“She was there all the time”. A qualitative study exploring how women at higher risk for preterm birth experience midwifery continuity of care

TY - JOUR

T1 - “She was there all the time”. A qualitative study exploring how women at higher risk for preterm birth experience midwifery continuity of care

AU - Brigante, L.

AU - Coxon, K.

AU - Fernandez Turienzo, C.

AU - Sandall, J.

N1 - Funding Information: The POPPIE programme was funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research South London (NIHR CLAHRC South London, UK) - now recommissioned as NIHR Applied Research Collaboration (ARC) South London, UK and NHS Lewisham Clinical Commissioning Group. LB was partially funded by the CLAHRC South London, Guy's and St Thomas’ NHS Foundation Trust, London, UK and the Royal College of Midwives, London, UK. JS, KC and CFT are supported by the NIHR CLAHRC and ARC South London. JS is an NIHR Senior Investigator and CFT is supported by a NIHR Development and Skills Award (NIHR301603). JS and CFT are also supported by a NIHR Global Health Research Group, UK (NIHR133232). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care, UK. Funding Information: The POPPIE programme was funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research South London (NIHR CLAHRC South London, UK) - now recommissioned as NIHR Applied Research Collaboration (ARC) South London, UK and NHS Lewisham Clinical Commissioning Group. LB was partially funded by the CLAHRC South London, Guy’s and St Thomas’ NHS Foundation Trust , London, UK and the Royal College of Midwives , London, UK. JS, KC and CFT are supported by the NIHR CLAHRC and ARC South London. JS is an NIHR Senior Investigator and CFT is supported by a NIHR Development and Skills Award ( NIHR301603 ). JS and CFT are also supported by a NIHR Global Health Research Group ,UK ( NIHR133232 ). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care, UK. Publisher Copyright: © 2023

PY - 2023/7

Y1 - 2023/7

N2 - Problem: There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care. Background: Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives. Design: Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial. Findings: Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control. Key conclusions: Recognising that known midwives were ‘there all the time’ made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.

AB - Problem: There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care. Background: Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives. Design: Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial. Findings: Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control. Key conclusions: Recognising that known midwives were ‘there all the time’ made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.

KW - High risk pregnancy

KW - Maternal Health

KW - Midwifery continuity of care

KW - Models of care

KW - Preterm birth

UR - http://www.scopus.com/inward/record.url?scp=85146587031&partnerID=8YFLogxK

U2 - 10.1016/j.wombi.2023.01.003

DO - 10.1016/j.wombi.2023.01.003

M3 - Article

AN - SCOPUS:85146587031

SN - 1871-5192

VL - 36

SP - e397-e404

JO - Women and Birth

JF - Women and Birth

IS - 4

ER -