Exploring the attitudes and beliefs of women regarding the implementation of midwife-led care in India: A mixed methods study.

PROBLEM

Despite the recent introduction of midwifery services in India to improve maternal and newborn healthcare, there is limited research on women's perspectives on midwife-led care.

BACKGROUND

The Government of India initiated midwifery services guidelines in 2018 to improve the quality of care for pregnant women and newborns across the country. It is important to develop evidence-based strategies which can optimise the implementation of these new midwifery services.

AIM

This study explored women's attitudes and beliefs towards the implementation of midwife-led care in two southern states of India.

METHODS

A convergent mixed methods design was employed using an online questionnaire and semi-structured online interviews. Quantitative data was analysed using descriptive statistics and qualitative analysis used a framework approach. Data from both sources were then integrated through merging techniques.

FINDINGS

A total of 307 women completed the online survey, and 23 participated in in-depth interviews. The study highlighted inadequate knowledge of midwife-led care among women. Despite this, 60 % expressed optimism about its benefits. Key factors to women's acceptance included better understanding outcomes, having trust in midwives, receiving respectful care, and having autonomy in decision-making. They also required midwife-led birthing units would be clean, accessible, and well resourced.

DISCUSSION

Most participants perceived midwife-led care as beneficial, valuing its skilled, responsive and compassionate services.

CONCLUSION

Insights from this study have implications for the implementation of midwife-led care which should consider the informational needs, safety standards and cultural contexts of women and their families living in both urban and rural areas of India.