Partnership in a hospital setting: Consumer perspectives of hospital midwifery care in Aotearoa New Zealand

Abstract

Background: Midwives in Aotearoa New Zealand, regardless of the setting, practise within a model of midwifery partnership. Soliciting feedback on practice provides an essential mechanism for midwives to work towards improving their practice. The New Zealand College of Midwives provides such a process for consumers of midwifery services to give feedback on their experiences directly to the midwife, via online consumer feedback forms. Aim: To identify the characteristics of midwifery care that contribute to positive and negative midwifery care relationships within the hospital setting. Methods: A retrospective mixed methods approach was used to analyse the consumer feedback on hospital midwives received between 1 January and 31 December, 2019. Quantitative data from feedback forms were analysed descriptively in combination with an iterative and reflexive thematic approach for the qualitative data. The analysis sought to identify characteristics of care that contributed to a positive or negative midwifery care experience in a hospital setting. Findings: There were 1,284 online feedback forms received for hospital midwives. The majority of respondents who completed feedback questionnaires were satisfied with their care (92%), reporting that hospital midwives provided information/explanations to support informed decision-making (94.0%), that they felt involved in planning/decisions about their care (93.7%) and that they experienced respect for decisions made (93.7%); these characteristics having the highest levels of agreement. Via qualitative analysis, we identified four key themes as contributing to the midwifery care experience in a hospital setting. Positive experience themes included: Building trust quickly, Respecting decision-making and Fostering maternal confidence, resulting in Meaningful partnerships. The negative experience themes were found to be the inverse of a positive midwifery care experience in a hospital setting. Specifically, these were: Not giving time and Judgement and disrespect, resulting in an Unsafe space and an Absence of partnership. Conclusion: The data from consumer feedback forms for 2019 affirm that the quality of the relationship with a hospital midwife is important in shaping the maternity care experience of women and birthing whānau in Aotearoa New Zealand. The characteristics of care that contribute to a positive midwifery care relationship in hospital reflect the principles outlined in the model of midwifery partnership.