Providing individualised care to high-risk women in the intrapartum period - an interpretive descriptive study

Research has demonstrated the benefits of providing individualised care tailored to the specific needs of women during labour and birth, a key tenet of Respectful Maternity Care. To achieve this care, support from midwives and obstetricians is essential. There is limited evidence on how women classified as high-risk can receive personalised care during labour and birth.

This study aimed to explore how healthcare professionals provide individualised care to high-risk women during labour and birth.

Using an interpretive descriptive approach, midwives and obstetricians (n = 12) took part in semi-structured, online interviews. Data were analysed using a constant comparative method using open, axial and selective coding.

Participants articulated a conflict between the clinical responsibility to one woman whilst simultaneously being part of an institution that was required to ensure the safe birth of multiple women. Standardised processes of the institution, such as guidelines, were invoked to care for multiple women. To provide individualised care, participants articulated the need to know the woman in advance of labour, and this increased their willingness to facilitate women's wishes.

Institutional processes can impede the provision of individualised care to high-risk women, particularly if the HCP has not been afforded the opportunity to know the woman prior to labour and birth. Further research is required to understand the nuances of seniority and professional status which may increase facilitation of individualised care requests.