Dutch midwives’ views on and experiences with woman-centred care — A Q-methodology study

• Published in: Women and birth : journal of the Australian College of Midwives 2019-12, Vol.32 (6), p.e567-e575
• Main Authors: Fontein-Kuipers, Yvonne, de Groot, Rosa, van Beeck, Elise, van Hooft, Susanne, van Staa, AnneLoes
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Female; Health Personnel; Humane; Humans; Interviews as Topic; Job-crafting; Midwifery; Netherlands; Nursing; Pregnancy; Prenatal Care; Q-methodology; Woman-centred care
• ISSN: 1871-5192; 1878-1799
• DOI: 10.1016/j.wombi.2019.01.003

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. To reveal midwives’ distinct perspectives about woman-centred care. 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. 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. 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.