Experiences and views of midwives performing antenatal cardiotocography in Dutch primary care: a qualitative study.

Geplaatst op

Objective: In the current Dutch maternity care system, pregnant women with indication for an antenatal cardiotocography (CTG) to be undertaken need to be referred from primary midwife-led care to secondary obstetric-led care.

Within three different regions in the Netherlands independent primary care midwives perform antenatal CTG in primary care, introduced as a pilot project. The aim of this study was to evaluate the experiences and views of primary care midwives who perform antenatal CTG in primary care.

Design: Using a qualitative approach data were collected by seventeen in depth semi-structured interviews. The interview recordings were transcribed verbatim and analysed using thematic coding.

Setting: Three regions in the Netherlands where midwives carry out antenatal CTG in primary care during this pilot project.

Participants: Seventeen primary care midwives were interviewed between July and November 2017.

Findings: In general, midwives were satisfied with performing antenatal CTG and felt it contributed positively towards the midwife-client relationship. However, midwives experienced an increased workload, partly due to time-consuming technical difficulties. Furthermore, mixed feelings existed on whether antenatal CTG contributes to a more physiological or to a more pathological approach in midwifery practice. Most midwives believed that performing antenatal CTG contributes to the physiological process: strengthening of their gate-keeper role, increased confidence of their clients and improved midwife-client relationship. In contrast, some midwives believed it contributes to a pathological process: medicalization and relying too much on technical devices.

Key conclusions: This study showed an overall positive attitude of primary care midwives towards performing antenatal CTG when required, in primary midwife-led care. However, performing the antenatal CTG can be a challenge for midwives, as midwifery care within this setting is often for healthy women who have a straightforward pregnancy. For some midwives, providing antenatal CTG monitoring in the primary care setting may be seen as using a pathological approach to midwifery care.

Implications for practice: There seems to be a place for antenatal CTG in primary midwife-led care. However, further research is needed before this practice can be implemented widely.

Vraagstelling/hypothese

The aim of this study is to evaluate the experiences and views of midwives performing antenatal CTG in a primary care setting by undertaking a qualitative study.

Relevantie

Zie Doel

Conclusies

This study showed an overall positive attitude of primary care midwives towards performing antenatal CTG when required, in primary midwife-led care. However, performing the antenatal CTG can be a challenge for midwives, as midwifery care within this setting is often for healthy women who have a straightforward pregnancy. For some midwives, providing antenatal CTG monitoring in the primary care setting may be seen as using a pathological approach to midwifery care.

Begeleider(s)

Dr. C. Verhoeven
Marit van der Pijl

Uitvoerder(s)

Marit van der Pijl Ellen Tiel Groenestegen

Contactpersonen

Dr. C. Verhoeven

Periode

gesubmit (januari 2019)



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