gms | German Medical Science

Background: Irrespective of the risks involved, 98,7% of all women in Germany give birth in hospital [1]. In addition to the usual obstetrician-led model of care models of midwife-led care [2] have been established for women with low-risk pregnancies.

Aim: Within the scope of the Master’s thesis, the preferences of low-risk first-time mothers were recorded with regard to their decision criteria for a clinical model of care.

Methods: The study design used mixed-methods. Initially, two homogeneous focus groups with pregnant women from both clinical care options were studied in order to trial the decision criteria derived from the literature. Based on this, a survey was conducted using the Analytic Hierarchy Process [3], a quantitative approach, to assess the importance of the decision criteria. Women from both models of care were interviewed by telephone. Ethical approval was obtained by the ethics commission of the hsg Bochum.

Results: 33 questionnaires were analysed and the results expressed in weights. Taking the overall sample into account, the women show a preference to rely on their own individual ability to give birth (w_lokal: 0,543) and the one-to-one support of a midwife (w_lokal: 0,407). In descending order of precedence an intimate atmosphere (w_lokal: 0,377) is followed by the desire for no routine interventions (w_lokal: 0,271). Not having to change the model of care for pain relief (w_lokal: 0,186), the presence of a doctor at birth (w_lokal: 0,126) and not having the ability to influence decision-making are of minor importance (w_lokal: 0,089). The model-specific analysis reveals diverging preferences between the groups considered, which affect the unrestricted access to pain relief.

Relevance: There is little information on the decision criteria used for any clinical model of care. However, it is essential to be aware of the users’ needs in order to be able to guarantee individual women-centred care.

Conclusions: The attitude towards birth depends on individual understanding. Consequently, the women’s differing requirements for care during birth emphasise the future existence of both obstetrician-led and midwife-led care. However, the desire for one-to-one support by midwives is evident across all groups.

Ethics and conflicts of interest: An ethics vote has been obtained. The research was financed by own resources. There are no conflicts of interest.