Midwifery-Led Care and Practice: Promoting Maternal and Child Health—Second Edition

A Special Issue of Healthcare (ISSN 2227-9032) belonging to the section "Women’s and Children’s Health".

Deadline for manuscript submissions: 26 January 2027 | Viewed by 1388

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Guest Editor
Section of Midwifery, Department of Women’s Health, University Hospital Tuebingen, Eberhard Karls University, Calwerstrasse 7, 72076 Tuebingen, Germany
Interests: public Health; gender medicine; social determinants of health; midwifery science; women’s health; health services research
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Special Issue Information

Dear Colleagues,

Following the positive reception of the first edition, we are delighted to announce the second edition of this Special Issue.

Despite continuous advances in medicine, healthcare, and society, pregnancy and birth remain characterized by vulnerability. In developing countries, reducing maternal and infant mortality remains a key challenge. Even in industrialized countries such as the USA, pregnancy and birth outcomes are clearly dependent on the social status of pregnant women, recurring from different levels of health literacy and different perceptions of health rights. This results in phases of vulnerability, which, according to the results of several studies, affect more than 30% of all pregnant women as distress with insufficiently understood long-term effects on the health of the mother and child (fetal programming). Continuous midwifery care, which is based on the principles of evidence-based care but follows a holistic approach that also emphasizes the social causes of illness and health, can mitigate social inequalities in care and improve short- and long-term outcomes. Against this background, the WHO and UN have identified midwives as key actors in improving women's health.

Given this background, the aim of this Special Issue is to publish innovative midwifery care projects that focus on improving maternal and child health. We are pleased to invite you to submit relevant research results.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Research findings (including health service research) on innovations that improve care, even under complex conditions in individual phases of the care cycle (from pregnancy to breastfeeding);
  • Research findings on midwife-led care to improve women's and children's health;
  • Articles outlining women's health challenges in the context of pregnancy and childbirth;
  • Studies and reviews on the promotion of physiological processes even under complex conditions;
  • Research findings on the opportunities and risks of AI-based care in the context of midwifery science and women's health.

Thematically relevant studies from the field of teaching research are also welcome.

I look forward to receiving your contributions.

Dr. Joachim Graf
Guest Editor

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Keywords

  • midwifery
  • women’s health
  • vulnerability in pregnancy
  • midwife-led care
  • fetal programming
  • pregnancy outcomes in the context of social inequality
  • improvement of child health
  • improvement of women’s health
  • gender-sensitive care

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Published Papers (2 papers)

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21 pages, 339 KB  
Article
Personality-Related Characteristics, Cultural Beliefs, and Labor Pain Perception After the 2023 Türkiye Earthquakes: A Prospective Study in Hatay
by Esra Akın, Gülay Rathfisch and Meserret Aslan
Healthcare 2026, 14(13), 1827; https://doi.org/10.3390/healthcare14131827 - 23 Jun 2026
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Abstract
Background/Objectives: Labor pain is a multidimensional experience associated with physiological, cultural, psychological, and contextual factors. This study aimed to examine the association of personality-related characteristics, cultural beliefs, obstetric characteristics, and proxy indicators of post-disaster context with labor pain perception among women giving birth [...] Read more.
Background/Objectives: Labor pain is a multidimensional experience associated with physiological, cultural, psychological, and contextual factors. This study aimed to examine the association of personality-related characteristics, cultural beliefs, obstetric characteristics, and proxy indicators of post-disaster context with labor pain perception among women giving birth in Hatay after the 2023 Türkiye earthquakes. Methods: This prospective observational study was conducted with 314 women admitted to Hatay Training and Research Hospital between February and June 2025. Participants were between 38 and 42 gestational weeks, had a singleton healthy fetus, were admitted in active labor, and were expected to give birth vaginally. Data were collected using a researcher-developed questionnaire, the Ten-Item Personality Inventory, and the Visual Analog Scale. Labor pain was assessed at 6 cm, 8 cm, and full cervical dilatation (10 cm). Results: VAS scores increased significantly across cervical dilatation points, from 5.04 ± 0.81 at 6 cm to 7.01 ± 0.82 at 8 cm and 8.06 ± 0.93 at full cervical dilatation (10 cm). Repeated-measures ANOVA showed a significant within-person increase in pain intensity across the three assessment points, F(2, 626) = 996.444, p < 0.001, partial η2 = 0.761. Age was not significantly correlated with VAS pain score at full cervical dilatation. In exploratory unadjusted comparisons, VAS scores at full cervical dilatation differed according to education level, official marriage status, previous birth history and mode, attendance at antenatal education, and praying to relieve labor pain. In the multivariable regression model, higher Extraversion and higher education level were associated with lower VAS scores, whereas attendance at antenatal education, greater importance given to traditional rules, previous assisted vaginal/cesarean birth, and current place of residence were independently associated with VAS scores. Conscientiousness was not significantly associated with VAS scores in the adjusted model. Earthquake experience was not significantly associated with VAS scores. Conclusions: Labor pain perception was associated with selected sociodemographic, obstetric, and cultural characteristics. The findings support the importance of individualized, culturally sensitive, and trauma-informed midwifery care in disaster-affected regions. Personality-related findings should be interpreted cautiously because the corrected reliability analysis showed low internal consistency for Agreeableness, Emotional Stability, and Openness to Experience, although Extraversion showed high internal consistency and Conscientiousness showed relatively better but still limited internal consistency. Disaster-related findings should also be interpreted cautiously because post-disaster context was assessed using only limited proxy indicators; current place of residence was independently associated with VAS scores in the adjusted model, whereas earthquake experience was not. Because of the observational design, causal interpretations cannot be made. Full article
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16 pages, 1584 KB  
Study Protocol
FAIR-Birth: Development and Feasibility Testing of an AI-Supported Advance Birth Planning Application for Midwifery-Led Antenatal Care—A Mixed-Methods Study Protocol
by Michaela Schunk, Christoph Hübener, Sebastian Robert, Sebastian P. Bayerl and Karolina Luegmair
Healthcare 2026, 14(12), 1607; https://doi.org/10.3390/healthcare14121607 - 8 Jun 2026
Viewed by 537
Abstract
Background/Objectives: Clinical childbirth in high-income countries is increasingly shaped by standardised routines that do not always accommodate individual preferences. In Germany, approximately one in eight pregnant persons experiences clinically significant childbirth-related post-traumatic stress disorder symptoms, with pregnant persons facing language or health-literacy [...] Read more.
Background/Objectives: Clinical childbirth in high-income countries is increasingly shaped by standardised routines that do not always accommodate individual preferences. In Germany, approximately one in eight pregnant persons experiences clinically significant childbirth-related post-traumatic stress disorder symptoms, with pregnant persons facing language or health-literacy barriers being at particular risk of inadequate preference integration. Methods: This paper presents the conceptual foundation and proposed study design for FAIR-Birth, an interdisciplinary initiative to develop and feasibility-test a mobile application supporting Advance Birth Planning (ABP) embedded within midwifery-led antenatal care. The intervention combines four elements: transfer of the Advance Care Planning concept to antenatal care, a domain-restricted Large Language Model (LLM) supporting multilingual preference articulation, integration of the resulting ABP document into midwifery-led continuity of care, and iterative adaptation. Following the updated MRC framework, this study will employ a sequential mixed-methods design encompassing systematic review, participatory instrument development, Delphi consensus on the knowledge base, iterative technical development with usability testing, and a feasibility study across two perinatal centres in Bavaria. Results/Conclusions: FAIR-Birth is expected to generate a content-validated ABP instrument, a domain-restricted multilingual LLM dialogue system, and an evaluated application prototype. The work corresponds to the development and feasibility phases of the MRC framework; effectiveness questions are reserved for a planned subsequent randomised controlled trial. Full article
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