Maternity care interventions and trends

Background and purpose

Nearly five million women experience childbirth in Europe each year. There are, however, major differences in maternity care cultures, interventions used and health outcomes. Many studies have identified financial, organizational or personal barriers to e.g. prenatal care as was shown in an European study concerning ten countries by Delvaux et al. 2001 (see also EuroPeristat 2008). Personal, health services organization, or cultural problems are important to understand and need to be addressed. Also patient safety is the concern globally as birth injuries have been chosen one of the indicators for patient safety in OECD countries as well as by WHO. Routine and technological interventions shape prenatal and labour care and have long term effects on women's health. Specific examples include prenatal diagnosis and the overuse of caesarean section, induction of labour or other interventions such as episiotomy. We need information of trends, organizational culture and policy behind interventions used.

Maternity services research program has its roots in the 1980’s. During 1990’s studies of councelling models of mothers, fathers and families were studied with some international comparisons by the PI funded by the Academy of Finland. Several research methods have been used in the study such as observations, interviews, questionnaires, instruments, registers and analyzed by grounded theory, phenomenology, statistical methods as well as action research. International and national publications as well as dissertations have been produced of the study.

Purpose

The purpose of the present study is to get in-depth information of maternity care trends and policy behind interventions used in labour and delivery. The purpose is twofold; to ask “what is happening” and “why it is happening”. The first purpose is to describe and explain the trends in maternity care interventions by register based data. The ultimate aim is twofold: to obtain information of the outcomes and test new methodology. The second question is to analyze health professionals’ (midwives and obstetricians) as well as women’s ( from different cultures) views of the culture behind the use of maternity care interventions as well as existing care protocols or guidelines for professionals.

Research team

PI: Katri Vehviläinen-Julkunen, PhD, RN, RM, Professor, University of Eastern Finland,Department of Nursing Science and Kuopio University Hospital

The research team includes e.g. following collaborators:

  • Professor Seppo Heinonen, MD, PhD, University of Eastern Finland, Kuopio University Hospital (M)
  • Professor Mika Gissler, PhD, Dr.Pol.Sc., National Institute for Health and Welfare, Finland and Nordic School of Public Health, Gothenburg, Sweden, 
  • Filio Degni, PhD, Dr.Soc Sci, Medical sociology/Antropology, Post doctoral researcher, Dept of Public Health, University of Turku
  • Reeta Lamminpää, M.Sc., PhD student,National Post graduate school in Nursing Science
  • Sari Räisänen, PhD, Lecturer
  • two other PhD students and several MSc students, International Experts

Several international collaborators are involved : researcher from Europe and Asia. Currently, Katri Vehviläinen-Julkunen is a member of COST Action IS0907 activity funded by ESF for years 2011-2014 "Childbirth Cultures, Concerns and Consequences: Creating a dynamic EU framework for optimal maternity care" led by prof. Soo Downe, University of Lanchasire, GB and Nordic network Barnafödandet i Norden.