Woman-centred care

Changes over the past decade have emphasised the individual service user an d their relationship with the health service. Within the maternity services this has been interpreted as woman-centred care a result of key initiative s: the Winterton Report (House of Commons, 1992. Maternity Services. Second Report of the Health Committee (Winterton Report), Vol. 1. HMSO, London) a nd Changing Childbirth (DoH, 1993a, Changing childbirth: reports of the exp ert maternity group parts 1 & 2. HMSO. London). Changing Childbirth outline d key principles of the maternity services and the need for the woman land her partner, if she wishes) to be the focus of care. The key principles are choice, continuity and control. High quality care depends on the recogniti on of individuals as having unique needs which continues to be reflected wi thin contemporary policy documents (DoH, 1997, The new NHS: modern and depe ndable. HMSO, London). This paper presents findings related to the provision of woman-centred care from a national research and development study. The study design incorpora ted (i): a national survey which was undertaken with midwives, midwife supe rvisors and doctors; and (ii): in-depth case studies in which information w as obtained through interviews with midwives, midwife supervisors, educator s, managers, doctors and mothers. Midwives, at all levels, are involved in changing maternity service provision and adapting to new systems of care wh ich aim to increase continuity of care and carer for the woman. The researc hers sought to understand how woman-centred care was interpreted and experi enced in practice. The findings have been used to identify the continuing e ducational needs of midwives, and to develop an open learning educational p ackage to meet identified need. The curriculum was designed to enhance the move towards the provision of a more integrated woman-centred service. (C) 2001 Elsevier Science Ltd. All rights reserved.