How women with high risk pregnancies perceive interactions with healthcare professionals when discussing place of birth: A qualitative study

Lee, Suzanne; Ayers, Susan; Holden, Debra J

doi:10.1016/j.midw.2016.03.009

Cited by 15 publications

(20 citation statements)

References 38 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Midwives in this study were supportive of women’s birth wishes because they trust the natural course of birth and women’s instinctive knowledge. Accordingly, the women interviewed by Lee et al [ 30 ] mentioned that they felt empowered by their midwives because their midwives expressed trust in them, their body and the natural birth process. The stories of these care providers show that women who initially distrusted the hospital, started to trust the hospital again, after they visited the designated clinic.…”

Section: Discussionmentioning

confidence: 99%

“…Literature shows that care providers may feel vulnerable and find it emotionally difficult to accept a woman’s decision when this decision, in the professional’s perspective, may put her and/or her child at risk. Other care providers are apprehensive regarding liability issues in case of a bad outcome when the woman’s wishes are respected [ 3 , 4 , 13 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

Opdam¹,

Dillen

Vries

et al. 2021

IJERPH

View full text Add to dashboard Cite

Background: An increasing number of maternity care providers encounter pregnant women who request less care than recommended. A designated outpatient clinic for women who request less care than recommended was set up in Nijmegen, the Netherlands. The clinic’s aim is to ensure that women make well-informed choices and arrive at a care plan that is acceptable to all parties. The aim of this study is to make the clinic’s approach explicit by examining care providers’ experiences who work with or within the clinic. Methods: qualitative analysis of in-depth interviews with Dutch midwives (n = 6) and obstetricians (n = 4) on their experiences with the outpatient clinic “Maternity Care Outside the Guidelines” in Nijmegen, the Netherlands. Results: Four main themes were identified: (1) ”Trusting mothers, childbirth and colleagues”; (2) “A supportive communication style”; (3) “Continuity of carer”; (4) “Willingness to reconsider responsibility and risk”. One overarching theme emerged from the data, which was “Guaranteeing women’s autonomy”. Mutual trust is a prerequisite for a constructive dialogue about birth plans and can be built and maintained more easily when there is continuity of carer during pregnancy and birth. Discussing birth plans at the clinic was believed to be successful because the care providers listen to women, take them seriously, show empathy and respect their right to refuse care. A change in vision on responsibility and risk is needed to overcome barriers such as providers’ fear of adverse outcomes. Taking a more flexible approach towards care outside the guidelines demands courage but is necessary to guarantee women’s autonomy. Key conclusions and implications for practice: In order to fulfil women’s needs and to prevent negative choices, care providers should care for women with trust, respect for autonomy, and provide freedom of choice and continuity. Care providers should reflect on and discuss why they are reluctant to support women’s wishes that go against their personal values. The structured approach used at this clinic could be helpful to maternity care providers in other contexts, to make them feel less vulnerable when working outside the guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

Opdam¹,

Dillen

Vries

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Discussion and assessment of ‘risk’ is complex; women's and health professionals’ assessments of risk may differ, and may not fit with assumptions 25–29 . However, common ground between women and health professionals can be found if there is openness, mutual respect and a shared commitment to an agreed care plan 30–33 . The potential benefits of this approach have been demonstrated in one ‘maternity care outside guidelines’ clinic in the Netherlands 34…”

Section: Discussionmentioning

confidence: 99%

Intrapartum‐related perinatal deaths in births planned in midwifery‐led settings in Great Britain: findings and recommendations from the ESMiE confidential enquiry

Rowe

Draper

Kenyon

et al. 2020

BJOG

View full text Add to dashboard Cite

Objective To review quality of care in births planned in midwifery‐led settings, resulting in an intrapartum‐related perinatal death. Design Confidential enquiry. Setting England, Scotland and Wales. Sample Intrapartum stillbirths and intrapartum‐related neonatal deaths in births planned in alongside midwifery units, freestanding midwifery units or at home, sampled from national perinatal surveillance data for 2015/16 (alongside midwifery units) and 2013–16 (freestanding midwifery units and home births). Methods Multidisciplinary panels reviewed medical notes for each death, assessing and grading quality of care by consensus, with reference to national standards and guidance. Data were analysed using thematic analysis and descriptive statistics. Results Sixty‐four deaths were reviewed, 30 stillbirths and 34 neonatal deaths. At the start of labour care, 23 women were planning birth in an alongside midwifery unit, 26 in a freestanding midwifery unit and 15 at home. In 75% of deaths, improvements in care were identified that may have made a difference to the outcome for the baby. Improvements in care were identified that may have made a difference to the mother's physical and psychological health and wellbeing in 75% of deaths. Issues with care were identified around risk assessment and decisions about planning place of birth, intermittent auscultation, transfer during labour, resuscitation and neonatal transfer, follow up and local review. Conclusions These confidential enquiry findings do not address the overall safety of midwifery‐led settings for healthy women with straightforward pregnancies, but suggest areas where the safety of care can be improved. Maternity services should review their care with respect to our recommendations. Tweetable abstract Confidential enquiry of intrapartum‐related baby deaths highlights areas where care in midwifery‐led settings can be made even safer.

show abstract

“…[25][26][27][28][29] However, common ground between women and health professionals can be found if there is openness, mutual respect and a shared commitment to an agreed care plan. [30][31][32][33] The potential benefits of this approach have been demonstrated in one 'maternity care outside guidelines' clinic in the Netherlands. 34 Intermittent auscultation of the baby's heart rate is a key element of monitoring and assessment during labour, with clear national guidance about the timing and frequency of IA in the first and second stages.…”

Section: Interpretation (In Light Of Other Evidence)mentioning

confidence: 99%

Intrapartum-related Perinatal Deaths in Births Planned in Midwifery-led Settings in Great Britain: Findings and Recommendations From the ESMiE Confidential Enquiry

Rowe¹,

Draper²,

Kenyon³

et al. 2021

Obstetric Anesthesia Digest

View full text Add to dashboard Cite

Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.When citing, please reference the published version. Take down policyWhile the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

show abstract

How women with high risk pregnancies perceive interactions with healthcare professionals when discussing place of birth: A qualitative study

Abstract: professionals working with women with high risk pregnancies should acknowledge women's concerns and deliver impartial, evidence-based advice.

Cited by 15 publications

References 38 publications

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

Intrapartum‐related perinatal deaths in births planned in midwifery‐led settings in Great Britain: findings and recommendations from the ESMiE confidential enquiry

Intrapartum-related Perinatal Deaths in Births Planned in Midwifery-led Settings in Great Britain: Findings and Recommendations From the ESMiE Confidential Enquiry

Contact Info

Product

Resources

About