PURPOSE:
To share the experience and outcomes of a midwife-led outpatient clinic managing prolonged pregnancies (≥41 weeks), focusing on maternal and neonatal outcomes and patient satisfaction. This study highlights the role of midwife-led counseling in supporting informed, shared decision-making in late-term pregnancy.

DISCUSSION:
Prolonged pregnancy presents important clinical challenges, as decisions regarding induction of labour versus expectant management have significant impact on maternal and perinatal outcomes. Midwives, who are responsible for managing uncomplicated pregnancies, provide woman-centered care emphasizing empathy, responsiveness, and respect for the natural physiological process of labour. This midwife-led model of care supports shared decision-making and may contribute to enhanced birth experiences and higher satisfaction levels among pregnant women.

EVIDENCE WHERE RELEVANT:
A retrospective cohort study was conducted at the midwife-led clinic of Hospital Clínic (Barcelona) from November 2023 to November 2024, including 100 women with pregnancies ≥41 weeks managed under a midwife-led care model. Data collected included maternal and neonatal characteristics, labour onset and method, birth mode, and patient satisfaction assessed through the SERVQUAL questionnaire. Results showed that 64.1% of women opted for labour induction, while 31.1% experienced spontaneous labour onset. Spontaneous labour was significantly associated with higher vaginal delivery rates (p < 0.049). Induction with dinoprostone (Propess®) was linked to better birth outcomes compared to the Cook balloon method (p < 0.036). No statistically significant differences were found in maternal or neonatal complications across groups. Patient satisfaction scores were high overall, with particularly strong ratings in the domains of empathy and responsiveness, reflecting the quality and effectiveness of midwife-led care.

KEY MESSAGE:
Midwife-led care in prolonged pregnancy ensures safe, evidence-based management with consistently high levels of patient satisfaction. This model highlights the important and evolving role of midwives in counseling, supporting shared decision-making, and providing respectful, personalized care that honors women’s preferences and actively promotes positive, empowering birth experiences. Poster session 2 (Group A)