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Improving the quality and content of midwives’ discussions with low-risk women about their options for place of birth : co-production and evaluation of an intervention package
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Henshall, Catherine, Taylor, Beck, Goodwin, Laura, Farre, Albert, Jones, Miss Eleanor and Kenyon, Sara (2018) Improving the quality and content of midwives’ discussions with low-risk women about their options for place of birth : co-production and evaluation of an intervention package. Midwifery, 59 . pp. 118-126. doi:10.1016/j.midw.2018.01.016 ISSN 0266-6138.
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Official URL: http://doi.org/10.1016/j.midw.2018.01.016
Abstract
Objective
Women's planned place of birth is gaining increasing importance in the UK, however evidence suggests that there is variation in the content of community midwives’ discussions with low risk women about their place of birth options. The objective of this study was to develop an intervention to improve the quality and content of place of birth discussions between midwives and low-risk women and to evaluate this intervention in practice.
Design
The study design comprised of three stages: (1) The first stage included focus groups with midwives to explore the barriers to carrying out place of birth discussions with women. (2) In the second stage, COM-B theory provided a structure for co-produced intervention development with midwives and women representatives; priority areas for change were agreed and the components of an intervention package to standardise the quality of these discussions were decided. (3) The third stage of the study adopted a mixed methods approach including questionnaires, focus groups and interviews with midwives to evaluate the implementation of the co-produced package in practice.
Setting
A maternity NHS Trust in the West Midlands, UK.
Participants
A total of 38 midwives took part in the first stage of the study. Intervention design (stage 2) included 58 midwives, and the evaluation (stage 3) involved 66 midwives. Four women were involved in the intervention design stage of the study in a Patient and Public Involvement role (not formally consented as participants).
Findings
In the first study stage participants agreed that pragmatic, standardised information on the safety, intervention and transfer rates for each birth setting (obstetric unit, midwifery-led unit, home) was required. In the second stage of the study, co-production between researchers, women and midwives resulted in an intervention package designed to support the implementation of these changes and included an update session for midwives, a script, a leaflet, and ongoing support through a named lead midwife and regular team meetings. Evaluation of this package in practice revealed that midwives’ knowledge and confidence regarding place of birth substantially improved after the initial update session and was sustained three months post-implementation. Midwives viewed the resources as useful in prompting discussions and aiding communication about place of birth options.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Library of Congress Subject Headings (LCSH): | Birth plans -- Great Britain, Midwifery, Childbirth, Childbirth -- Social aspects, Birthing centers, Health promotion -- Planning -- Methodology, Hospitals -- Maternity services -- Psychological aspects | ||||||
Journal or Publication Title: | Midwifery | ||||||
Publisher: | Elsevier Sci Ltd. | ||||||
ISSN: | 0266-6138 | ||||||
Official Date: | April 2018 | ||||||
Dates: |
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Volume: | 59 | ||||||
Page Range: | pp. 118-126 | ||||||
DOI: | 10.1016/j.midw.2018.01.016 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 24 May 2023 | ||||||
Date of first compliant Open Access: | 24 May 2023 | ||||||
RIOXX Funder/Project Grant: |
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