Background: Primigravida women experience increased labor pain and emotional distress. Midwife-led continues labor support offers emotional benefits and reduces maternal and newborn complications; however its effects on primigravidas’s labor pain ,satisfaction, and newborn admissions has not been studied in Ethiopia.

Objective: This study aimed to evaluate the effect of midwife-led continuous labor support on primigravida women’s labor pain, satisfaction, and newborn admission rates.

Methods: A quasi-experimental study compared midwife-led continuous labor support with routine care among 419 primigravida women at four Ethiopian hospitals (two intervention, two control). Data were collected from July to December 2024 through interviews and records. Senior midwives and the principal investigator trained all midwives at the intervention sites, as well as two additional for overload periods. Support averaged 90 minutes per woman. McNemar testes assed changes (P<0.05).

Results: Midwife-led continuous labour support increased maternal satisfaction among primigravida women from 147 (71.4%) in the control group to 167 (78.4%) in the intervention group, a net increase of 7% (P< 0.001). It reduced pain from 136 (66%) to 98 (46%), a net decrease of 20% (P < 0.037). Neonatal intensive care unit admissions decreased from 23 (11.2%) to 12 (5.6%), a net reduction of 6.6% (P < 0.004). There was no effect on newborn death rates.

Conclusions: Midwife-led support effectively reduced pain, increased satisfaction, and decreased NICU admission for primigraviada women in Ethiopia through continues psychological and physical support , improving maternal and newborn wellbeing. Implement this approach facility-wide and evaluate sustainability in routine care is necessary.

Mengstu Melkamu Asaye completed his PhD in midwifery and women’s health at the age of 36 at the University of Gondar, Ethiopia. He is the head of the Women and Family Health Department at the School of Midwifery at the University of Gondar. He has over 32 publications that have been cited more than 520 times, and his publication H-index is 17. He has served as an editor for several journals. Currently, he is an implementation science researcher in Ethiopia, and he is co-supervising 11 PhD students in Ethiopia. He has been leading the PhD program in midwifery and women’s health at the University of Gondar, Ethiopia.