Exploration moving beyond medical facility walls: opportunities, challenges and attitudes of midwives towards planned homebirth: a qualitative study

Abstract

Background: The establishment of Saudi Vision 2030 has led to a shift from obstetric care to midwifery-led care in maternity care, giving rise to planned home birth (PHB). This study may enable midwives to carry out PHB and achieve the goals of the Saudi health vision. The general aim is to explore Saudi midwives’ attitudes towards the PHB, opportunities and challenges associated with PHB implementation in Saudi Arabia. Methods: We employed a qualitative study design and conducted interviews using open-ended questions with 19 Saudi midwives recruited from thirteen health regions. Thematic analysis was manually performed to analyze the qualitative data. Results: Thematic analysis revealed seven major themes: midwives as care providers in PHB, health institutions, academic institutions, national policy for PHB, Women’s health status, socio-economic and physical environment suitability, and maternal and neonatal health outcomes. However, Saudi midwives would exhibit a favorable attitude towards PHB if decision-makers from the Ministry of Health and the Ministry of Education addressed the challenges and promoted opportunities for providers, organizations, and the population. Conclusion: The findings of the thematic analysis shed light on several positive aspects, including job opportunities and high financial incomes for midwives. However, they also revealed challenges such as a shortage of midwifery staff, a scarcity of midwifery academic programs, and an ineffective administrative support system for midwives. Integrating both sets of findings enhances the understanding of the challenges and opportunities of planned home birth in Saudi Arabia from various perspectives, capturing the breadth and depth of the obtained data.