The Effect of Midwife-Led Continuous Labor Support Care on Delivery Mode and Timely Initiation of Breastfeeding in Primigravida Women in Northwest Ethiopia: A Hybrid Type I Implementation Study

Midwife-led continuous labor and childbirth support reduces the episiotomy rate and increases the rates of vaginal delivery and early initiation of breastfeeding. However, no studies have yet been conducted in Ethiopia. This study aimed to evaluate the effect of midwife-led continuous labor and childbirth support. A quasi-experimental study involving 419 primigravida women compared an intervention given by trained midwives at two hospitals to routine at two others. Data were collected from July to December 2024 through interviews and record reviews. The McNemar test was used to compare changes, with a p-value of less than 0.05. Midwife-led continuous labor support increased the rate of spontaneous vaginal delivery among primigravida women from 55.8% in the control group to 81.2% in the intervention group, resulting in a net increase of 25.4%. The intervention reduced the episiotomy rate from 25.2% in the control group to 16.4% in the intervention group, with a net reduction of 8.8%. It also increased early initiation of breastfeeding from 56.8% in the control group to 73.3% in the intervention group, with a net increase of 16.5%. Midwife-led continuous labor and childbirth support was effective in this study. The intervention enhances positive childbirth outcomes and could be implemented and sustained.