Study on collaboration of midwives with obstetricians:

With special focus on midwifery autonomy

Abstract

Purpose
This study aimed to understand the professional autonomy of midwives and identify influential factors regarding the collaborative relationship of midwives and obstetricians. Through these analyses, it finally attempted to gain suggestions for a desired direction to improve current maternity care systems by finding ways of enhancing collaboration between the two professions.
Method
This study employed a cross-sectional, quantitative approach using self-administered questionnaires that were sent to and collected from randomly-selected, full-time midwives with over three years working experience who are currently practicing midwifery at medical facilities providing parturient care. Quantitative analysis was carried out based on the basic attributes of the responding midwives and the levels of their professional autonomy, collaboration with obstetricians in medical care decision-making, and satisfaction in the decision-making process.
Results
A total of 578 midwives responded to the questionnaire (total response rate: 59.5%).
Midwifery autonomy showed positive correlations with age, position, years of midwifery experience, years of current employment, and the number of midwifery cases. Collaboration between midwives and obstetricians was positively correlated with the position of midwives and the number of midwifery cases.
Midwives with a higher autonomy level showed a high level of collaboration with obstetricians, which revealed a positive correlation between professional autonomy and collaboration.
In addition, midwives practicing at in-hospital birth centers were found to mark higher in professional autonomy and significantly higher in collaboration with obstetricians, compared with those working outside of hospitals.
Conclusion
The results suggest that the accumulation of midwifery clinical practice and experience is one of the factors necessary to nurture the professional autonomy of midwives. They also suggest that, to further promote the collaborative relationship with obstetricians, midwives should develop qualities and abilities required of team leaders, acquire proficient midwifery skills, and enhance midwifery autonomy as a medical profession. In particular, midwives at in-hospital birth centers showed high levels of professional autonomy and collaboration with obstetricians, which are considered indispensable for maternity care. This suggests that the increased use of midwives with professional autonomy and ability to work with other professions will contribute a great deal to the development of an effective maternity care system for mothers and newborns.