Continuous Support During Childbirth by Maternity Care Assistants: An Exploration of Opinions in the Netherlands

Abstract

BACKGROUND:The Netherlands maintain a high rate of home births relative to other well-resourced countries. Maternity care assistants (MCAs) play an important role, as part of the maternity care team, assisting the midwife during birth and providing postpartum care to women and babies in their homes. A Cochrane review recently described the advantages of continuous support during childbirth. We were interested in the opinions of MCAs about them having an expanded role to include continuous emotional support during childbirth as well as medical tasks such as checking the condition of the fetus and maternal labor progress through internal examination.METHODS:To explore the opinions of MCAs, four semistructured group discussions took place and 190 questionnaires were sent out to MCAs nationally.RESULTS:In both the group discussions and questionnaires, MCAs displayed positive attitudes toward providing continuous support during childbirth. In general, MCAs were not keen on adding medical tasks. The importance of a clear distribution of responsibilities between midwives and MCAs was reported. Most (60.0%) thought midwives would appreciate MCAs providing continuous support. Furthermore, 40.5% disagreed with dividing the profession into childbirth care and postpartum care teams. Two-thirds mentioned the need for extra training in childbirth assistance.CONCLUSION:In general, MCAs were positive about providing continuous support during childbirth. Most MCAs think that it is unwise to give MCAs additional medical responsibilities. The opinions differ concerning issues of practical organization. MCAs generally thought extra schooling was important to be and feel competent to assist childbirth.

Women's Suggestions for Improving Midwifery Care in The Netherlands

“…Women indicated that they preferred the midwife to remain present for a longer period of time. Furthermore, some women suggested the midwife could improve her profession by not attending to more births at the same time, being on time at the birth, and providing more care directly after the birth (on call shifts of Dutch midwives are described in detail by Baas et al ).

Take more time for the check‐ups, which are now so rushed that I only dare to ask the most necessary. Questions that have a lower priority, I search on the Internet.

…”