gms | German Medical Science

GMS Zeitschrift für Hebammenwissenschaft

Deutsche Gesellschaft für Hebammenwissenschaft e.V. (DGHWi)

ISSN 2366-5076

Best practice in interprofessional antenatal care

Research Article

  • corresponding author Ramona Koch - ZHAW – Zurich University of Applied Sciences, Switzerland
  • Christine Loytved - ZHAW – Zurich University of Applied Sciences, Switzerland
  • Martina König-Bachmann - Health university of applied sciences tyrol, Austria
  • Susanne Grylka-Baeschlin - ZHAW – Zurich University of Applied Sciences, Switzerland

GMS Z Hebammenwiss 2021;8:Doc04

doi: 10.3205/zhwi000023, urn:nbn:de:0183-zhwi0000236

This is the English version of the article.
The German version can be found at:

Received: September 30, 2020
Accepted: February 22, 2021
Published: December 8, 2021

© 2021 Koch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at


Background: Although the advantages of interprofessional care have been proven and pregnant women in Switzerland have free choice of caregivers, most of them are cared for exclusively by physicians.

Objective: To collect expert knowledge on the factors determining success or failure of interprofessional collaboration between midwives and gynaecologists within antenatal care in Switzerland.

Research question: What does best practice look like in interprofessional antenatal care provided by midwives and gynaecologists in Switzerland?

Methods: Five semi-structured dyadic and group interviews with six midwives and five gynaecologists who provide interprofessional antenatal care in Switzerland. Interviews were transcribed verbatim and qualitative content analysis was applied.

Findings: Information was acquired on best practice topics such as values, knowledge and context. A new topic, interpersonal relationships and workplace culture, emerged as an additional factor in the success of interprofessional antenatal care.

Conclusions: There is no “best” form of internal organisation for interprofessional collaboration. What is more important is a clear concept, supported by all participants, and good interpersonal relationships among caregivers. The implementation of interprofessional collaboration presents political, economic, social and organisational challenges.

Keywords: prenatal care, interdisciplinary, midwives, gynaecologists


Although the advantages of interprofessional care have been proven and pregnant women in Switzerland have free choice of caregivers, the majority are still cared for exclusively by physicians. Interprofessional antenatal care provided by midwives and gynaecologists meets women’s needs for midwife-led care [24] combined with the safety expected from medical care [23]. Historically, antenatal care, as opposed to assistance during birth, was not something traditionally provided by physicians ([18] p.24f). It was not until the mid-20th century that by means of financial incentives, antenatal care became part of the area of responsibility of practice-based physicians, primarily general practitioners. Midwives were not part of this concept ([27] p.227ff). There is currently a growing need for interprofessional collaboration in this area due to the better medical outcomes for mothers and babies and increased satisfaction among pregnant women [22], [24] as well as for reasons of cost-efficiency [29].

Interprofessionality is defined as effective collaboration between experts from at least two professions ([30] p.5), with the best qualified person taking the lead, depending on the task at hand ([10] p.5f). Best practice is the approach or course of action which achieves the optimum result in the respective field of interest. According to Bavier and Schwager [3], values, knowledge and context, as described by Broesskamp-Stone et al. [6], are the cornerstones of best practice in midwifery (see Figure 1 [Fig. 1]).

Switzerland currently has no uniform standard with regards to the content and structure of antenatal care, nor do pregnant women have maternity records in a nationally standardised format. The vast majority of pregnant women are currently cared for by gynaecologists in a non-hospital context [13]. Since 2017, however, legislation has been in place stipulating that for normal, healthy pregnancies both midwives and gynaecologists are authorised to carry out all antenatal check-ups [8].

State of research

To date, on the subject of best practice in interprofessional antenatal care, there has been one study conducted in the USA [22], two each in both the Netherlands [21], [25] and Canada [5], [20] and four in Switzerland [1], [2], [11], [19]. Five of these studies present views and aspirations regarding interprofessional collaboration between midwives and gynaecologists during antenatal care based on already existing arrangements [5], [11], [21], [22], [25]. Four of the studies [1], [2], [19], [20] refer to the expectations of practitioners and pregnant women regarding planned future projects.

Interprofessional clarification of needs: USA

A pilot project in the USA [22] showed that a useful approach was to offer women with particular problems an appointment to discuss their specific needs during pregnancy with a midwife and a medical professional. The range of different care services provided by the two professions can be tailored to the woman’s individual needs thus avoiding any contradictory information. This is the only study to address the notion of a consultation with both professionals in one room.

Systems with primary care: Netherlands and Canada

The strict classification into specific levels of care in the Netherlands makes flexible collaboration between professionals difficult [25]. To keep access to several professionals at the same time low threshold and to facilitate regular communication between those professionals, they should work at the same location [21]. Both studies are critical of the fact that there is no single uniform system of documentation. Schölmerich et al. [25] add that the system of remuneration often provides no financial incentive for midwives and gynaecologists to work together.

Similarly, in Canada, this separation of the two professions is also viewed negatively: the billing systems of the two professions are structured differently, which makes it difficult to combine different services [20]. In addition to this, there is often a lack of time and space [5].

The research groups in both of these two countries agree that midwives and gynaecologists have different views on pregnancy, which in turn influences the antenatal care they provide [5], [21]. Because of the different approaches there is a lack of mutual trust and confidence, particularly when it comes to indications for interventions [5]. There is a lack of shared values and objectives, a lack of knowledge about the other profession’s field of work, and a lack of appreciation [21], [25]. The competitiveness between the different professions in obstetrics was addressed in all four studies [5], [20], [21], [25]. At the organisational level, some of the studies recommended jointly developed uniform interprofessional workflows, which would govern the care process and its content [20], [21]. Members of both professions were worried that collaboration would result in financial losses and a loss of their autonomy [5], [21]. Effective and satisfactory collaboration requires mutual respect, trust, open and honest communication, clarity when it comes to professional roles and areas of responsibility, joint decision-making and a flexible approach to interprofessional care [20], [21], [25]. All of this evolves when there is collaboration and a regular exchange of ideas and information in the form of team meetings as well as in an informal context [20]. One study describes the sometimes negative attitude among nurses and physicians towards midwifery work [20]. The study identifies the origins of this negativity as the lack of experience with interprofessional collaboration. Several researchers thus recommend that, during their training, doctors should be given an insight into the work of midwives [20], [25].

Findings from Switzerland

A study showed that pregnant women were more satisfied with the care they received from a midwife-led unit in a university hospital in Switzerland than through the conventional model [11]. In the view of both the pregnant women and the professionals, the following factors make it more difficult to establish a midwife-led unit in a Swiss university hospital: pregnant women may feel safer being looked after by a gynaecologist than by a midwife. Moreover, gynaecologists are less willing to change the familiar way of doing things and give midwives more responsibility [19]. There are also concerns that physicians have very little opportunity to acquire experience of normal, healthy pregnancies during their training [19]. A government-commissioned evaluation of the factors that were conducive to or impeded the implementation of interprofessional antenatal care in Switzerland confirmed the findings of studies from other countries [1]. Midwives would like a list of criteria for referring a client to medical care [19]. Practitioners from both professions could benefit from receiving practical experience of antenatal care during their training [2]. Thus the question arises as to how best practice in interprofessional antenatal care provided by midwives and gynaecologists can be implemented in Switzerland.

Aim and research question

The objective was to conduct an evaluation of the values of professionals in Switzerland as well as factors that are conducive to or impede interprofessional collaboration on the basis of the best practice concept with a view to answering the following research question: What does best practice in interprofessional antenatal care provided by midwives and gynaecologists in Switzerland look like? The results of this evaluation are intended to serve as the basis to develop strategies for and implement satisfactory, sustainable interprofessional collaboration, also in other countries besides Switzerland.


A qualitative study design was selected with semi-structured dyadic and group interviews conducted by experts ([16] p.148, [12] p.111).

In May 2018, via the Swiss Association of Midwives, all midwives from the Zurich region were contacted by email and direct contact was also made with midwives outside the Zurich region. Inclusion criteria for participation in the study was solely involvement in implementing interprofessional antenatal care by midwives and gynaecologists. Declines were received from several hospitals, primarily due to a lack of capacity.

A systematic literature review was conducted using the relevant keywords in combination with suitable Boolean operators including in the CINAHL and PubMed databases. The interview guidelines for the semi-structured interviews using the SPSS principle drew on recent research findings (until end of 2018) ([14] p.182). The five dyadic and group interviews with existing interprofessional teams were conducted in 2018 by the first author with a notetaker in attendance (average duration 57 minutes; minimum 39 and maximum 84 minutes). We tried to influence the interviewees’ responses as little as possible to ensure internal validity of the survey ([16] p.56, [26]). Audio recordings were made of all interviews, and participants’ main points as well as observations regarding their interaction were recorded in writing ([7] p.81). Based on Kruse ([16] p.354) the recordings were transcribed using the f4transkript [9] software, adapted to written German and evaluated using Atlas.ti software, version 8. The qualitative content analysis developed by Kuckartz ([17] p.109ff) used to structure the content was conducted continuously and in parallel with the data collection. The content of the interviews was coded using alternating inductive and deductive processes, grouped into main categories and correlated ([4] p.223ff). The subject areas in the interview guideline served as a basis to guide the creation of the categories. However, during the two-stage coding process, new codes were obtained and existing codes thus reworded. To validate the code system ([16] p.56) individual sections of text were independently processed by the second author. The results were then discussed and the code system was adjusted wherever necessary. Detailed documentation of all research steps served to verify the intersubjectivity and transparency. In addition, a written presentation of the results was sent to the interviewees to be checked for accuracy.


Six midwives and five physicians from a total of five practices took part in the interviews. The interviewees had been in their professions for between 10 and 31 years (average 23 years). Three individuals were in their first year of working in their current practice and others had worked there for as many as 38 years. Seven participants worked full-time or almost full-time (90–100 percent workload), two worked part-time with a 10 percent workload and two worked part-time with a 40 percent and 60 percent workload, respectively. The internal organisation at the five practices also differed. In one practice, the midwife was employed by the gynaecologist. In another, also owned by the gynaecologist, the midwife was freelance and rented space on a specific day at the practice. This midwife documents her notes in the same system but invoices her services separately. Two other teams were each part of a large group practice where they work together with other professionals. In one practice, both the midwife and the gynaecologist were employed by the practice and all administrative tasks go through the practice. In another practice, according to their contracts, the midwives were employed by the physicians but here, in terms of having a say in decision-making as well as the hourly wages, everyone is treated equally. The fifth practice was established by one of the midwives but all professionals working there are freelance. All of the institutions used a workflow. However, this differed from practice to practice, including in the level of detail it contained.

The findings presented below are based on statements in German taken from the interviews and translated into English. They were summarised in four thematic categories. This enabled us to take all three dimensions of the best practice concept into account and develop one new topic (see Figure 2 [Fig. 2]).


Midwives see interprofessional collaboration as easing their workload and stress: they value the opportunity to turn to a gynaecologist if there are any abnormalities during antenatal check-ups. This means that there is not just one individual bearing all the responsibility:

“For me this is an excellent way of doing things. In a way it provides a sense of certainty as well as someone to discuss things with, whether that’s another midwife or a doctor.” (Midwife B)

The midwives we interviewed deem it invaluable that they are more efficient when working in a practice where they can conduct several antenatal check-ups in a row, instead of having to travel to women’s homes for each check-up. Being part of a practice also means that the costs for the premises and equipment can be shared. Being part of a network with other professionals is also useful, through access to an external laboratory, for instance. The gynaecologists value the fact that midwives can take on certain aspects of antenatal care that they are often unable to find enough space and time for during their routine medical check-ups. Both the midwives and the gynaecologists emphasise that the close collaboration offers mutual benefits. Two of the gynaecologists we interviewed trained midwives to use the ultrasound equipment to check the foetal position.

In all five practices the professionals worked together at the same location. The interprofessional collaboration makes it possible to extend the range of care that can be offered by each practice.

Two gynaecologists underlined that it is important to them to also support normal, healthy pregnancies.

“I think the way we are organised here makes a lot of sense. Everyone is able to do everything during a check-up. […] I think this is great”. (Gynaecologist C)

That said, if there are several professionals working together and they do not all buy in to the concept to the same extent, this can cause problems.

“On the other hand, it can be somewhat sticky, because there have been, and still are, gynaecologists who don’t want to give things up, who would actually rather do the check-ups themselves. […] And in those cases I always have to ask ‘hey, why is this woman not with me? We have clear rules’ and so on.” (Midwife H)


In order for interprofessional collaboration to function effectively, it is important to develop a clear plan, which represents everyone and serves as a basis for the professionals involved to provide consistent care as a team for the entire client base. Two midwives described how, at the beginning, they needed courage to take on the first and second trimester check-ups as this was something they had little hands-on experience of. However, they did have the theoretical knowledge, which quickly enabled them to feel more confident.

All of the institutions studied use workflows and were in agreement that this is important to ensure that no information or examinations are missed or duplicated. When it comes to the organisation of work within the team and the content of the individual check-ups, in some instances, the five practices differ significantly. In three of the practices it is clearly set out which of the check-ups are conducted in which week of pregnancy by a midwife and which are the responsibility of a gynaecologist. In two of these three practices, midwives take on the antenatal check-ups for normal, healthy pregnancies on their own and also bear full responsibility for them. That said, they do have the option of involving a gynaecologist at their own discretion. When there are pathologies, it is decided on a case-by-case basis whether the gynaecologist should perform the ultrasound and the midwife then take over for the rest of the check-up or whether the entire check-up should be done by the gynaecologist.

One of the midwives reported discussing each case with the gynaecologist bearing the primary responsibility, either before or after each antenatal check. The midwife predominantly conducts check-ups for normal, healthy pregnancies, with clearly defined boundaries when it comes to her area of responsibility. Another of the practices has stipulated the content of each antenatal check-up, irrespective of which professional is carrying out the check-up. Since all the ultrasound examinations are performed at external institutions, the midwives and gynaecologists are all equally capable of conducting antenatal check-ups at the practice. This applies to all the tasks associated with the check-up.

“I think the way we are organised here makes a lot of sense. Everyone is able to do everything during a check-up. […] I think this is great”. (Gynaecologist C)

At one practice, the pregnant women are mainly cared for by the midwives or, if necessary, alternating with the gynaecologist, who is called in to conduct ultrasounds or for advice.

In relation to the role of the gynaecologist, all experts mentioned ultrasound examinations to monitor foetal development, the function of the placenta and the length of the cervix, as well as for early detection of abnormalities. Given that midwives are only allowed to prescribe medication to a limited extent, this is also part of the doctor’s area of responsibility in antenatal care. In addition, the provision of information on potential risks and options for prenatal diagnostic tests is clearly part of the gynaecologist’s remit. Two gynaecologists emphasised that it was important to them to also support normal, healthy pregnancies and not only be involved when there are problems or abnormalities.

For the midwives and the gynaecologists alike, the network with other professionals involved in antenatal care is essential. This enables them to tailor antenatal care to the needs of each individual pregnant woman.

Contextual factors

The midwives and gynaecologists from three of the practices were critical of the fact that the content of antenatal check-ups increasingly concentrated on the detection of possible pathologies. They felt that, following this approach, it was difficult to meet the individual needs of the pregnant woman. There are calls for midwife care to be promoted by the system. Antenatal care has so far been led by the fear of overlooking something. There is less and less trust and confidence that the pregnancy will be healthy.

“I think it sometimes needs a lot of courage to assume a healthy pregnancy. […] Gynaecologists […] do these ordinary, mundane things less and less, simply because they are scared. And I don’t think that’s a positive development”. (Gynaecologist C)

Because an antenatal check-up conducted by a midwife generates significantly less revenue than a consultation with a gynaecologist, this makes collaboration with midwives financially unattractive. There is still insufficient evidence of the health and financial benefits of the work midwives carry out and as a result, the remuneration paid by the health insurance companies is still too low. Experts across the board would like to be paid for more time per check-up. This would enable them to advise the pregnant women more effectively and respond to their questions in more detail.

“To be involved, to make independent, well-informed decisions. All this needs time. And it IS time-consuming. And no-one is prepared to pay a cent for it. NOONE. So every piece of equipment is paid for. But the consultation is not.” (Gynaecologist K)

The professionals would like to have more time to provide information and raise awareness regarding the available care options and the freedom to choose which pregnant women have in Switzerland.

Different experts noted that during their practical medical training, doctors often learn too little about the physiology of pregnancy. Neither the gynaecologists nor the midwives acquired very much experience of supporting pregnant women continuously and particularly those in early pregnancy during their training.

“Neither doctors nor midwives learn that. […] Because as a junior doctor you don’t see patients.” (Gynaecologist E)

The experts we interviewed were all in agreement that collaboration must be fostered in practice.

“Because during their studies, in particular, doctors don’t yet have to decide in which direction they want to go. And then, by the time they do decide on their specialty they aren’t attending lectures anymore. […] I think it’s not until they start clinical work that they actually begin to learn how things function in practice.” (Midwife B)

Close collaboration should broaden people’s perspectives of the work and skills of the other professionals and thus result in more understanding. Ideally, this collaboration would already start during training or in the first few years of a professional’s career.

“If only we had a greater understanding of the work carried out by others e.g. through working TOGETHER, women would benefit from this. This is down to the willingness of each individual. For instance, if a midwife takes a young assistant doctor under their wing.” (Midwife L)

When it comes to the theoretical basis, the experts feel well trained and there is also an extensive range of opportunities for further training.

Interpersonal level and workplace culture

Factors that influence the interpersonal relationship between the different members of a team play a key role in ensuring effective collaboration. This is something all the experts we interviewed agree on. The pursuit of a shared idea motivates a team and strengthens its cohesion. To facilitate this, it is important that the professionals know one another and have an opportunity to discuss their medical approach and their perceptions of antenatal care. The experts invest a lot of time in building relationships. This requires open and honest communication and the commitment of all team members to the process.

“Open and honest communication is the most important thing. We have to be able to tell each other if we don’t agree with something.” (Gynaecologist E)

According to the experts, another key aspect of good collaboration is that everyone knows each other well and there is complete trust. A prerequisite for this trust is that the professionals work carefully and recognise and stay within the bounds of their authority and expertise. At the same time, there must be opportunities to discuss uncertainties.

“And to have trust in each other that we will each do this as long as we are able and we will not go beyond that point. In other words, we recognise that we are going too far and that we now need to pass the task on to someone else. Whether this means a hospital or that we need to discuss it with a doctor.” (Midwife D)

The experts believe that it is precisely this trust that many professionals are lacking and that this poses an obstacle for collaboration.

“There aren’t many doctors who trust midwives enough to really hand over responsibility to them.” (Gynaecologist E)

The experts see it as expedient that everyone interacts with each other in a respectful manner and as equals. This is an approach they practice towards one another as a team and also towards their clients. In order for this to become the normal way of working together, role models are needed. Professionals are more likely to treat one another respectfully if they see their superiors doing the same.

According to the experts we interviewed, there is strong competition between midwives and gynaecologists when it comes to the care of pregnant women. Not only does this make the work of the professionals more difficult, it also has a negative impact on quality of care. It is interpreted as a personal failing if other professionals are (or have to be) involved.

“That you don’t make yourself the focus. […] The midwife thinks she is more important than the doctor. And the doctor thinks, ha, they can’t do anything at all without me. That’s why I then have to show them that they haven’t done it right.” (Gynaecologist A)

The experts suspect that this competitive mentality has historical origins. These two groups of professionals have been fighting for authority in the care of pregnant women for many years.

“Erm, for me this is an age old story. One, which to some extent runs very deep and can’t really be resolved. Especially among the older midwives. […] I know this comes from both sides. There are also doctors who say midwives aren’t capable of doing anything.” (Gynaecologist A)

There are often prejudices against the other professional in the room or it is perceived as a personal failing or sign of incompetence if another professional has to become involved.

In the opinion of the experts, the reason changes have not taken place is not because interprofessional collaboration would be in any way disadvantageous to the professionals concerned. It is rather that change requires effort and for people to move out of their comfort zone. This is why many prefer to continue carrying out the check-ups just as they “have always been done”.


This study presents the experiences and insights of midwives and gynaecologists who provide interprofessional antenatal care to women in Switzerland. The following aspects of best practice could be determined:

The values of interprofessional collaboration referred to by the experts included professional and personal enrichment through regular interaction and exchange of ideas, the improvement of the care provided through the addition of different skills and expertise as well as an emphasis on the value of a healthy pregnancy. Similar to an earlier study [22] the experts also recognised that interprofessional collaboration results in more flexibility and creates sufficient scope to meet individual needs. Combining different areas of responsibility in the context of interprofessional collaboration allows continuity of care over a longer period than support provided by a single profession – this finding is consistent with the views expressed by pregnant women receiving care in a midwife-led obstetrics unit in Switzerland [11]. From the perspective of the professionals surveyed, good collaboration between midwives and gynaecologists improves the quality of antenatal care, which coincides with the findings from other research studies [1], [5], [22].

When it comes to the knowledge factor, networking with other professionals seems helpful. To prevent uncertainty, the workflow, division of labour and responsibilities, as well as the roles and duties of the different professionals should be clearly defined within the team. The results of this study confirm previous research findings that effective communication between professionals also makes an important contribution to the satisfaction of all involved and to achieving a high quality of care [1], [21], and a nationally standardised system of documentation would also make communication significantly easier [2], [20], [21], [25].

Beneficial contextual factors such as legal requirements and guidelines as well as monetary compensation and cost-efficiency were also mentioned in three previous studies [1], [2], [25]. A standardised system for billing both the medical services provided by a doctor and those provided by a midwife would also appear to improve efficiency. Those surveyed in this study as well as other studies described training content as important: interprofessional elements should be integrated into the theoretical part of training [2], [19] and students should receive more training on the physiological processes of pregnancy as part of their medical degree [15], [20], [21], [25]. Given that midwifery is now a degree subject, some kind of rapprochement is expected between the two professions putting them on more equal footing [21].

In addition to the aspects of best practice, another essential criterion mentioned by the experts we interviewed was the interpersonal dimension and a shared workplace culture. This includes shared attitudes and goals, sympathy and kindness, mutual trust, respectful treatment and appreciation. It is helpful if the professionals have had relevant experience of these values in practice during their career. Obstacles referred to were a competitive mentality and a lack of readiness to change. This is also in line with other studies: it is important that the professionals working together have shared values and philosophies [5], [21], [25]. The members of the team have to trust and be kind to one another [20]. Competitiveness was another factor addressed by some research studies [5], [20], [21], [25]. According to our interviewees, the reasons for competitive attitudes were prejudices against the members of the other profession, pride, a fear among the professionals of losing autonomy and under certain circumstances, even their career. Flat hierarchies must be created to prevent this rivalry [5]. This is achieved by way of respectful treatment of others and clarity regarding roles and areas of responsibility of the others in the team, joint decision-making and flexibility of the individual team members [1], [20], [21], [25].

We only surveyed a very small group of professionals which means it is not possible to generalise the results. However, since the type of collaboration differed significantly between the five practices studied, we could take a variety of aspects into account. The method of a joint survey of midwives and gynaecologists in one practice was chosen deliberately. On the one hand, the interaction and discussion between the participants allowed us to acquire additional information during the interviews, on the other, however, we cannot rule out the possibility that the responses given were simply those participants thought were expected of them.


The provision of interprofessional antenatal care by midwives and gynaecologists in Switzerland poses political, economic, social and organisational challenges. It can be beneficial for the professionals, the pregnant women being cared for and even the entire health service.

In terms of practice, both midwives and gynaecologists have good theoretical training in antenatal care but both groups lack practical experience. More in-depth knowledge about how to care for women in early pregnancy in particular must be part of the training for both professions. Collaboration in interprofessional teams must already start during training.

These are valuable findings for the implementation of best practice in interprofessional collaboration beyond the Swiss context.



An assessment by the Ethics Commission of the Canton of Zurich determined that the Human Research Act does not apply to this study (BASEC-Nr. Req-2018-00401).

Competing interests

The authors declare that they have no competing interests.


Atzeni G, Schmitz C, Berchtold P. Die Praxis gelingender interprofessioneller Zusammenarbeit [The practice of successful interprofessional cooperation]. Swiss Academies Reports. 2017;12(2). DOI: 10.4126/FRL01-006409147 External link
Aubry E, Cignacco E. Hebammengeleitete Geburtshilfe im Kanton Bern – Ein Expertinnen- und Expertenbericht [Midwife-led obstetric care in Switzerland, Canton Bern – An expert report]. Bern; 2015 [Access: 10 Nov 2020]. Available from: External link
Bavier U, Schwager M. Best Practice in der Hebammenarbeit – eine Anleitung fuer bestmoegliche praktische Arbeit [Qualifikationsarbeit] [Best practice in midwifery – a guide to best practice in practice]. Donau-Universitaet Krems; 2009.
Bazeley P. Qualitative data analysis: Practical strategies. London: Sage Publications Ltd.; 2013.
Behruzi R, Klam S, Dehertog M, Jimenez V, Hatem M. Understanding factors affecting collaboration between midwives and other health care professionals in a birth center and its affilitated Quebec hospital: a case study. BMC Pregnancy Childbirth. 2017;17(200):36-50. DOI: 10.1186/s12884-017-1381-x External link
Broesskamp-Stone U, Ackermann G, Ruckstuhl B, Steinmann R. Best Practice – Ein normativer Handlungsrahmen fuer optimale Gesundheitsfoerderung und Krankheitspraevention [Best Practice – A normative framework for optimal health promotion and disease prevention]. [Access: 10 Nov 2020]. Available from: External link
Bruesemeister T. Qualitative Forschung: Ein Ueberblick [Qualitative Research: An Overview]. Wiesbaden: Springer Verlag; 2008.
Bundesversammlung der Schweizerischen Eidgenossenschaft. Bundesgesetz ueber die Krankenversicherung (KVG); 1994 [Access: 10 Nov 2020]. Available from: External link
Dr. Dresing & Pehl GmbH. f4transkript. audiotranskription; 2018.
Eidgenoessisches Departement des Innern (EDI), Bundesamt fuer Gesundheit (BAG). Foerderprogramm Interprofessionalitaet im Gesundheitswesen 2017-2020. 2017 [Access: 10 Nov 2020]. Available from: External link
Floris L, Irion O, Bonnet J, Politis Mercier MP, de Labrusse C. Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction. Women and Birth. 2018;31(2):124-133. DOI: 10.1016/j.wombi.2017.06.021 External link
Glaeser J, Laudel G. Experteninterviews und qualitative Inhaltsanalyse. Wiesbaden: Springer Verlag; 2010.
Grylka-Baeschlin S, Borner B. Ausfuehrlicher Statistikbericht der frei praktizierenden Hebammen der Schweiz. 2020 [Access: 10 Nov 2020]. Available from:ührlicher-Statistikbericht-SHV_Rapport-statistique-detaillé-2019.pdf External link
Helfferich C. Die Qualitaet qualitativer Daten – Manual fuer die Qualitaet qualitativer Daten [The quality of qualitative data – Manual for the quality of qualitative data]. Wiesbaden: Springer Verlag fuer Sozialwissenschaften; 2011.
King TL. Interprofessional Collaboration: Changing the Future. J Midwifery Womens Health. 2015;60(2):117-119. DOI: 10.1111/jmwh.12318 External link
Kruse J. Qualitative Interviewforschung [Qualitative interview research]. Weinheim und Basel: Beltz Juventa; 2015.
Kuckartz U. Mixed Methods - Methodologie, Forschungsdesigns und Analyseverfahren [Mixed Methods – Methodology, research designs and analytical procedures]. Wiesbaden: Springer Verlag; 2014.
Loytved C. Von der Wehemutter zur Hebamme: Die Gruendung von Hebammenschulen mit Blick auf ihren politischen Stellenwert und praktischen Nutzen. Bramsche: Rasch; 2001.
Maillefer F, de Labrusse C, Cardia-Vonèche L, Hohlfeld P, Stoll B. Women and healthcare providers’ perceptions of a midwife-led unit in a Swiss university hospital: a qualitative study. BMC Pregnancy Childbirth. 2015;15:56. DOI: 10.1186/s12884-015-0477-4 External link
Munro S, Kornelsen J, Grzybowski S. Models of maternity care in rural environments: barriers and attriubutes of interprofessional collaboration with midwives. Midwifery. 2013;29(6):646-652. DOI: 10.1016/j.midw.2012.06.004 External link
Perdok H, Jans S, Verhoeven C, Henneman L, Wiegers T, Mol BW, et al. Opinions of maternity care professionals and other stakeholders about integration of maternity care: A qualitative study in the Netherlands. BMC Pregnancy Childbirth. 2016;16(1):1-12. DOI: 10.1186/s12884-016-0975-z External link
Phillippi JC, Holley SL, Schorn MN, Lauderdale J, Poumie CL, Benntt K. On the same page: A novel interprofessional model of patient-centered perinatal consultation visits. J Perinatol. 2016;36(11):932-938. DOI: 10.1038/jp.2016.124 External link
Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, et al. Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. Lancet. 2014;384(9948):1129-1145. DOI: 10.1016/S0140-6736(14)60789-3 External link
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2015;4. DOI: 10.1002/14651858.CD004667.pub5 External link
Schoelmerich VL, Posthumus AG, Ghorashi H, Waelput AJ, Groenewegen P, Denktas S. Improving interprofessional coordination in Dutch midwifery and obstetrics: a qualitative study. BMC Pregnan. 2014;14:145-152. DOI: 10.1186/1471-2393-14-145 External link
Schulze B, Angermeyer M. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med. 2003;56(2):299-312. DOI: 10.1016/s0277-9536(02)00028-x External link
Schumann M. Die Institutionalisierung der Geburten in der Bundesrepublik 1950 bis 1975 – Auswirkungen auf den Hebammenberuf. In: Herausforderungen: 100 Jahre Bayerische Gesellschaft fuer Geburtshilfe und Frauenheilkunde. Stuttgart: Thieme; 2012. S. 227-236.
Slinkard Philipp M, Stonehocker J. Women’s health outpatient care teams: Focus on advanced practice providers. Clin Obstet Gynecol. 2018;61(1):76-89. DOI: 10.1097/GRF.0000000000000333 External link
Sottas B, Kissmann S, Bruegger S. Interprofessionelle Ausbildung (IPE): Erfolgsfaktoren – Messinstrument – Best Practice Beispiele. Expertenbericht fuer das Bundesamt fuer Gesundheit, Bern. Bourguillon; 2016.
World Health Organization. Framework for action on interprofessional education and collaborative practice. Genf; 2010. Available from: External link