Centre for Midwifery, Child and Family Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia.
Canterbury Hospital, Sydney Local Health District, 575 Canterbury Rd, Campsie, NSW 2194, Australia.
Women Birth. 2022 Feb;35(1):59-69. doi: 10.1016/j.wombi.2021.03.006. Epub 2021 Mar 23.
Having a known midwife throughout pregnancy, birth and the early parenting period improves outcomes for mothers and babies. In Australia, midwifery continuity of care has been recommended in all states, territories and nationally although uptake has been slow. Several barriers exist to implementing midwifery continuity of care models and some maternity services have responded by introducing modified models of continuity of care. An antenatal and postnatal continuity of care model without intrapartum care is one example of a modified model of care that has been introduced by health services.
The aim of this study was to explore the value and acceptability of an antenatal and postnatal midwifery program to women, midwives and obstetricians prior to implementation of the model at one hospital in Metropolitan Sydney, Australia.
A qualitative descriptive methodology was undertaken to discover the value and acceptability to the implementation of the model. Data was collected via focus groups and one to one interviews from the service users (pregnant women and two partners) and service providers (midwives and obstetricians). We also collected demographic data to demonstrate the diversity of the setting. The Quality Maternal Newborn Care (QMNC) Framework was used to guide the focus groups and analyse the data.
Four themes emerged from the data that were named feeling safe and connected, having more quality time and being confident, having a sense of community and respecting cultural diversity. The findings were analysed through the lens of the quality components of the QMNC framework. The final findings demonstrate the value and acceptability of implementing this model of care from women's, midwives and obstetrician's perspective.
CONCLUSIONS/IMPLICATIONS: Providing midwifery continuity of care through the antenatal and postnatal period without intrapartum care, is being implemented in Australia without any research. Using the QMNC framework is a useful way to explore the qualities of a new emerging service and the values and acceptability of this model of care for service providers and service users.
在整个孕期、分娩和早期育儿阶段有一位熟悉的助产士,可改善母婴结局。在澳大利亚,所有州、领地和全国都推荐提供助产士连续性照护,但采用速度较为缓慢。实施助产士连续性照护模式存在一些障碍,一些产科服务机构通过引入改良的连续性照护模式做出了回应。一种没有分娩期照护的产前和产后连续性照护模式就是卫生服务机构引入的改良照护模式之一。
本研究旨在澳大利亚悉尼大都市的一家医院实施该模式之前,探讨该模式对妇女、助产士和产科医生的价值和可接受性。
采用定性描述方法,了解实施该模式的价值和可接受性。数据通过焦点小组和一对一访谈从服务使用者(孕妇及其两名伴侣)和服务提供者(助产士和产科医生)处收集。我们还收集了人口统计学数据,以展示该环境的多样性。质量产妇新生儿护理(QMNC)框架用于指导焦点小组和分析数据。
从数据中得出了四个主题,分别是感到安全和联系、有更多的优质时间并充满信心、有社区感和尊重文化多样性。通过 QMNC 框架的质量组成部分对研究结果进行了分析。最终研究结果从妇女、助产士和产科医生的角度展示了实施这种护理模式的价值和可接受性。
结论/意义:在澳大利亚,没有任何研究的情况下,正在实施不包括分娩期照护的产前和产后连续性助产士照护。使用 QMNC 框架是一种探索新出现服务的质量以及这种护理模式对服务提供者和服务使用者的价值和可接受性的有用方法。