The Influence of Integrated Midwifery Care on Postpartum Depression Screening and Maternal Well-Being: A Systematic Review

Abstract

Midwifery-led care is internationally recognized for its role in enhancing maternal satisfaction, minimizing medical interventions, and improving psychological outcomes. However, its specific influence on postpartum depression (PPD) screening and maternal well-being remains insufficiently examined within the Saudi Arabian context. This systematic review aims to synthesize both global and regional evidence regarding the relationship between midwifery care models, the uptake of PPD screening, and maternal well-being, with the goal of informing healthcare practices in Saudi Arabia. In accordance with PRISMA 2020 guidelines, a comprehensive search was conducted across five databases Cochrane Library, PubMed, Scopus, CINAHL, and Google Scholar for studies published between 2010 and 2024. A total of 153 studies meeting inclusion criteria were critically appraised using CASP and JBI tools, and analyzed through thematic synthesis. The review revealed five central themes: continuity and relational care, respectful and autonomous maternity care, maternal satisfaction and emotional well-being, environmental and cultural context of birth, and institutional and policy influences. Midwifery-led continuity models were consistently associated with higher rates of PPD screening, largely due to the development of trusting relationships that promote emotional openness. Women who received midwifery care reported greater satisfaction, empowerment, and improved psychological adjustment. These findings highlight integrated midwifery care as a key enabler of PPD screening and enhanced maternal mental health. In the Saudi context, implementing midwife-led continuity models aligned with cultural values of modesty, privacy, and gender-congruent care is essential. The results provide a strong evidence base to guide healthcare reform under Saudi Vision 2030, advocating for the expansion of woman-centered midwifery services to improve maternal mental health outcomes.