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Evaluation of a model of woman-centred care during childbirth

Authors Ingela Lundgren
Olof Asta Olafsdottir
Charles Taft
Christina Nilsson
Anna Dencker
Marie Berg
Published in 31th ICM Triennieal Congress 18-22 June 2017
Publication year 2017
Published at Institute of Health and Care Sciences
Language en
Subject categories Nursing, Other Health Sciences, Reproductive health


Background: Based on a synthesis of 12 qualitative studies on women’s and midwives’ experiences of childbearing, a model of woman-centred care has been developed. The model has three central intertwined themes: a reciprocal relationship, a birthing atmosphere, and grounded knowledge; and two overall themes: the cultural context and the balancing act. Purpose/Objective: To evaluate the use and effects of the model of woman-centred care provided by midwives during childbirth. Method: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, and an ethnographic actions research study at the labour ward of Landspitali, University Hospital in Iceland. The intervention in Sweden comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin (n=1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=801). 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 (n=120). The qualitative part will study if the model is considered applicable by midwives, obstetricians, assistant nurses and managers at delivery wards, and to the content of midwifery care. An ethnographic field study with midwives and a focus-group study with assistant nurses, obstetricians, midwives and managers have been conducted before start and will be performed after the intervention. The ethnographic action research study in Iceland is focusing on midwives’ experiences and the development of guidelines for implementing the model in practice. The study period was Mars 2015-Mars 2016. Key Findings: Findings from the study will be presented at the conference. Discussion: The findings will present knowledge about the clinical relevans of a theretical midwifery model of woman-centred care. References: Berg M, Olofsdottir O, & Lundgren I. (2012). A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings. Sexual and Reproductive Healthcare, 3(2), 79-87. Bryar R, & Sinclair M. (2011). Theory for midwifery practice (andra upplagan). NY: Palgrave Macmillan Cohen S, Kamarck T, Mermelstein R. (1983). A global measure of perceived stress. Health Soc Behav, 24, 385-396. Hildingsson I, Westlund K, Wiklund I. (2013). Burnout in Swedish midwives. Sex Reprod Healthcare. 4(3), 87-91. doi: 10.1016/j.srhc.2013.07.001. Epub 2013 Jul 30. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013). Continuous support for women during childbirth. Cochrane Database Syst Rev. Jul 15;7:CD003766. [Epub ahead of print] Karasek R, Theorell T. (1990). Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Book Inc. Kristensen T, Borritz M, Villadsen E, Christensen, K. (2005). The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192-207. Morse Jm & Niehaus L (2009). Mixed Method Design: Principles and Procedures. Walnut Creek, CA, USA: Left Coast Press Inc.

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