gms | German Medical Science

Background: The German health care system provides midwifery care for women and young families during pregnancy, childbirth, and the postpartum period. Thinking along with the user’s perspective can demonstrably contribute to the improvement of care. Which aspects constitute an appropriate and ideal care from the user’s perspective was the subject of the presented study. Furthermore, in the course of the academization of the midwifery profession, the areas of competence of midwives in this work context as well as the interprofessional cooperation with gynecologists and other professional groups could be adapted and optimized.

Aim/research question: The aim of this study was to survey women’s expectations, preferences and needs for professional care in the reproductive phase. The study looked at the phase of preconception, pregnancy, childbirth and early parenthood in the context of midwifery care.

Methods: This was a qualitative study with five interviews with women in the pre-conceptional phase, seven online focus groups in early and late pregnancy, and six online focus groups with women shortly after birth, in the postpartum period, and later during the first year of parenthood. Data were analyzed using qualitative content data analysis as described by Mayring.

Results: A total of 45 women participated in the study. Women’s experiences of midwifery care varied, with some stating that the care structures were not immediately apparent to them. The results highlighted women’s appreciation of the professional knowledge of the midwife providing care. It was also found that midwifery support can subjectively lead to greater confidence in bodily processes and self-efficacy. Continuity of care was rated as the best possible concept. In addition, well-functioning interprofessional collaboration was rated positively, as were stringent information and individualized counseling. An adequate staffing throughout the phases and communication as well as standardized information would improve the care situation from the users’ point of view.

Relevancy: Midwives play a central role in health care, birth preparation, during birth, in the first year of the child’s life and in prevention for the health of the young family. Since 2020, the midwifery profession has been academized in Germany. The results of the study could be incorporated into the development and adaptation of curricula at universities, and teaching content could be adapted accordingly, expanded or given additional focus.

Recommendations/conclusion: In order to quantitatively map the care situation, individualize care, and optimize care models, an instrument will be developed to assess the quality of care and to evaluate the needs of women in midwifery care. From a public health perspective, deficits in the German health care system regarding inadequate intra-sectoral communication, time pressure and low remuneration should be addressed in further research steps and policy measures. The insights gained in the study provide data that can help improve the system for example it addresses a more effective interprofessional teamwork within the continuum of midwifery care as a factor to obtain a better quality of care.

Ethics and conflicts of interest: A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.