A team of Dutch researchers have published an analysis of data gathered from nearly three and a half thousand women who responded to questions about how midwifery care could be improved. I have to say that the findings of this research echo the words and feelings of so many of the midwives who I meet and talk with in my workshops and who talk about what they wish they could offer: individualised, woman-centred care.
This is one of the largest studies to have ever looked at such a question, and it was made possible by adding questions to those asked of women who were already participating in the DELIVER study. Recruited from 20 midwifery practices in the Netherlands, women were asked to fill out questionnaires and the question which generated the data for this study was, “Do you have any suggestions on how your midwife could improve his/her provision of care?”
And yes, the 3,499 women who answered this question did have suggestions, with the overarching theme being the women’s desire for individualised care. Other important themes related to time and information and the researchers summarised the take-home messages for midwifery care as being:
“1) more continuity of the care provider during the prenatal, natal, and postnatal periods,
2) more information and information specifically tailored for the person,
3) client-centered communication, and
4) a personal approach with
5) enough time spent per client.”
As I said above, many of the midwives who I meet want exactly the same things. I think it’s important to remember this, because midwives and other members of the maternity care team don’t practice in a vacuum. Instead, most practice in bureaucratic systems of care which focus on risk, take a population-based approach to ‘managing’ people, create fences around the kinds of information which women are offered and prioritise paperwork over spending time with women and their families. All of these processes and the structures in which they sit militate against the kind of care that midwives want to give and that women want to receive. Let’s hope that, by sharing the findings of studies like this one, we can enable more people to see the problem and become active in seeking change.
Baas CI, Erwich JJHM, Wiegers TA et al (2015). Women’s Suggestions for Improving Midwifery Care in The Netherlands. Birth. Online ahead of print. DOI: 10.1111/birt.12185
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