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From Midwife-Dominated to Midwifery-Led Antenatal Care: A Meta-Ethnography

Author

Listed:
  • Bente Dahl

    (Centre for Women’s, Family and Child Health, Faculty of Health and Social Sciences, University of South Eastern Norway, P.O. Box 235, N-3603 Kongsberg, Norway)

  • Kristiina Heinonen

    (Metropolia University of Applied Sciences, Health Promotion, P.O. Box 4000, FI-00079 Metropolia, Helsinki, Finland
    Department of Nursing Science, University of Eastern Finland, Finland, Yliopistonranta 1, 70210 Kuopio, Finland)

  • Terese Elisabet Bondas

    (Faculty of Health Sciences, University of Stavanger, P.O. Box 8600, N-4036 Stavanger, Norway)

Abstract

Provision of antenatal care includes risk identification, prevention and management of pregnancy-related diseases, but also health education, health promotion, support and guidance to smooth the transition to parenthood. To ensure good perinatal health, high-quality, free and easily accessed antenatal care is essential. The aim of this study was to identify, integrate and synthesize knowledge of midwives’ experiences of providing antenatal care, attending to clients’ individual needs whilst facing multiple challenges. We conducted a meta-ethnography, which is a seven-step grounded, comparative and interpretative methodology for qualitative evidence synthesis. A lines-of-argument synthesis based on two metaphors was developed, based on refutational themes emerging from an analogous translation of findings in the included 14 papers. The model reflects midwives’ wished-for transition from a midwife-dominated caring model toward a midwifery-led model of antenatal care. Structural, societal and personal challenges seemingly influenced midwives’ provision of antenatal care. However, it emerged that midwives had the willingness to change rigid systems that maintain routine care. The midwifery-led model of care should be firmly based in midwifery science and evidence-based antenatal care that emphasize reflective practices and listening to each woman and her family. The change from traditional models of antenatal care towards increased use of digitalization no longer seems to be a choice, but a necessity given the ongoing 2020 pandemic.

Suggested Citation

  • Bente Dahl & Kristiina Heinonen & Terese Elisabet Bondas, 2020. "From Midwife-Dominated to Midwifery-Led Antenatal Care: A Meta-Ethnography," IJERPH, MDPI, vol. 17(23), pages 1-22, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:23:p:8946-:d:454554
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    References listed on IDEAS

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    1. Kenneth Finlayson & Soo Downe, 2013. "Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies," PLOS Medicine, Public Library of Science, vol. 10(1), pages 1-12, January.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Simon Lewin & Claire Glenton & Heather Munthe-Kaas & Benedicte Carlsen & Christopher J Colvin & Metin Gülmezoglu & Jane Noyes & Andrew Booth & Ruth Garside & Arash Rashidian, 2015. "Using Qualitative Evidence in Decision Making for Health and Social Interventions: An Approach to Assess Confidence in Findings from Qualitative Evidence Syntheses (GRADE-CERQual)," PLOS Medicine, Public Library of Science, vol. 12(10), pages 1-18, October.
    4. McCourt, Christine, 2006. "Supporting choice and control? Communication and interaction between midwives and women at the antenatal booking visit," Social Science & Medicine, Elsevier, vol. 62(6), pages 1307-1318, March.
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    Cited by:

    1. Kristiina Heinonen, 2021. "Strengthening Antenatal Care towards a Salutogenic Approach: A Meta-Ethnography," IJERPH, MDPI, vol. 18(10), pages 1-28, May.

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