Abstract

Background - Maternity care in Gauteng and South-Africa is at a crossroad: the public sector is overburdened, intervention rates are high in the private sector, and private obstetrician-led care is expensive. Midwife-led care has proven to be a safe model of maternity care, their outcomes and interventions compared well with the rest of the world, and is more affordable (Jordaan, 2015), but midwives need the backup of obstetricians and pediatricians when risk factors or complications arise. Obstetricians and pediatricians in the private sector tend to be ‘risk averse' and have a different philosophy about the ‘normalcy' of pregnancy and birth. To align with the global priorities in maternity care and to ensure quality of care, midwives, obstetricians and pediatricians cannot function optimally in their own silos, but they must collaboratively aim for evidence-based, women-centered care to ensure the safety and quality of care. Outcomes as well as satisfaction of care is thus affected by the way in which midwives, obstetricians and pediatricians communicate and collaborate regarding shared responsibilities.

Purpose - With this presentation the presenter aims to reflect on the barriers and facilitators for inter-professional collaboration and woman-centeredness in the promotion of safe outcomes for mothers and babies in midwife-led private practice.

Methods - This is a personal reflection of the presenter as an independent midwife on the barriers and facilitators for inter-professional collaboration in midwife-led care from seven years' experience. The personal reflection is compared with the evidence reported globally on barriers and facilitators, and how to break the silos down.

Results - Independent midwife-led care is expanding in South Africa, but they need to collaborate with obstetricians and pediatricians when there are complications during birth. Where there is inter-professional collaboration, low risk mothers and babies are referred to a safe, evidence-based, more affordable and women-centered service, while mothers and babies with complications benefit from a more intervention-based service. Important barriers to inter-professional collaboration include breakdown in communication, when midwives are expected to adhere to an intervention prone system of maternity care, and lack of mutual respect. Facilitators include mutual respect and understanding of each other's approach, open communication and learning with and from each other. Conclusions Inter-professional collaboration between independent midwives, obstetricians and pediatrician is important for optimal outcomes of mothers and babies. Implications Strategies should be formulated to establish inter-professional collaboration between midwife-led and obstetrician-led practices to benefit mothers and babies.

Author Details

Christãl Jordaan, MCur, Independent Midwife at Midwives Exclusive, Pretoria, South Africa

Sigma Membership

Tau Lambda at-Large

Lead Author Affiliation

Midwives Exclusive, Pretoria, South Africa

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Other

Keywords:

Mid-wife Led Care, Multidisciplinary Collaboration, Maternity Care

Conference Name

Inter-professional Education and Collaborative Practice for Africa Conference

Conference Host

Tau Lambda at-Large Chapter of Sigma Theta Tau International||Amref International University||WHO-FIC Collaborating Centre for the African region||Africa Interprofessional Education Network (AfrIPEN)||WHO Regional Office for Africa

Conference Location

Nairobi, Kenya

Conference Year

2019

Rights Holder

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Faculty/Mentor Approved: Sigma Academy Participant Poster

Acquisition

Proxy-submission

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Reflections on barriers and facilitators for inter-professional collaboration in independent midwife-led care

Nairobi, Kenya

Background - Maternity care in Gauteng and South-Africa is at a crossroad: the public sector is overburdened, intervention rates are high in the private sector, and private obstetrician-led care is expensive. Midwife-led care has proven to be a safe model of maternity care, their outcomes and interventions compared well with the rest of the world, and is more affordable (Jordaan, 2015), but midwives need the backup of obstetricians and pediatricians when risk factors or complications arise. Obstetricians and pediatricians in the private sector tend to be ‘risk averse' and have a different philosophy about the ‘normalcy' of pregnancy and birth. To align with the global priorities in maternity care and to ensure quality of care, midwives, obstetricians and pediatricians cannot function optimally in their own silos, but they must collaboratively aim for evidence-based, women-centered care to ensure the safety and quality of care. Outcomes as well as satisfaction of care is thus affected by the way in which midwives, obstetricians and pediatricians communicate and collaborate regarding shared responsibilities.

Purpose - With this presentation the presenter aims to reflect on the barriers and facilitators for inter-professional collaboration and woman-centeredness in the promotion of safe outcomes for mothers and babies in midwife-led private practice.

Methods - This is a personal reflection of the presenter as an independent midwife on the barriers and facilitators for inter-professional collaboration in midwife-led care from seven years' experience. The personal reflection is compared with the evidence reported globally on barriers and facilitators, and how to break the silos down.

Results - Independent midwife-led care is expanding in South Africa, but they need to collaborate with obstetricians and pediatricians when there are complications during birth. Where there is inter-professional collaboration, low risk mothers and babies are referred to a safe, evidence-based, more affordable and women-centered service, while mothers and babies with complications benefit from a more intervention-based service. Important barriers to inter-professional collaboration include breakdown in communication, when midwives are expected to adhere to an intervention prone system of maternity care, and lack of mutual respect. Facilitators include mutual respect and understanding of each other's approach, open communication and learning with and from each other. Conclusions Inter-professional collaboration between independent midwives, obstetricians and pediatrician is important for optimal outcomes of mothers and babies. Implications Strategies should be formulated to establish inter-professional collaboration between midwife-led and obstetrician-led practices to benefit mothers and babies.