Advertisement

Model of care matters: An integrative review

Published:January 13, 2023DOI:https://doi.org/10.1016/j.wombi.2022.12.007

      Abstract

      Background

      Pregnant women are entitled to quality care during pregnancy. Some health districts offer a variety of maternity care models but, not all women are aware of what is available and there is limited research on the experiences of women within their chosen or allocated model of care.

      Aim

      The aim of this integrative review is to explore the available literature on women’s experiences of the model of care accessed during pregnancy.

      Method

      A database search of CINAHL, MEDLINE, SCOPUS, OVID, JBI and Cochrane Database was conducted to identify original research articles published in English between 2011 and 2021. In total, 20 articles met the inclusion criteria.

      Findings

      The included papers came from nine different countries and reported on eight different models of care. Following analysis of the articles one overarching theme ‘Model of care matters’, and six sub themes were identified: 1.‘Choosing a model’, 2.‘Learning about pregnancy and birth’, 3.‘Being known’, 4.‘Making social and emotional connections’, 5.‘Receiving enabling or disabling care’ and 6.‘Integrated care is best’. Some women disclosed that they had no choice in the model they were allocated, while others stated they were not provided with information about all available models of care.

      Conclusion

      A lack of integrated care between medical and midwifery models led to feelings of dissatisfaction and distress during pregnancy. Positive experiences were reported when women developed a connection with the care provider. The development of a well-informed decision aid could alleviate deficits of information, and clarify the subtle differences that occur within various models.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Beaverton: Ringgold Inc; 2017.

        • Homer C.S.E.
        • Foureur M.J.
        • Allende T.
        • Pekin F.
        • Caplice S.
        • Catling-Paull C.
        ‘It's more than just having a baby’ women's experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families.
        Midwifery. 2012; 28: e509-e515
        • Donnolley N.
        • Butler-Henderson K.
        • Chapman M.
        • Sullivan E.
        The development of a classification system for maternity models of care.
        Health Inf. Manag. J. 2016; 45: 64-70
        • Yuill C.
        • McCourt C.
        • Cheyne H.
        • Leister N.
        Women's experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research.
        BMC Pregnancy Childbirth. 2020; 20: 343
        • Rogers H.J.
        • Hogan L.
        • Coates D.
        • Homer C.S.E.
        • Henry A.
        Responding to the health needs of women from migrant and refugee backgrounds—models of maternity and postpartum care in high‐income countries: A systematic scoping review.
        Health Soc. Care Community. 2020;
        • 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. 2016;
        • Sutcliffe K.
        • Caird J.
        • Kavanagh J.
        • et al.
        Comparing midwife-led and doctor-led maternity care: a systematic review of reviews.
        J. Adv. Nurs. (John Wiley Sons, Inc. ). 2012; 68: 2376-2386
        • Talukdar S.
        • Dingle K.
        • Miller Y.D.
        A scoping review of evidence comparing models of maternity care in Australia.
        Midwifery. 2021; : 99
      2. Goncalves A.S., Ferreira I.M., Pestana-Santos M., Prata A.P., McCourt C. Antenatal care policies for low-risk pregnant women in high-income countries with a universal health system: a scoping review protocol: JBI Evidence Synthesis. 18(7):1537–1545,July 2020.; 2020.

        • Perriman N.
        • Davis D.L.
        • Ferguson S.
        What women value in the midwifery continuity of care model: A systematic review with meta-synthesis.
        Midwifery. 2018; 62: 220-229
        • Symon A.
        • Pringle J.
        • Cheyne H.
        • et al.
        Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care.
        BMC Pregnancy Childbirth. 2016; 16: 1-15
        • Downe S.
        • Finlayson K.
        • Tunçalp Ö.
        • Gülmezoglu A.M.
        Provision and uptake of routine antenatal services: a qualitative evidence synthesis.
        Cochrane Database Syst. Rev. 2019;
        • Brock E.
        • Charlton K.E.
        • Yeatman H.
        Identification and evaluation of models of antenatal care in Australia - A review of the evidence.
        Aust. N. Z. J. Obstet. Gynaecol. 2014; 54: 300-311
      3. Critical Appraisal Skills Programme (CASP) Checklist. Critical Appraisal Skills Programme UK (2018) CASP checklists UK.

        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6 (e1000097-e)
        • Whittemore R.
        • Knafl K.
        The integrative review: updated methodology.
        J. Adv. Nurs. (Wiley-Black ). 2005; 52: 546-553
        • Stevens G.
        • Thompson R.
        • Kruske S.
        • Watson B.
        • Miller Y.D.
        What are pregnant women told about models of maternity care in Australia? A retrospective study of women's reports.
        Patient Educ. Couns. 2014; 97: 114-121
        • Butler M.M.
        • Sheehy L.
        • Kington M.
        • et al.
        Evaluating midwife-led antenatal care: Choice, experience, effectiveness, and preparation for pregnancy.
        Midwifery. 2015; 31: 418-425
        • McNeil D.A.
        • Vekved M.
        • Dolan S.M.
        • Siever J.
        • Horn S.
        • Tough S.C.
        Getting more than they realized they needed: A qualitative study of women's experience of group prenatal care.
        BMC Pregnancy Childbirth. 2012; : 12
        • Lucas C.
        • Charlton K.
        • Brown L.
        • Brock E.
        • Cummins L.
        Review of patient satisfaction with services provided by general practitioners in an antenatal shared care program.
        Aust. Fam. Physician. 2015; 44: 317-321
        • Mattern E.
        • Lohmann S.
        • Ayerle G.M.
        Experiences and wishes of women regarding systemic aspects of midwifery care in Germany: a qualitative study with focus groups.
        BMC Pregnancy Childbirth. 2017; 17: 1-16
        • Symon A.
        • McFadden A.
        • White M.
        • Fraser K.
        • Cummins A.
        Using the Quality Maternal and Newborn Care Framework to evaluate women's experiences of different models of care: A qualitative study.
        Midwifery. 2019; 73: 26-34
        • Hunter L.J.
        • Da Motta G.
        • McCourt C.
        • et al.
        Better together: A qualitative exploration of women's perceptions and experiences of group antenatal care.
        Women Birth. 2019; 32: 336-345
        • Andersson E.
        • Christensson K.
        • Hildingsson I.
        Comparison of parental stress six months after birth in parents receiving group based antenatal care or standard antenatal care-clinical trial.
        Arch. Women'S. Ment. Health. 2015; 18: 296-297
        • Novick G.
        • Sadler L.S.
        • Kennedy H.P.
        • Cohen S.S.
        • Groce N.E.
        • Knafl K.A.
        Women’s Experience of Group Prenatal Care.
        Qual. Health Res. 2011; 21: 97-116
        • Swift E.M.
        • Zoega H.
        • Stoll K.
        • Avery M.
        • Gottfreðsdóttir H.
        Enhanced Antenatal Care: Combining one-to-one and group Antenatal Care models to increase childbirth education and address childbirth fear.
        Women Birth. 2021; 34: 381-388
        • Symon A.
        • Pringle J.
        • Cheyne H.
        • et al.
        Midwifery-led antenatal care models: Mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care.
        BMC Pregnancy Childbirth. 2016; 16: 1
        • Beake S.
        • Acosta L.
        • Cooke P.
        • McCourt C.
        Caseload midwifery in a multi-ethnic community: The women's experiences.
        Midwifery. 2013; 29: 996-1002
        • Allen J.
        • Kildea S.
        • Tracy M.B.
        • Hartz D.L.
        • Welsh A.W.
        • Tracy S.K.
        The impact of caseload midwifery, compared with standard care, on women's perceptions of antenatal care quality: Survey results from the [email protected] randomized controlled trial for women of any risk.
        Birth. 2019; 46: 439-449
        • Brown S.J.
        • Weetra D.
        • Glover K.
        • et al.
        Improving Aboriginal women's experiences of antenatal care: findings from the Aboriginal families study in South Australia.
        Birth. 2015; 42: 27-37
        • Floris L.
        • Irion O.
        • Bonnet J.
        • Politis Mercier M.-P.
        • de Labrusse C.
        Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction.
        Women Birth. 2018; 31: 124-133
        • Forster D.A.
        • McLachlan H.L.
        • Davey M.A.
        • et al.
        Continuity of care by a primary midwife (caseload midwifery) increases women's satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial.
        BMC Pregnancy Childbirth. 2016; 16: 28
        • Josif C.M.
        • Barclay L.
        • Kruske S.
        • Kildea S.
        'No more strangers': Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia.
        Midwifery. 2014; 30: 317-323
        • Teate A.
        • Leap N.
        • Rising S.S.
        • Homer C.S.E.
        Women's experiences of group antenatal care in Australia—the CenteringPregnancy Pilot Study.
        Midwifery. 2011; 27: 138-145
        • Brown S.J.
        • Weetra D.
        • Glover K.
        • et al.
        Improving aboriginal women's experiences of antenatal care: Findings from the Aboriginal families study in South Australia.
        Birth: Issues Perinat. Care. 2015; 42: 27-37
        • Brown Sutherland
        • Gunn G.A.
        • Yelland JS J.M.
        Changing models of public antenatal care in Australia: Is current practice meeting the needs of vulnerable populations.
        Midwifery. 2014; 30: 303-309
        • Keedle H.
        • Peters L.
        • Schmied V.
        • Burns E.
        • Keedle W.
        • Dahlen H.G.
        Women's experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia.
        BMC Pregnancy Childbirth. 2020; 20: 1
        • Donnolley N.R.
        • Chambers G.M.
        • Butler-Henderson K.A.
        • Chapman M.G.
        • Sullivan E.A.
        More than a name: Heterogeneity in characteristics of models of maternity care reported from the Australian Maternity Care Classification System validation study.
        Women Birth. 2017; 30: 332-341
        • Baldwin A.
        • Harvey C.
        • Willis E.
        • Ferguson B.
        • Capper T.
        Transitioning across professional boundaries in midwifery models of care: A literature review.
        Women Birth. 2019; 32: 195-203
        • Seal A.N.
        • Hoban E.
        • Panzera A.
        • McGirr J.
        Birthing in regional Australia: women's decision making surrounding birthplace.
        Aust. Health Rev. 2021; 45: 570-577
        • Davison C.
        • Hauck Y.L.
        • Bayes S.J.
        • Kuliukas L.J.
        • Wood J.G.
        The relationship is everything: Women's reasons for choosing a privately practising midwife in Western Australia.
        Midwifery. 2015; 31: 772-778
        • Dahlen H.G.
        • Downe S.
        • Jackson M.
        • Priddis H.
        • de Jonge A.
        • Schmied V.
        An ethnographic study of the interaction between philosophy of childbirth and place of birth.
        Women Birth. 2021; 34: e557-e566
        • Wyles K.
        • Miller Y.D.
        Does it get better with age? Women's experience of communication in maternity care.
        Women Birth. 2019; 32: e366-e375
        • O'Brien D.
        • Butler M.M.
        • Casey M.
        The importance of nurturing trusting relationships to embed shared decision-making during pregnancy and childbirth.
        Midwifery. 2021; 98 (N.PAG-N.PAG)
        • Buultjens M.
        • Farouque A.
        • Karimi L.
        • Whitby L.
        • Milgrom J.
        • Erbas B.
        The contribution of group prenatal care to maternal psychological health outcomes: A systematic review.
        Women Birth. 2021; 34: e631-e642
        • Fernandez Turienzo C.
        • Rayment‐Jones H.
        • Roe Y.
        • et al.
        A realist review to explore how midwifery continuity of care may influence preterm birth in pregnant women.
        Birth: Issues Perinat. Care. 2021; 48: 375-388
        • Pao C.
        • Guintivano J.
        • Santos H.
        • Meltzer-Brody S.
        Postpartum depression and social support in a racially and ethnically diverse population of women.
        Arch. Women'S. Ment. Health. 2019; 22: 105-114
        • Rocca‐Ihenacho L.
        • Yuill C.
        • McCourt C.
        Relationships and trust: Two key pillars of a well‐functioning freestanding midwifery unit.
        Birth: Issues Perinat. Care. 2021; 48: 104-113
        • Davis-Floyd R.
        • Gutschow K.
        • Schwartz D.A.
        Pregnancy, Birth and the COVID-19 Pandemic in the United States.
        Med. Anthropol. 2020; 39: 413-427
        • Styles C.
        • Kearney L.
        • George K.
        Implementation and upscaling of midwifery continuity of care: The experience of midwives and obstetricians.
        Women Birth. 2020; 33: 343-351
        • Stevens G.
        • Miller Y.D.
        • Watson B.
        • Thompson R.
        Choosing a Model of Maternity Care: Decision Support Needs of Australian.
        Women Birth: Issues Perinat. Care. 2016; 43: 167-175
        • Stacey D.
        • Légaré F.
        • Lewis K.
        • et al.
        Decision aids for people facing health treatment or screening decisions.
        Cochrane Database Syst. Rev. 2017;
        • Hindmarsh C.
        • Davis D.L.
        A Decision Aid for midwifery continuity of care: Development and pilot acceptability testing.
        Women Birth. 2021; 34: e624-e630