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Dutch midwives’ views on and experiences with woman-centred care: a Q-methodology study

Publicatie van Kenniscentrum Zorginnovatie
J.A.C.A. Fontein-Kuipers, R. Groot, de, E. Beeck, van, S.M. Hooft, van, A.L. Staa, van | Artikel | Publicatiedatum: 24 januari 2019
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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