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Providing quality care for women with vasa praevia: Challenges and barriers faced by Australian midwives
Nasrin Javid1, Jon A Hyett2, Caroline Se Homer1
1Centre for Midwifery, Child and Family Health, University of Technology Sydney, Building 10, Jones Street, Broadway, Sydney, NSW 2007, Australia.
Objective:
To explore the barriers to providing quality maternity care for women with vasa praevia as identified by Australian midwives.
Design:
A qualitative descriptive study using semi-structured in-depth telephone interviews.
Setting:
Australian maternity system.
Methods:
Midwives were recruited from across Australia. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis.
Participants:
Twenty midwives from five Australian states practising in 15 different public or private hospitals who had cared for at least one woman with vasa praevia during 2010-2016 were interviewed. More than half of the participants held senior positions. Twelve were involved in a neonatal death or 'near-miss' due to vasa praevia.
Findings:
Two categories and five themes were identified in relation to barriers to the provision of quality care. Practitioner-level barriers included two themes: identifying lack of midwifery education and lack of knowledge. System-level barriers included lack of a local policy to guide practice, limited information for women, and paucity of research about vasa praevia.
Conclusion:
Midwives experienced a number of barriers in caring for women with vasa praevia. Offering more comprehensive pre-registration and continuing professional education to midwives, developing local protocols, and providing clear written information for women may improve the provision of quality care.
Implications For Practice:
Midwives have a critical role in caring for and supporting women with vasa praevia. Improving midwives' knowledge with contemporary evidence and clinical guidelines could enable them to deliver safer maternity care and improve a women's journey through this potentially catastrophic condition.
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