Is it possible to incorporate evidence-based professional midwifery practices into public health services in Mexico? |
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| Institution: | 1. Division of Determinants and Challenges of Health Systems, Centre for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico;2. Division of Reproductive Health, Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico;1. Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;2. Erasmus University Rotterdam, Erasmus School of Health Policy & Management, Rotterdam, The Netherlands;3. Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, The Netherlands;4. Centre for Psychological Wellbeing and Pregnancy, Amsterdam, The Netherlands;5. School of Health Professions Education (SHE), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands;1. Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia;2. Gold Coast University Hospital, Griffith University, Gold Coast, Australia;3. SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia;4. Burnet Institute, Melbourne, Victoria, Australia;5. Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia;6. Institute for Social Science Research, The University of Queensland, Brisbane, Australia;7. Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia;8. University of Sydney, Sydney, NSW, Australia;9. Kolling Institute of Medical Research, University of Sydney, NSW, Australia;10. The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia;11. Safer Care Victoria, Department of Health and Human Services, Melbourne, Victoria, Australia;1. Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany;2. Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany;3. Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Germany;4. Clinic for Gynecology and Obstetrics, HELIOS University Clinic, Wuppertal, University Witten/Herdecke, Germany |
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| Abstract: | Problem and backgroundDuring the past two decades, Mexico has launched innovative maternal health initiatives to improve maternal and neonatal outcomes, placing emphasis on the incorporation of professional midwifery practices into the healthcare system. This study explored the perceptions of healthcare providers and women using public birth care services regarding professional midwifery practices and how can the inclusion of evidence-based midwifery techniques improve the quality of service.MethodologyWe conducted a qualitative, cross-sectional study of three healthcare networks in Mexico. A content analysis was performed of data collected through 109 semi-structured interviews: 72 with healthcare providers and 37 with women.ResultsHealthcare providers and women had minimal knowledge of the competencies and skills of professional midwives. Medical personnel accepted the incorporation of some evidence-based midwifery practices. Women had experienced fear and anguish during childbirth so they considered that incorporating professional midwifery practices into maternal health services would be favourable in that it would render birth care more respectful.Discussion and conclusionsHealthcare providers are willing to consider the inclusion of some evidence-based midwifery practices in health services and regard assistance from professional midwives. They believe that structural conditions will complicate their incorporation. Although the women interviewed had experienced fear, anxiety and loneliness during childbirth, most of them admitted to feeling “safer” in a hospital (secondary-care health centre) setting where possible complications could be resolved. This perception of safety served to justify the delivery of healthcare in a manner that is inattentive to women’s needs, which go beyond biomedical issues and include emotions and the positive experience of childbirth. |
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| Keywords: | Midwifery Childbirth Evidence-based practice Quality of health care Mexico |
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