Defining midwifery autonomy in Belgium: Consensus of a modified Delphi study

Area of Science:

• Maternal Health
• Healthcare Professionalism
• Nursing and Midwifery

Background:

• Midwifery autonomy is a concept with substantial literature but lacks a clear, communal understanding.
• Previous attempts to define midwifery autonomy have not resulted in a shared consensus.
• A consistent definition is crucial for advancing the practice and recognition of midwifery.

Purpose of the Study:

• To establish a consistent and communal definition of midwifery autonomy specifically within the Belgian context.
• To address the vagueness and lack of clarity surrounding the concept of midwifery autonomy.
• To provide a foundation for a shared understanding among stakeholders in maternity care.

Main Methods:

• A modified Delphi survey methodology was employed, involving content experts.
• Components of midwifery autonomy were identified from existing literature and translated.
• An online Delphi panel assessed the clarity and relevance of these components over multiple rounds.

Main Results:

• Content experts evaluated and refined 17 initial components of midwifery autonomy.
• After three rounds, 15 components were validated as clear and relevant.
• A preliminary definition was generated and subsequently confirmed as valid after minor modifications.

Conclusions:

• A communal definition of midwifery autonomy in Belgium has been successfully established.
• This consensus definition fosters a joint understanding of midwifery autonomy.
• The definition includes 15 components related to work content, professionalism, and relationships, with potential to encourage international dialogue and strengthen professional midwifery autonomy.