Using codesign to support the implementation of a midwifery unit in Europe.

Area of Science:

• Maternity Care Models
• Healthcare Implementation Science
• Patient-Centered Care

Background:

• Midwifery units (MUs) offer safe, cost-effective maternity care, improving outcomes and satisfaction.
• Implementation of MUs is a growing focus in European countries seeking better healthcare resource utilization.
• Limited research exists on the practical aspects of implementing midwifery units.

Purpose of the Study:

• To observe and support the implementation process of a new midwifery unit in Italy.
• To codesign an implementation plan for transitioning from an obstetrically led unit to an integrated model with a MU.
• To engage diverse stakeholders in the development of a new maternity care model.

Main Methods:

• A 4-stage participatory action research (PAR) project was employed.
• Codesign principles were utilized, involving maternity professionals, managers, and service users.
• Online focus groups and eSurveys facilitated stakeholder engagement.

Main Results:

• Ten key themes for implementation were identified, including team vision, multidisciplinary collaboration, and midwife-led care.
• Guidelines for intrapartum care for low-risk women and effective risk assessment were prioritized.
• Service users expressed strong support for the proposed initiatives and the MU model.

Conclusions:

• This study pioneered the use of codesign and PAR with a comprehensive stakeholder group for MU implementation.
• A collaborative codesign approach proved valuable for the implementation process.
• The findings and methodology are adaptable and potentially beneficial for international contexts.