"She was there all the time". A qualitative study exploring how women at higher risk for preterm birth experience midwifery continuity of care.
High risk pregnancy
Maternal Health
Midwifery continuity of care
Models of care
Preterm birth
Journal
Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
28
06
2022
revised:
16
01
2023
accepted:
17
01
2023
medline:
12
6
2023
pubmed:
23
1
2023
entrez:
22
1
2023
Statut:
ppublish
Résumé
There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care. Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives. Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial. Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control. Recognising that known midwives were 'there all the time' made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
Sections du résumé
PROBLEM
OBJECTIVE
There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care.
BACKGROUND
BACKGROUND
Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives.
DESIGN
METHODS
Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial.
FINDINGS
RESULTS
Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control.
KEY CONCLUSIONS
CONCLUSIONS
Recognising that known midwives were 'there all the time' made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
Identifiants
pubmed: 36682950
pii: S1871-5192(23)00016-1
doi: 10.1016/j.wombi.2023.01.003
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e397-e404Informations de copyright
Copyright © 2023. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of interest LB, KC, CFT and JS declare no competing interest.