Martin-Arribas Anna1, Canet-Velez Olga2, Casañas Sanchez Rocío3, Salgado Poveda Isabel4, Espada-Trespalacios Xavier5, Rodriguez Coll Pablo6, Pujol Abajo Montserrat7, González-Blázquez Cristina8, Escuriet Ramon9. 1. Faculty of Medicine, Nursing Department,Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain.; School of Health Sciences Blanquerna, Universitat Ramon Lull, Carrer Padilla 326, 08025 Barcelona, Spain.. Electronic address: annama7@blanquerna.url.edu. 2. School of Health Sciences Blanquerna, Universitat Ramon Lull, Carrer Padilla 326, 08025 Barcelona, Spain.. Electronic address: olgacv@blanquerna.url.edu. 3. Escola Superior d'Infermeria del Mar (ESIM), Universidad Pompeu Fabra (UPF), Carrer Dr. Aiguader 80, 08003 Barcelona, Spain.; Centre d'Higiene Mental Les Corts, CHM Salut Mental Barcelona, Carrer de Numància 103 Baixos, 08029 Barcelona, Spain.. Electronic address: rocio.casanas@chmcorts.com. 4. Vall d'Hebron University Hospital, Carrer Vall d'Hebron 119-129, 08035 Barcelona, Spain.. Electronic address: m.salgado@vhebron.net. 5. Obstetric care area. Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Bacelona, Spain.. Electronic address: xespada@fphag.org. 6. Maternal and Child Healthcare Department. Fundació Sanitària de Mollet, Ronda Pinetons 8, 08100 Mollet del Vallès, Bacelona, Spain.. Electronic address: pablo.rodriguez.coll@gmail.com. 7. Santa Creu i Sant Pau Hospital, Carrer Sant Quintí 89, 08041 Barcelona, Spain. Electronic address: mpujola@santpau.cat. 8. Faculty of Medicine, Nursing Department,Universidad Autónoma de Madrid, Calle Arzobispo Morcillo 4, 28029 Madrid, Spain.. Electronic address: cristina.gonzalez01@uam.es. 9. School of Health Sciences Blanquerna, Universitat Ramon Lull, Carrer Padilla 326, 08025 Barcelona, Spain.; Catalan Health Service, Government of Barcelona, Travessera de les Corts 131, 08028 Barcelona, Spain.. Electronic address: rescuriet@gencat.cat.
Abstract
BACKGROUND: Normal birth has major benefits for women and infants. Nevertheless, during the last few decades, the advancement in technology and an increasing domination of obstetrician-led childbirths have resulted in the medicalization of childbirth. Midwives are interested in amending this trend and aim to support women to achieve the best possible birth experience for them. OBJECTIVE: This study aimed to explore midwives' experiences on the facilitators and barriers of normal birth in conventional obstetric units. DESIGN: A descriptive qualitative study. Three focus groups were audio recorded and transcribed verbatim. Recurrent themes were identified and formulated. Feedback from data were analysed using thematic analysis. Investigator triangulation was used during the analysis. SETTING: Midwives from eleven different public hospitals in Catalonia participated in the study. PARTICIPANTS: A purposive sample of 33 midwives participated in the focus groups. FINDINGS: Midwives identified several factors that complicated their task of facilitating normal birth. Barriers included: (1) inadequate institutional support; (2) existing obstetrician-led practices, (3) lack of evidence-based practice and (4) midwives' lack of awareness of professional competencies. Factors facilitating normal birth included: (1) midwives' positive perceptions of normal birth, (2) midwives' additional effort and (3) women's awareness of normal birth. KEY CONCLUSIONS: Midwives wishing to promote normal birth in obstetric units face a number of challenges and often feel unsupported. Nonetheless, the midwives perceive the increasing women's demand for normal births as an opportunity to implement changes in such a way that women are involved in the decision-making process and midwives act as their advocates. IMPLICATIONS FOR PRACTICE: There is a need to increase the midwifery workforce and enhance regulations and funding strategies to support their practice as well as normal birth. Policy makers in settings without well-functioning midwife-led care should consider implementing this model after successfully scaling up of the number of midwives and ensuring an effective midwifery training.
BACKGROUND: Normal birth has major benefits for women and infants. Nevertheless, during the last few decades, the advancement in technology and an increasing domination of obstetrician-led childbirths have resulted in the medicalization of childbirth. Midwives are interested in amending this trend and aim to support women to achieve the best possible birth experience for them. OBJECTIVE: This study aimed to explore midwives' experiences on the facilitators and barriers of normal birth in conventional obstetric units. DESIGN: A descriptive qualitative study. Three focus groups were audio recorded and transcribed verbatim. Recurrent themes were identified and formulated. Feedback from data were analysed using thematic analysis. Investigator triangulation was used during the analysis. SETTING: Midwives from eleven different public hospitals in Catalonia participated in the study. PARTICIPANTS: A purposive sample of 33 midwives participated in the focus groups. FINDINGS: Midwives identified several factors that complicated their task of facilitating normal birth. Barriers included: (1) inadequate institutional support; (2) existing obstetrician-led practices, (3) lack of evidence-based practice and (4) midwives' lack of awareness of professional competencies. Factors facilitating normal birth included: (1) midwives' positive perceptions of normal birth, (2) midwives' additional effort and (3) women's awareness of normal birth. KEY CONCLUSIONS: Midwives wishing to promote normal birth in obstetric units face a number of challenges and often feel unsupported. Nonetheless, the midwives perceive the increasing women's demand for normal births as an opportunity to implement changes in such a way that women are involved in the decision-making process and midwives act as their advocates. IMPLICATIONS FOR PRACTICE: There is a need to increase the midwifery workforce and enhance regulations and funding strategies to support their practice as well as normal birth. Policy makers in settings without well-functioning midwife-led care should consider implementing this model after successfully scaling up of the number of midwives and ensuring an effective midwifery training.
Authors: Xavier Espada-Trespalacios; Felipe Ojeda; Mercedes Perez-Botella; Raimon Milà Villarroel; Montserrat Bach Martinez; Helena Figuls Soler; Israel Anquela Sanz; Pablo Rodríguez Coll; Ramon Escuriet Journal: Int J Environ Res Public Health Date: 2021-04-20 Impact factor: 3.390