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 “Resume Journal Kebidanan”

title : Woman-centred care: An integrative review of the empirical literature.

Authors : Brady S, Lee N, Gibbons K, Bogossian
Publication : International Journal of Nursing Studies Vol 94 Page 107-119
Date : 06/2019
DOI : 10.1016/j.ijnurstu.2019.01.001
URL : https://linkinghub.elsevier.com/retrieve/pii/S002074891930001X

Woman-centred care: An integrative review of the empirical literature

Midwifery care is focused on the unique needs, hopes and aspirations of individual women, rather
than the needs of the midwifery profession or institution. The International Confederation of
Midwives supports a partnership philosophy of women-centeredness, cultural sensitivity and
normalcy around birth; promotion of self-care, and the right to self-determination (International
Confederation of Midwives, 2017). The oft-cited woman-centered characterization of care proposed
by Nicky Leap also encapsulates the principles of choice, control, caregiver continuity, and adds the
right to self-determination. Leap (2009). Woman-centred care emerged in response to the increasing
medicalization of pregnancy and birth. thus giving birth to Care that describes women-centred care
as a process in which women have control, make choices, and involve all aspects of care and their
relationship with midwives

Woman-centred Care in Clinical Practice

women-centred care into midwifery practice for example by exploring the factors that influence
clinical decision-making and attitudes to promote physiologic delivery. seeks to understand first-time
mothers' perspectives on the 'good' midwife in childbirth, exploring the views of socially
disadvantaged women on barriers to participation in decision-making around their care. so that
women feel they have choices and control, women empowerment, activities that occur within the
practices that protect normal births, the relationships that midwives form with women as a way of
promoting women. women-centered care, and the characteristics of midwives who support women-
centered care.

Choice and Control

A key element of the provision of woman-centred care identified in the studies was that of the
woman having choice and control. The midwives in this study observed that women who had
received accurate and up-to-date information about delivery issues and the options available were
able to make informed choices. This study demonstrates a premise common across all studies of this
subtheme, that women's perceptions of choice and control can be influenced by models of care
provision

Empowerment

Empowerment requires involving women in shared decision-making taking into account their
individual preferences and needs during the provision of care. the goal of empowering women to feel
confident in their own abilities to give birth. Empowerment of women is achieved through building
trust, building relationships and working in mutually respectful partnerships empowerment,
described as “a state in which women and midwives can interact without fear of perceived or actual
psychological (or physical) harm and directly impact a woman's ability to engage. in decision making
and gain a sense of control”.

Protecting normal birth

It is important to maintain the physiology of pregnancy and childbirth by reassuring women that
pregnancy and childbirth are natural and normal processes. Midwives with a strong and positive
attitude towards the promotion of women-centred and physiological birth invest in empowering
women to make their own choices. Despite this view, normality of birth is often described in terms of
the absence of complications or medical intervention. In clinical practice, midwives uphold the
normality of birth and promote women-centred care by developing effective relationships with
women and working in partnerships.

Relationships
proposes a conceptual about what makes a midwife “good” in childbirth, suggesting that “when a
trusting relationship is established between women and midwives, mothers are more likely to have
positive memories of their birth experiences, midwives need to dedicate the necessary time to build
a trusting relationship. trusting relationship with individual women which includes knowing women,
listening, developing relationships and providing individualized care

The individual midwife

women expect that midwives should be able to “interpret knowledge, recommendations, and
guidelines based on each woman's individual preferences, providing woman-centred care rather than
procedure-centered care the personal attitude of the midwife is also important. “Being positive, calm
but confident, professional, sensitive and friendly” (p.678) are all seen as important components of
midwifery behavior. the way midwives can have a powerful effect on women in labour; they suggest
midwives should be aware that they have the power to influence both positive and negative birth
experiences

Woman-centred care in maternity service

The provision of maternity care services can also contribute to a woman-centred care experience.
This is reflected in the three sub-themes identified: models of care, continuity of care, and systems of
maternity care. when women are admitted into the medical system and labeled as “high risk”, it
stifles their selfconfidence and changes their perception of pregnancy as a normal physiological
process. provision of women-centered care such as "routine and frequent use of medical
interventions for all women" and "the power of physician orders controlling the basic care of care.
limits the ability of nurses to promote women's autonomy and offer choices during labor and birth,
elements of woman-centred care To address the medicalization of childbirth, midwives can
“collaborate with others when other care is needed

Continuity of care

Women-centred care provided by midwives is known to have a positive impact on maternal

satisfaction without any adverse outcomes “continuity noted as an important part of the trusted
female provider relationship” continuity comes in many forms, through a single provider during
pregnancy, shared philosophy and practice among physicians or alignment of antenatal and
intrapartum care.

Maternity care systems

identify systems that support or hinder the provision of women-centred care. The time allotted for
the provision of women-centred care in the maternity care system matters a lot. The maternity care
providers in this study identified “inadequate time for antenatal visits and systems that encourage
medical intervention.

Woman- centred care in education

education can be an effective approach to improving women-centred care practices

Registered practitioners

registered practitioner education that what emerged from their data was a common voice across
participants for “greater interprofessional understanding and emphasis on a shared ethos. midwife
advises that sharing of information is a shared responsibility of mother and midwife, recommends
individual or group teaching sessions, presented in the woman's own language

Citation :
Brady S, Lee N, Gibbons K, Bogossian F. Woman-centred care: An integrative review of the empirical
literature. Int J Nurs Stud. 2019 Jun;94:107-119. doi: 10.1016/j.ijnurstu.2019.01.001. Epub 2019 Jan
8. PMID: 30951986.