Title
How the intentions of maternity care providers influence normal physiological birth.
Background
Childbirth is a significant life event and often a profound experience in a woman’s life. While most women desire to birth vaginally, over the past decade research has consistently reported a significant decline in rates of normal physiological birth. While previous studies have explored practices to improve normal physiological birth, research into the influence of maternity care providers attitudes and intentions on normal birth rates is lacking.
Aims
To explore factors influencing intentions to facilitate normal physiological birth from the perspective of midwives and obstetricians.
Methods
The Theory of Planned behaviour informed a qualitative approach, with data collected via semi-structured interviews. Data was analysed thematically, using an inductive and deductive approach in keeping with the methodological underpinnings of critical realism.
Results
Factors shown to inhibit and support facilitation of normal physiological birth from both midwives’ and obstetricians’ perspectives will be presented and explored. Emerging themes reveal that intentions to be ‘with woman’ were supportive in facilitating normal physiological birth, while inhibitive factors were more aligned with intentions to be ‘with institution’. Key influences will be highlighted including maternity care providers own perceived identities and roles, workplace culture and collegial factors, models of care, as well as impacts of central monitoring and micro-management.
Conclusions
This study highlights key factors that influence midwives’ and obstetricians’ intentions to facilitate normal physiological birth. While attitudes and beliefs influencing practice that aligned with a woman-centric approach were supportive, other influences such as those considered to be aligned with institution are inhibitive. However, the later are potentially modifiable within the context of maternity care services and can be translated into clinical practice.