Midwife-led antenatal consultation: towards a communication model

Abstract

Aim: Evidence on effective communication in antenatal consultations between midwives and pregnant women is lacking. In a study, antenatal consultations implementation outcomes were evaluated. From the data, relevant aspects emerged concerning communication during consultations. This paper presents selected results and proposes a theoretical foundation for antenatal consultations. Design: A qualitative design. Methods: Semi-structured interviews were conducted with ten midwives, eight pregnant women, eight managers, and eight physicians in two hospitals. The interviews were audiotaped, transcribed, and analyzed with framework analysis using the following steps: 1) Familiarization; 2) Coding: first, inductive coding (open coding to identify new themes), followed by deductive coding (by theory-predefined codes); 3) Development and application of an analytic framework; 4) Data-charting in a matrix; and 5) Interpretation. Results: Amongst others, the following findings emerged from the data: communication about childbirth is influenced by the perceptions and conceptions of the midwife and the pregnant woman herself; pregnant women's degree of participation in the consultation process depends to a significant extent on the attitude of the midwife. Conclusion: To assure the success of consultations, we propose a consultation model comprising the following elements: the life world of the woman and midwife, the construction of a social reality, and the mediation of mutual goals, expectations, intentions, wishes, and beliefs.