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Journal of Nursing Research and Practice

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A grounded theory research using constructivism: Midwifery continuity of care models are being implemented

Author(s): Arnold Winfield*

When women and their newborns are supported by midwifery continuity of care approaches, strong international data shows that they have much better outcomes. Despite this, widespread deployment, particularly in regional settings, has yet to be achieved. To gain a theoretical understanding of the elements that help or hinder the adoption of midwifery continuity models in different regions. The data from 34 interviews with key informants from regional public hospitals was collected and analysed using a Constructivist Grounded Theory approach. 'Engaging the gatekeepers,"midwives lacking confidence,' and 'women rallying together' were three theory notions that arose. A substantive theory emerged from the notions of theory and sub-categories: For major hospital stakeholders to invest in the implementation of midwifery continuity of care models, a collaboration between midwives and women is required to establish confidence and enable the promotion of current evidence. The outcomes of this study imply that midwives and women can have a big say in how midwifery continuity models are implemented in their local maternity facilities, especially in regional settings. Midwives' apprehension about transitioning stems from a lack of confidence and understanding of what it's like to operate in midwifery continuity models. Women, too, require education to raise awareness of the benefits of continuity of care, and a collaboration between women and midwives can be a powerful political force in overcoming many of the obstacles. To improve knowledge of the benefits of midwifery continuity of care, a coordinated ground-up approach is required, in which midwives collaborate with women and promote wider dissemination of evidence for this model, directed at consumers, midwives, and hospital management.


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