Midwives perspectives of barriers and facilitators for the practice of promoting women's positive childbirth experience in China: A qualitative study.

Abstract

Background: Women-centered care for positive childbirth experiences is currently a global trend. However, there are some barriers to promoting women's positive childbirth experiences in practice. This study explored midwives' perspectives on the barriers and facilitators to promoting women's positive childbirth experience in practice.

Methods: Qualitative semi-structured interviews were undertaken with 18 midwives in the birth unit of four tertiary care hospitals in Hefei, Anhui Province, China. Thematic analysis was used to code the interviews with deductive codes, and we organized findings according to levels of influence within the Dahlgren and Whitehead rainbow model, a socioecological model of health.

Result: Midwives reported barriers to women's positive childbirth experience were identified on four levels: individual factors included psychological barriers and childbirth expectations (micro level), social and community and organization factors included interpersonal violence, medical mistrust and obstetric violence and outcome (meso level), healthcare system factors included midwife shortage and hospital environment (macro level). Facilitators for a positive birth experience include antenatal education, community continuum of care, and respectful and understanding care.

Conclusion: This study indicated that midwives experienced several barriers and facilitators in providing positive childbirth experience care to women in the Chinese context. The findings will help maternity care providers and policymakers develop multi-level implementation strategies at the individual, social, community, organization, and healthcare system levels.