Research Advances and Innovative Optimization Routes of Midwifery Models for Advanced-Age Pregnant Women
School of Nursing and Health Management, Wuhan Donghu College, Wuhan, Hubei, China
Abstract
Advanced-age parturients (maternal age≥35years at delivery) have become a key population for maternal and infant safety protection due to age-related physiological decline and high incidence of pregnancy complications (e.g., pregnancy-induced hypertension, gestational diabetes mellitus). With the global trend of delayed childbearing and the implementation of China’s three-child policy, the number of advanced-age parturients has continued to rise. The traditional physician-led single midwifery model can no longer meet their individualized care needs. This article systematically reviews the research status of midwifery models for advanced-age parturients at home and abroad from 2019 to 2025, analyzing the application scenarios, implementation effects, and existing limitations of various models from two dimensions: "typical international models" (obstetrician-led care, midwife-led continuous care, group prenatal care, etc.) and "domestic innovative practices" (group-based prenatal care, midwife clinics, integrated delivery rooms, MDT multidisciplinary collaboration, etc.). It focuses on comparing the differential advantages of different models in reducing the cesarean section rate, decreasing postpartum complications, and improving the psychological status of advanced-age parturients, and identifies core issues in domestic models, such as "uneven resource allocation, inconsistent evaluation standards, and shortage of midwives". Based on this, an optimization path of "midwife-centered multidisciplinary collaborative model" is proposed, including improving the primary-level service network, establishing a unified evaluation system, and strengthening midwife competency training. This study aims to provide references for enhancing maternal and infant outcomes of advanced-age parturients and promoting the high-quality development of obstetric care.
Keywords:
Advanced-Age Parturients; Midwifery Model; Maternal and Infant Outcomes; Midwife-Led Continuous Care; MDT Multidisciplinary Collaboration; Group Prenatal CareData Availability Statement
This article is a narrative review and does not include original data. All sources referenced are publicly available and cited accordingly.
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