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Midwives' readiness for midwife-led care: a mixed-methods study.

Yvonne J Kuipers1, Valerie Bosmans2, Ellen Thaels3

  • 1School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, Scotland EH11 4BN, United Kingdom.

Women and Birth : Journal of the Australian College of Midwives
|November 1, 2024
PubMed
Summary

Belgian midwives show adequate knowledge but low self-efficacy and performance for midwife-led care, indicating limited readiness for antenatal and intrapartum services.

Keywords:
Change readiness, midwife-led careMidwiferyMixed-methodsProfessional autonomy

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Area of Science:

  • Maternal Health
  • Healthcare Systems
  • Midwifery Practice

Background:

  • Integrating midwife-led care in Belgian maternity services requires understanding midwives' readiness for this shift.
  • Current practices are primarily focused on postpartum services, with limited scope in antenatal and intrapartum care.

Purpose of the Study:

  • To explore Belgian midwives' readiness for midwife-led care.
  • To understand the underlying processes influencing this readiness.

Main Methods:

  • A mixed-methods sequential study involving a survey of 414 midwives and interviews with 12 midwives.
  • Quantitative analysis used general linear models for readiness indicators (knowledge, self-efficacy, performance).
  • Qualitative analysis employed thematic analysis based on the Readiness Assessment Framework.

Main Results:

  • Midwives demonstrated adequate knowledge but low self-efficacy and performance scores for midwife-led care.
  • Qualitative findings revealed challenges related to governmental/institutional support, regulation, reimbursement, and awareness among stakeholders.
  • A significant trend showed decreasing scores for most readiness indicators, particularly for extending care to antenatal and intrapartum services.

Conclusions:

  • Belgian midwives are well-positioned for postpartum services but face significant challenges in extending midwife-led care to antenatal and intrapartum phases.
  • Readiness for midwife-led care is limited, influenced by systemic factors and a need for greater awareness and support.
  • Further development is needed to facilitate the integration of comprehensive midwife-led care in Belgium.