PhD defence Karyna Viktorovna Chaibekava

Keywords: Continuous care, Childbirth, Maternity care assistants, Epidural

"Continuous Care by Maternity Care Assistants During Labor: Evaluating Effectiveness & Feasibility"

This thesis investigated whether continuous care during labor, provided by trained maternity care assistants, improves birth outcomes and whether this type of care is feasible and cost-neutral. Continuous care by maternity care assistants means that the maternity care assistant stays with the woman throughout the active phase of labor, offering emotional, practical, physical, and informational support. In a large randomized trial, this approach was compared with standard care. While the main analysis did not show a statistically significant reduction in epidural analgesia use, per-protocol analyses among women who actually received continuous care demonstrated fewer epidurals and other pain medication, fewer caesarean sections, and more spontaneous vaginal births, without an increase in complications. Costs were similar between groups. The findings suggest that continuous care by maternity care assistants is a safe and effective way to promote physiological childbirth

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