MiMo - a study of a midwifery model of woman-centred care during childbirth
Woman-centred care is a main goal for theory and practice in childbirth. Theoretical models of midwifery care has been developed in different countries and maternity care settings. Even if there are similarities with the models by focusing on the woman´s perceptive and the relationship with health professionals, differences exists related to cultural differences and professional roles. Therefore, based on previous research, a theoretical midwifery model of woman centred care in the Nordic context (MiMo) has been developed.
The model is based on a synthesis of 12 qualitative studies on women´s and midwives experiences of care during childbirth performed in Sweden and Iceland an it includes five main themes. Three central intertwined themes; a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes are the cultural context (with hindering and promoting norms); and the balancing act. The model has been further validated by focus group interviews in Sweden and Iceland 2012-2013 with 30 midwives.
The overall aim of the MiMo-project is to evaluate and assess a model of woman-centred care provided by midwives during childbirth in Swedish and Icelandic delivery wards.
A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, The intervention comprised a one-day (8 hours) education about the MiMo-model together with regularly scheduled reflection groups for midwives during one year Mars 2015-Mars 2016. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0). The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, and sense of coherence before and one year after the intervention. An ethnographic research study has been carried out at labour ward of Landspitali, University Hospital, Iceland testing and developing practical guidelines. Before the study started, an ethnographic field study has been carried out focusing midwifery care during the birth. MiMo is further evaluated by focus group interviews with the same professionals in each group; midwives, managers, obstetricians and assistant nurses before the intervention started, and after the interventions was finished.
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