Woman-centered care 2.0: Bringing the concept into focus

Abstract

INTRODUCTION Woman-centered care has become a midwifery concept with implied meaning. In this paper we aim to provide a clear conceptual foundation of woman-centered care for midwifery science and practice. METHODS An advanced concept analysis was undertaken. At the outset, a systematic search of the literature was conducted in PubMed, OVID and EBSCO. This was followed by an assessment of maturity of the retrieved data. Principle-based evaluation was done to reveal epistemological, pragmatic, linguistic and logic principles, that attribute to the concept. Summative conclusions of each respective component and a detailed analysis of conceptual components (antecedents, attributes, outcomes, boundaries) resulted in a definition of woman-centered care. RESULTS Eight studies were selected for analyses. In midwifery, woman-centered care has both a philosophical and a pragmatic meaning. There is strong emphasis on the woman-midwife relationship during the childbearing period. The concept demonstrates a dual and equal focus on physical parameters of pregnancy and birth, and on humanistic dimensions in an interpersonal context. The concept is epistemological, dynamic and multidimensional. The results reveal the concept's boundaries and fluctuations regarding equity and control. The role of the unborn child is not incorporated in the concept. CONCLUSION An in-depth understanding and a broad conceptual foundation of womancentered care has evolved. Now, the concept is ready for research and educational purposes as well as for practical utility.

Traumatic childbirth experiences: practice‐based implications for maternity care professionals from the woman's perspective

“…Optimal care can be achieved when maternity care professionals critically evaluate and reflect on the intrapartum care they give, their overall attitude, counselling competencies, their views on the woman-midwife relationship and on communication and shared decision-making processes (23,24,28). Care practices that maternity professionals should be aware of are as follows: the application of informed consent procedures (22,23), the interaction and communication with the woman (24,26), the provision of transparent care and information (3) and to involve and empower the woman (27). Reflection of the maternity care professional on whether the woman is part of her own birthing process and experience seems a major issue (9).…”

“…In addition, reflection is needed on the way care professionals communicate, explain and provide emotional and practical support during labour (9,12,13). These dynamics coincide with woman-centred care, a model of care that is based on humanity that recognises the importance of the dialogue between the woman and the midwife as well as the value and importance of women's experiences during childbirth (24 Women felt unsupported in how to cope with changes and events during the birth process. No professional information was given about management of care or what the expected course of labour was.…”

“…Interpersonal or intrapersonal self-disclosure has proven to be effective in reducing pregnancy and birth-related anxiety (30). Discussing personal values and beliefs about pregnancy, birth and parenthood seem of importance in the woman-healthcare professional relationship (24). As standards of birth often root in a social and cultural context, group antenatal care (i.e.…”

Using a quality care framework to evaluate user and provider experiences of maternity care: A comparative study

“…This factor has also been identified in the Netherlands (Posthumus et al 2013) and elsewhere in the UK (Aquino et al 2015). It seems intuitive that tailored care is much more likely within the relational context of continuity of carer (Fontein-Kuipers et al 2018). It was notable that it was the senior midwives who raised this issue.…”

The International Childbirth Initiative: 12 steps to safe and respectful MotherBaby–Family maternity care

“…The ICI acknowledges and welcomes the ongoing development of care models that have shifted the traditional medical model of care to a value‐based model grounded in partnership between provider and user, in which the health needs and expectations of the care recipient, as well as the desired health outcomes, are the driving forces behind decision‐making and quality measurements . This is especially applicable to maternal and newborn care in the context of woman‐centred care, where there is a natural link to the full scope of care provided by midwives and other maternal and newborn healthcare providers …”