From Midwife antenatal care to midwifery.pptx
- 1. From Midwife-Dominated to Midwifery- Led Antenatal Care: A Meta-Ethnography
- 2. OBJECTIVE • The aim of this study was to identify, integrate andsynthesize knowledge of midwives’ experiences of providing antenatal care, attending to clients’individual needs whilst facing multiple challenges.
- 3. METHODOLOGY • This study relies on Geertz referred to as ‘thick descriptions’, or detailed reporting of social or cultural eventstaking place in people’s lives; it also draws on Turner’s theory of sociological understanding as‘translation’. This methodological approach consists of seven overlapping and iterative phases.
- 4. METHODOLOGY
- 5. METHODOLOGY • INCLUSION CRITERIA FOR SEARCH STRATEGY: • Qualitative Methodology studies were included • Mix Method studies were also included but only qualitative data. • Papers in English and Nordic language were included • High income countries • EXCLUSION CRITERIA • Quantitative studies, Theoretical paper, reviews and master thesis or dissertations. • Low income countries
- 6. DATABASE SEARCHING • A literature search was conducted in April and May 2018, followed by an updated search in May 2020. Our primary literature search covered a multitude of databases, including: PsycInfo, PubMed, ProQuest, Wiley, Scopus, MEDLINE and CINAHL. The updated search was conducted in PsycInfo, ProQuest Social Science Premium Collection, Scopus, CINAHL and MEDLINE. Medical subjectheadings and text words used for the searches included ‘prenatal care’, ‘antenatal care’, ‘visit’, ‘midwife’ and ‘public health nurse’ combined with ‘qualitative’. Boolean operators AND, OR and NOT were used to combine the terms and truncations were used to ensure a sufficiently broad search. • Furthermore,we searched the following journals to check that we did not miss articles that might have used other MESH terms: Qualitative Health Research, Journal of Midwifery & Women’s Health, Journal of Obstetric, Gynecologic & Neonatal Nursing, Birth, Sexual and Reproductive Healthcare, BMC Pregnancy & Childbirth, Women & Birth, International Journal of Childbirth and Journal of Advanced Nursing. • In addition, we backtracked reference lists in the included articles. The responsibility for conducting the literature searches was divided between the authors, and experienced librarians assisted in finding relevant key terms and performing the searches.
- 8. RESULTS • STUDIES INCLUDED FROM 4 COUNTRIES across different types of public or private antenatal care services, over a period of more than 20 years. • 3 Studies from sweden • 5 studies from UK • 5 studies from Australia • and only 1 study from Canada
- 9. RESULTS
- 10. MAIN THEMES IDENTIFIED • Willingness to Change from Routine ANC to Family-Centred ANC • Lack of Support from Colleagues • Lack of Cultural Understanding • Lack of Confidence, Knowledge and Skills to Support New Practices • Lack of Willingness to Learn about and Try Group-Based Care • Necessity of Changing Rigid Systems that Maintain Routine Care • Frustrated by Unfit Premises, Restricted Access to ICT and Interpreting Service • Frustrated by Rigid Structures, Risk Aversion and Medicalization • Frustrated by Time Pressure and Cultural Misunderstandings
- 11. • Midwives’ Readiness for Midwifery-Led and Family-Centred Models of ANC • Readiness to Use ICT to Complement Personal Encounters • Readiness to Listen to Parents’ Questions about and Requests for Group- Based Care • Readiness for Individual Continuity of Care • Readiness to Include Fathers and Family Members