Labouring Together: Clinicians' experiences of working together to get the best outcomes in maternity care.

Abstract

Interprofessional collaboration (IPC) is crucial for the safe provision of maternity care. However, IPC is poorly understood in the maternity care context, and the role of the childbearing woman within this collaboration remains unclear. The Labouring Together study used a mixed method, multi-site case study design to explore IPC and decision-making with women from the perspectives of maternity health care professionals (HCP). Case studies included a range of maternity models of care in metropolitan and regional settings in Australia. Cross-sectional surveys were used to investigate organizational context and HCPs' attitudes toward collaboration. Experiences and perceptions of collaboration and decision-making were explored using in-depth semi-structured interviews. A conceptual framework "Experience of collaboration: Working together to get the best outcomes" was formed from the interview findings, with major themes of "Organisation of care: working together for the organisation" and "Partnering in care: working together with women." Individual-level behaviors were employed by HCP to transcend interprofessional tensions relating to IPC. Entrenched organizational and policy-level barriers to effective IPC were identified; and whilst participants agreed that women should have autonomy with decision-making, most identified barriers at multiple levels to achieving this ideal.