What midwives think of collaboration with doctors at health check-up for pregnant women

Abstract

Purpose: The purpose of the study was to assess the thoughts and feelings of midwives collaborating with physicians to conduct prenatal health check-ups. Methods: The present study was a qualitative descriptive study. Between July and August 2010, semi-structured interviews of five midwives working in hospitals in the Kanto area who provide midwifery outpatient services, including health check-ups for pregnant women, were conducted. Codes were allocated to the interview results, and they were compared, analyzed, and organized according to the theme and story line. Results: When working together with physicians to conduct prenatal health check-ups, midwives felt a “sense of responsibility to provide midwifery outpatient services and were in fear of overlooking abnormal signs”. At the same time, they thought that “the task is challenging because they can acquire experiences and improve their skills” in midwifery outpatient practice. They felt “a sense of security when collaborating with physicians to provide pregnant women with outpatient services in midwifery practice”, and recognized that “standards for midwifery outpatient services serve as a link between midwives and physicians”. However, regarding collaboration with physicians in the implementation of maternal health check-ups, midwives had “difficulty and dilemma sharing their roles with physicians in providing pregnant women with care because it should be managed cooperatively”. Some midwives thought that “they caused inconvenience to patients when they felt hesitant in the presence of a physician”, and others had “difficulty providing midwifery outpatient care in the presence of a physician - a superior health care professional”. Some midwives even thought that “midwifery outpatient services are a useful tool for physicians in outpatient practice”. Conclusion: When collaborating with physicians to conduct prenatal health check-ups, midwives felt a sense of responsibility and were afraid of overlooking abnormal signs, although they considered the task as challenging and felt a sense of security in the presence of a physician. However, midwives had difficulty and faced with a dilemma when they had to share their roles with physicians in providing care, and they were hesitant to make their own decisions.