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  • Title: Dutch midwives' views on and experiences with woman-centred care - A Q-methodology study.
    Author: Fontein-Kuipers Y, de Groot R, van Beeck E, van Hooft S, van Staa A.
    Journal: Women Birth; 2019 Dec; 32(6):e567-e575. PubMed ID: 30685135.
    Abstract:
    BACKGROUND: Woman-centred care is a philosophy for midwifery care management of the childbearing woman. There is no mutually recognised internalised way in midwifery to provide woman-centred care. OBJECTIVE: To reveal midwives' distinct perspectives about woman-centred care. METHODS: A Q-methodology study amongst 48 Dutch community-based midwives who rank-ordered 39 statements on woman-centred care, followed by semi-structured interviews to motivate their ranking. By-person factor analysis was used to derive latent views, representing midwives (factors) with similar attitudes towards woman-centred care. The qualitative data was used to aid interpretation of the factors. RESULTS: Four distinct factors emerged: (1) the humane midwife, containing two twinning factors: (1+) The philosophical midwife, who is the woman's companion during childbearing in being an authentic individual human being; (1-) the human-rights midwife, who is the woman's advocate for achieving autonomy and self-determination regarding care during the childbearing period. (2) The quality-of-care midwife, who regards good perinatal health outcomes, responsive care and positive maternal experiences as benchmarks for the quality of woman-centred care. (3) The job-crafting midwife, who focuses on self-organisation while seeking balance between the childbearing woman, herself as a professional and an individual and as a colleague. CONCLUSION/IMPLICATIONS: Each factor represented specific perspectives feeding into woman-centred practice. Although the humane midwife seems to represent the dominant and preferable perspective of woman-centred care, awareness and exploration of and reflection on the thoughts patterns represented by the four different perspectives, should be considered in education and professional development of (student)midwives of be(com)ing a woman-centred midwife.
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