Exploring woman-centred care : mothers’ experiences

Abstract

Woman-centred care is a distinct concept of midwifery, that focuses on the woman’s individual physical, psychological, spiritual, cultural, social and emotional needs, her baby’s and those of her family, whilst recognizing the need for the woman to have choice, control and continuity from a known caregiver or caregivers (Leap, 2009). The aim of this study was to explore mothers’ experiences of woman-centred care, during labour and birth. The study’s objectives were to explore mothers’ experiences of continuity of care and carer during childbirth, and to explore mothers’ experiences of informed choices during labour and delivery of their child. To accomplish these objectives, a qualitative approach was adopted and semi-structured, face-to-face interviews were conducted with a purposive sample of ten Maltese mothers. All the mothers had gone through the experience of a normal vaginal delivery and gave birth to a healthy term infant. Mothers who met the inclusion criteria for participation were approached, and voluntarily accepted to participate. The interviews were audiotaped and transcribed verbatim. The transcripts were analysed using thematic analysis as described by Braun and Clarke (2006). Three themes were identified from the mothers’ accounts of their experiences; ‘Informed Choice during Labour’, ‘Continuity of Care and Caregiver during Labour’ and ‘Presence of the Midwife during Labour’. The findings revealed that, although mothers stated that they had the opportunity to make choices in labour, the researcher noted that information prior to decision-making was lacking. Continuity of carer was favoured over continuity of care, since mothers argued that having the same midwife in labour enabled them to form trusting relationships. Mothers also indicated that the constant presence of a supportive midwife during labour is beneficial due to the encouragement provided. In view of these findings, recommendations for practice and management, education and further research were proposed, including the need to provide mothers with information to enable informed decision-making; the requirement for midwives to be aware of the advantages of woman-centred care, and to start practicing it; to conduct further studies exploring mothers’ experiences of woman-centred care with regards to the antenatal or postnatal period; as well as to explore woman-centred care from the midwives’ perspectives.