Safe Maternity Care: The Perspectives of Childbearing Women and Healthcare Professionals
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The aim of this study was to enable a deeper understanding of safe maternity care as well as to develop, implement and evaluate an intervention to identify women’s and healthcare professionals’ experiences and perceptions of safe childbirth. This was achieved by exploring the meaning of women’s and healthcare professionals’ experiences and perceptions of safe and unsafe childbirth (Papers I and II) and healthcare professionals’ perceptions of what supports or hinders communication and teamwork, as well as how communication and teamwork promote safe maternity care (Paper II). In addition, the implementation and evaluation of the intervention highlighted the reasons for healthcare professionals’ unsafe actions (Papers II and III), including those behind decision-making intended to ensure safe care (Paper III). Data were collected by means of individual and focus groups interviews. The empirical findings from the perspectives of the women revealed the need to be informed, involved and guided through the childbirth process in order to experience safe maternity care (Paper I). From the perspectives of the healthcare professionals, the findings demonstrated the importance of promoting interprofessional teamwork and building capabilities by involving healthcare professionals and elucidating relevant strategies. The findings highlight the importance of facilitating trusting relationships to ensure a safe environment that enables the provision of safe maternity care (Paper II). In addition, the consequences of what managers do or fail to do constitute the meaning of taking responsibility for team collaboration to provide safe care (Paper III). The overall interpretation is based on the empirical findings. The hermeneutic interpretation, theoretical analysis and explanation enabled a deeper understanding. A pattern of dimensions emerged: Fear of childbirth versus feeling safe, Receptivity versus obligation to inform and Mistrust versus trusting relationships. In conclusion, a trusting professional relationship means being confirmed, respected and cared for. A prerequisite is the will and ability to create a trusting relationship that strengthens childbearing women’s confidence in the birth process by enabling them to participate in decision-making about care interventions. In contrast, mistrust evokes fear, despair and deprivation, resulting in meaninglessness and lack of trust in the relationship. It implies that the will and ability to provide information do not exist, thereby increasing unsafe care.
Has partsPaper I: Rönnerhag, M., Severinsson, E., Haruna, M. & Berggren, I. (2018). Qualitative study of women´s experiences of safe childbirth in maternity care. Nursing & Health Sciences, 20, 331-337. doi: 10.1111/nhs.12558
Paper II: Rönnerhag, M., Severinsson, E., Haruna, M. & Berggren, I. (2019). A qualitative evaluation of healthcare professionals’ perceptions of adverse events focusing on communication and teamwork in maternity care. Journal of Advanced Nursing, 75, 585-593. doi: 10.1111/jan.13864
Paper III: Rönnerhag, M., Severinsson, E., Haruna, M. & Berggren, I. (2019). Risk Management – evaluation of healthcare professionals’ reasoning about and understanding of maternity care. Journal of Nursing Management, 1-10. doi: 10.1111/jonm.12778