Mediating expectations and experiences that influence birth experiences in Canada's first Alongside Midwifery Unit

Area of Science:

• Maternal Health
• Midwifery Care
• Qualitative Research

Background:

• Midwifery-led birthing units are linked to positive maternal and neonatal outcomes.
• Understanding factors influencing patient satisfaction in these units is crucial.
• Canada's first Alongside Midwifery Unit (AMU) provides a unique setting to study these experiences.

Purpose of the Study:

• To explore and describe midwifery service user experiences at Canada's first AMU.
• To identify key aspects of midwifery care contributing to satisfaction.
• To understand how the AMU environment influences birth experiences.

Main Methods:

• Qualitative, grounded theory approach.
• Semi-structured interviews with 28 midwifery care recipients.
• Data collected between September 2018 and March 2020.

Main Results:

• Generated theory highlights four themes influencing birth experiences and satisfaction: maintaining the midwifery model of care, emphasizing control and choice, facilitating interprofessional relationships, and appreciating the AMU birthing environment.
• Participants reported that the AMU met or exceeded expectations.
• High levels of satisfaction were associated with alignment between care received and desired experiences.

Conclusions:

• Canada's first AMU successfully met service-user expectations, leading to high satisfaction.
• Key elements for childbirth satisfaction include adherence to the midwifery model of care, promotion of autonomy, and positive interprofessional interactions.
• The unique AMU birthing environment plays a significant role in enhancing patient satisfaction.