gms | German Medical Science

Background: Promotion of participation and facilitation of informed decision-making are an integral part of the ICM model of midwifery care [1]. Pregnant women and mothers' (women's) participation in decision-making entails that their individual needs and wishes – as 'users of services' – are at the centre of midwifery care.

Internationally there are studies which document women's wishes and needs in pregnancy, childbirth and the puerperium in order to identify future user-oriented research topics [2], [3] and eventually a tool to develop a national research agenda. Until 2015, Germany was lacking an empirical study, very broad in scope, which explored the subjective views of women regarding midwifery care without narrowing the research focus to specific interventions, settings, or periods of time.

Aim: The aim of the total qualitative study was: (1) to identify women's wishes and needs, (2) to explore the midwives' views, (3) to compare the perspectives of both target groups, and (4) based on the previous steps to identify central overarching themes relevant to midwifery care and for the future development of a national research agenda. The research question addressed here was: which wishes and needs do women have and what negative experiences did they have, in terms of midwifery care?

Methods: 15 pregnant women and 35 mothers were included in the interpretive-hermeneutic study. They shared their experiences and wishes in 10 heterogeneous (age, parity, model of care, satisfaction with care) focus groups (FG) in five German federal states. Some participants had a low level of education (n=9) and some were living in complex circumstances. Moreover, six mothers who lived in a mother & child home formed a FG and in another separate FG, five mothers participated who were at the same time attending a self-help group of the association Leere Wiege (empty cradle).

The digitally recorded FG conversations were transcribed and analyzed according to the hermeneutic by Gadamer [4]. Quality assurance measures included, among others, the independent analysis by team members and subsequent discussion for reaching a consensus. The ethics committee of the University issued a positive vote. The study which lasted from April 2015 until September 2016 was financed by the German Research Foundation (DFG).

Results: In the total study, seven overarching themes from the women's perspective and five overarching themes from the midwife's perspective were identified.

From the study's extensive and diverse results, the overarching theme 'participation and informed decision-making' from the women's perspective will be selected and presented. The theme's various aspects are: (a) expectant counselling on choices, (b) evidence-based information and time for reaching a decision, (c) written information, (d) self-efficacy/self-determination, (e) declining an intervention, and (f) hospital routine.

Conclusions: Counselling and enabling women to make an informed decision is a key competence and task within midwifery care. Therefore, the results are likely to inform midwives (hospital employed and caseload/independent), educators, researchers, as well as midwifery students.

Ethical criteria and conflict of interests: The research was submitted to an ethics committee. The work was financed by third party funds from the German Research Foundation (DFG). There is no conflict of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].