Title
Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands
Author
Perdok, H.
Jans, S.
Verhoeven, C.
Henneman, L.
Wiegers, T.
Mol, B.W.
Schellevis, F.
de Jonge, A.
Publication year
2016
Abstract
Background This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Results Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. Conclusions An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.
Subject
ELSS - Earth, Life and Social Sciences
Life
Healthy Living
Healthy for Life
Continuity of care
Integrated care
Maternity care
Obstetrics
Midwifery
Obstetrics
DNA transcription
Female
Human
Human experiment
Maternal care
Midwife
Model
Netherlands
Obstetrician
Patient care
Pediatrician
Primary medical care
Qualitative research
Responsibility
Scientist
Semi structured interview
Thematic analysis
CH - Child Health
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http://resolver.tudelft.nl/uuid:d40b7d46-ff78-405e-986c-70b197e653fd
DOI
https://doi.org/10.1186/s12884-016-0975-z
TNO identifier
538971
Source
BMC Pregnancy Childbirth, 16 (16)
Document type
article