Abstract
To clarify the state of coordination and collaboration between midwives and
obstetricians during in-hospital birth center, we conducted individual, semi-structured
interviews with midwives and obstetricians with professional experience. Each subject was
interviewed for approximately 30 minutes, during which they were asked about their
experience of transferring parturient women to the obstetrics ward from the in-hospital birth
center due to weak pains. The interviews mainly focused on the process up until a final
decision on ward transfer and what factors were prioritized in the decision making. As a
result, it was found that obstetricians left substantial decision-making on ward transfer to
midwives; the obstetricians gave the explanations regarding ward transfer to the parturient
women and their family members; the ward transfer during the day shift was a factor
prioritized in making a decision by both midwives and obstetricians; and facility standards on
transfer from in-hospital birth center to obstetric ward were set in each hospital, but they
were not strictly enforced and were applied in accordance with the situation. Thus, it appears
that the switch from midwife-led birth to obstetrician-led birth was made swiftly based on
judgment by midwives, and the day shift was of priority due to management system issues.
Results also suggested that the ward structure influenced decisions on ward transfer.
