Experiences of woman- centered care among Iranian midwives and women: a qualitative study

Résumé fourni par la source

Woman-centered care (WCC) is a recognized quality marker in maternity services, but its implementation in Iran is challenging due to high intervention levels and professional conflicts. This study was conducted with the aim of exploring the experience of woman- centered care among Iranian midwives and women, in Tabriz, Iran. This qualitative study was conducted on 15 midwives working in urban health centers, public and private hospitals, and 10 pregnant/postpartum women under their care the period from March to June 2023 in Tabriz, Iran. Midwives who were among the extreme cases (the top 10% and bottom 10% of the overall WCC score from the quantitative phase) and were willing and able to share their experiences regarding WCC were included. The inclusion criteria for pregnant and postpartum women in the study included willingness to participate, being at least 18 years old, and having utilized maternity and childbirth services during their pregnancy. Data collection was carried out through purposive sampling and semi-structured, in-depth face-to-face interviews using an interview guide. Data collection continued until no new codes/main themes in consecutive interviews were identified. Data analysis was conducted using the conventional content analysis. The results of the study led to the identification of 2 conceptual domains, “The characteristics of WCC” and “The implementation pathway of WCC”, and 8 and 3 main themes among midwives and 6 and 3 main themes among pregnant/postpartum women, respectively. The findings of this study provide good practical guidance for health system decision-makers and policymakers for designing strategic programs in the country’s healthcare systems. They can also help enhance the capabilities of midwives in providing quality care to women. Furthermore, the findings of the present study appear to be essential for guiding and managing midwifery students in clinical settings, enabling them to provide high-quality care to pregnant and postpartum women. Woman-Centered Care (WCC) empowers women by ensuring their choice and control during childbirth. It is operationalized through trusted relationships and collaborative, evidence-based decision-making. This approach enables women to navigate complex health systems, recognize their own capabilities, and ultimately improves health outcomes for both mother and newborn. Despite the studies conducted in this area and the emphasis on implementing WCC in the clinical setting, there is limited information regarding the experiences of midwives providing services and the women receiving those services in Iran. Therefore, we interviewed 15 midwives working in health centers, public and private hospitals, and 10 pregnant/postpartum women to explore their experience about WCC and its related factors in Tabriz, Iran. Our qualitative study findings revealed 2 conceptual domains, “The characteristics of WCC” and “The implementation pathway of WCC” among midwives and pregnant/postpartum women. Given the multifaceted nature of woman-centered care, integrating the experience of both midwives and the women under their care is a crucial and foundational step. The findings offer direct benefits for women, midwives, and the health system by providing practical guidance to policymakers for designing better programs. Ultimately, this enhanced guidance enables midwives to deliver higher-quality care, improving health outcomes for women and reducing health system costs.

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