The Effects Of Mother-Friendly Practices On Maternal And Fetal Outcomes: A Multicenter Study

Introduction and Objective: From early pregnancy to postpartum discharge, avoiding unnecessary non-evidence-based interventions and supporting natural physiological processes form the basis of the “mother-friendly hospital” model, a new program designed to enhance care quality. This study evaluated the impact of implementing mother-friendly hospital criteria on pain during labor, maternal satisfaction, and maternal and fetal outcomes. Materials and Methods: This prospective study included women with term pregnancies who delivered between February and June 2025 at Sakarya Research and Training Hospital (Group 1, with mother-friendly practices) and Ümraniye Research and Training Hospital (Group 2, without such practices). Exclusion criteria were maternal age > 45 years, chronic systemic disease (e.g., diabetes, hypertension, renal or hepatic disease), preeclampsia or gestational diabetes, premature rupture of membranes > 12 hours with chorioamnionitis findings, preterm birth (< 37 weeks), and small-for-gestational-age infants (< 2 SD). Maternal characteristics (age, education, cervical dilation, gestational week, childbirth education, delivery interventions, postpartum hemorrhage, non-pharmacological methods, duration of labor), pain levels using the Visual Analog Scale (VAS), and fetal outcomes (birth weight, Apgar scores, neonatal intensive care unit [NICU] admission) were recorded. Maternal satisfaction was assessed in the first postpartum hour using the Birth Satisfaction Scale. Results: A total of 281 women were enrolled (Group 1: 136, Group 2: 145). No significant differences were found between groups regarding age, body mass index, education, employment status, gestational week, labor duration, or postpartum hemorrhage (p > 0.05). Latent phase, active phase, and postpartum VAS scores were significantly lower in Group 1 compared with Group 2 (p < 0.001). Maternal satisfaction scores were significantly higher in Group 1 (p < 0.001). NICU admission was significantly less frequent in Group 1 (2.9% vs. 9.7%, p = 0.022). First- and fifth-minute Apgar scores were also higher in Group 1 newborns (p < 0.001 for both). Conclusion: Mother-friendly hospital practices, emphasizing minimal intervention and physiologic support, significantly reduce pain during labor, increase maternal satisfaction, and improve neonatal outcomes. Ensuring safe, high-quality, and mother-centered maternity care is a fundamental right for all women and can be achieved through implementation of mother-friendly approaches.