gms | German Medical Science

Background: Theoretical models of midwifery include the core of providing woman centred care, promoting normality of childbirth. As the professional roles of midwives and the cultural context of maternity care differ globally, there is need to develop, implement and assess usefulness and impact of midwifery models of care in different countries. Based on a synthesis of 12 qualitative research findings in Sweden and Iceland on women’s and midwives’ experiences of childbirth further validated by 30 midwives in 6 focus groups, a Midwifery Model of woman-centred care (MiMo) was developed [1].

Aim: A research project is ongoing with the overall aim to implement the MiMo model and evaluate its usefulness and impact in practice, such as on the experiences of women, health professionals and outcomes of labour and birth.

Methods: A mix of qualitative and quantitative methods have been used in different studies before and after an intervention in which the MiMo was implemented in practice in Sweden. This included focus group interviews with different health professionals to evaluate applicability and usefulness in practice [2] and an ethnographic study before the MiMo intervention to learn about the experiences and meaning of midwifery care [3]. Further developments of the MiMo is ongoing with ethnographic action research methods in Iceland, evaluating the usefulness of practical guidelines for further implementation. Quantitative measures are ongoing to assess impact of the use of MiMo in practice such as on intervention rate during childbirth and work satisfaction of midwives.

Results: The practical guidelines developed for implementation of MiMo in practice, include the central concepts of the model and steps on how to form reciprocal relationships with women, to create a birthing atmosphere of calmness and trust, strenghening and promoting normality of all birth and to use the gounded knowledge of the midwife and different kind of knowledge in relation to each woman. Furthermore, to reflect on how the midwife uses balancing acts to provide woman centred care, what are the promoting and hindering cultural norms for a midwifery salutogenic approach and positive outcomes for women, babies and families, in cooperation with other health professionals [1].

Studies within the MiMo project show that one advantage of using the MiMo is that it makes midwifery visible in practice by “giving words” to a woman-centred midwifery approach of care [2]. Midwives work in a “field of tension”, balancing contrasting models of care [3], [4], [5], indicating the need for a MiMo model of care and practical guidelines. Results of quantitative studies of the MiMo project are submitted for publication.

Conclusions: Few theoretical models of care have been formally implemented and evaluated in practice. The MiMo research project adds knowledge to how such models can be applied to and used in hospital birth care settings. It gives a tool to reflect on real situations in a cultural context that could help to define midwifery and the different roles and collaboration of health professionals to provide woman centred midwifery care.

Ethics and conflicts of interest: The study was approved by the Ethics committee in Gothenburg no. 840-14, on 1^st December 2014. The research was financed by own resources. There are no conflicts of interest.