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- Antenatal care policies for low-risk pregnant women in high-income countries with a universal health system: a scoping review protocolPublication . Gonçalves, Andreia Soares; Ferreira, Isabel Maria; Pestana-Santos, Márcia; Prata, Ana Paula; McCourt, ChristineObjective: The aim of this scoping review is to map the available evidence on the nature, extent, and range of antenatal care policies for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model. Introduction: Low-risk women in high-income countries have good evolutionary perinatal outcomes but high intervention rates in pregnancy and childbirth, which ultimately leads to high morbidity. This has implications at all levels including families, the health care system, and society. This review aims to inform future policy and identify the viability of the adoption of alternative models to the Portuguese context that can reduce unnecessary interventions. Inclusion criteria: Studies, protocols, guidelines, and policies that provide guidance on antenatal care for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model (universal health care) will be considered. Documents from 2005 to present will be included, and no language restrictions will be imposed. Methods: An initial search will be conducted in databases including MEDLINE (via PubMed) and CINAHL (via EBSCOhost), followed by a manual search of the reference lists from the documents accepted for inclusion, and a hand search of gray literature. For the countries whose policies are not available through the earlier steps, key persons from health ministries and academia will be contacted. Search results will be exported and data extracted using charting forms. Data will be synthesized using narrative description.
- Barriers and facilitators to the implementation of a midwifery-led-care model: a qualitative systematic review protocolPublication . Goncalves, Andreia Soares; McCourt, Christine; Pestana-Santos, Márcia; Prata, Ana PaulaIntroduction: Midwifery models of care are sustainable, cost-effective, safe, and effective models of care that have long been regarded as adequate and recommended for the care of women with uncomplicated pregnancies. The implementation of such models has, however, been very slow in countries where a medicalized culture towards pregnancy and birth prevails. Since there is no systematized evidence that examines the barriers and facilitators to the implementation of midwifery models of care. Objective: Identify and synthesize the literature on barriers and facilitators perceived by stakeholders to the implementation of a midwifery-led-care model in a healthcare system. Methods: The review will consider qualitative, and mixed methods studies. For the mix-methods studies only the qualitative component will be included in the review. No date limits will be applied. Studies written in English, Spanish and Portuguese will be included. The databases to be searched will include CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycINFO (EBSCOhost), and Web of Science (EBSCO). Sources of grey literature include ProQuest Dissertations and Theses, and relevant organizational websites. Study selection, critical appraisal, data extraction, and data synthesis will be performed independently by 2 reviewers. The synthesized findings will be graded according to the ConQual approach for establishing confidence in findings. Discussion: We anticipate that our systematic review will provide guidance for the implementation of midwifery-led care models in any healthcare setting. Conclusion: This protocol sets out the planning and documents the methodology the researchers will employ in this systematic review.
- Midwifery theories: A scoping reviewPublication . Paz, Sara D.C.; Soares Goncalves, Andreia; Moreira Freitas, Conceição; Sampaio, Filipa; Prata, Ana PaulaProblem: The identification of midwifery theories will contribute to the identification of a midwifery model of care for women experiencing low-risk pregnancies, and to support its implementation in Portugal. Background: Previous research has explored the concept of woman-centredness as the core principle underpinning midwifery practice, mapped existing midwifery models of care, synthesized multiple theories and the scope of midwifery to achieve conceptual integration, and identified the aspects of midwifery care that most significantly contribute to the quality of care for women and their babies. However, to the best of the authors' knowledge, no other review has mapped the theories that underpin midwifery practice. Aim: This study aims to map and summarise the theories that underpin midwifery practice. Methods: The JBI methodology for scoping reviews was used to conduct this review. Findings: A total of 16 documents were included in this review. Sixteen theories were identified and the differences between them vary in both underpinning philosophical ideas and the methodology used to develop them. Discussion: The four concepts of the nursing-midwifery metaparadigm were identified in all documents and a fifth concept, midwife's self-knowledge, should be included in the characterisation of a midwifery theory, once it has a strong presence in all four concepts, underpinning them. Conclusion: This scoping review identified the theories underpinning midwifery practice. The compilation of these theories can be used to strengthen the scientific area and profession: development of theoretical knowledge as professional autonomy and power, internal control for the profession, guidance to professional practice, practice standardization, inter and intra-professional communication, and outcomes assessment and improvement.