japan.
abstract: BACKGROUND
  Continuity of midwife-led care is recommended in maternity care because of its various positive outcomes. In Japan, midwife-led care is receiving broad attention as well. In order to popularise midwifery care within the entire system of perinatal care in Japan, there is a need to show evidence that continuity of midwife care for women will bring about positive outcomes.
  
  
  OBJECTIVE
  The objectives of this study were to compare the health outcomes of women and infants who received midwife-led care with obstetrician-led care in Japan.
  
  
  METHODS
  This was an observational study using non-random purposive sampling with a survey questionnaire. Settings where midwife-led care and obstetrician-led care were chosen by purposive samples. Participants were low-risk women who received antenatal care and delivered a term-singleton-infant at the participating settings during the research period. Measurements were: Women-centred care pregnancy questionnaire, Stein's maternity blues questionnaire, and Edinburgh Postnatal Depression Scale.
  
  
  RESULTS
  Midwife-led care was perceived by women to be beneficial and had no adverse outcomes compared to obstetrician-led care. Main findings are: (1) Perception of Women-centred care was higher; (2) Less premature rupture of membranes, and the Apgar scores of the infants were similar; (3) Exclusively breast-feeding during hospitalisation and at one-month postpartum; (4) Stein's maternity blues scale scores was lower in women who received midwife-led care than those who received obstetrician-led care.
  
  
  CONCLUSIONS
  Continuity of midwife-led care was perceived by women to be beneficial and had no adverse outcomes. Therefore, midwife-led care in low-risk pregnancy could be applicable and recommended.
authors.affiliation: Department of Midwifery in St. Luke's International University, Japan. Electronic address: mariko-iida@slcn.ac.jp.
authors.forename: Mariko
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Midwifery in St. Luke's International University, Japan; St. Luke's Birth Clinic, Japan.
authors.forename: Shigeko
authors.initials: S
authors.lastname: Horiuchi
authors.affiliation: Department of Midwifery in St. Luke's International University, Japan; St. Luke's Birth Clinic, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nagamori
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D008880:Midwifery; D009723:Nurse-Patient Relations; D009774:Obstetrics; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians; D011181:Postnatal Care / Q000379:methods* / Q000458:organization & administration; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods* / Q000458:organization & administration; D055815:Young Adult
keywords: Low-risk; Midwife-led; Obstetric outcomes; Postpartum depression; Pregnant women