Model of care matters: An integrative review

Background: Pregnant women are entitled to quality care during pregnancy. Some health districts offer a variety of maternity care models but, not all women are aware of what is available and there is limited research on the experiences of women within their chosen or allocated model of care.Aim: The aim of this integrative review is to explore the available literature on women's experiences of the model of care accessed during pregnancy. Method: A database search of CINAHL, MEDLINE, SCOPUS, OVID, JBI and Cochrane Database was conducted to identify original research articles published in English between 2011 and 2021. In total, 20 articles met the inclusion criteria.Findings: The included papers came from nine different countries and reported on eight different models of care. Following analysis of the articles one overarching theme 'Model of care matters', and six sub themes were identified: 1.'Choosing a model', 2.'Learning about pregnancy and birth', 3.'Being known', 4.'Making social and emotional connections', 5.'Receiving enabling or disabling care' and 6.'Integrated care is best'. Some women disclosed that they had no choice in the model they were allocated, while others stated they were not provided with information about all available models of care.Conclusion: A lack of integrated care between medical and midwifery models led to feelings of dissatisfaction and distress during pregnancy. Positive experiences were reported when women developed a connection with the care provider. The development of a well-informed decision aid could alleviate deficits of information, and clarify the subtle differences that occur within various models.

Automated summary

This article aims to explore the impact of the model of care accessed during pregnancy on women's experiences. Through the analysis of 20 articles, it was found that the model of care has significant implications for women's experiences, including the importance of choosing a model, learning about pregnancy and birth, establishing interpersonal connections, receiving positive or negative care, and the importance of integrated care. Some women lacked autonomy in choosing their care model and were not provided with information about all available models. The article suggests strengthening integrated care between medical and midwifery models, providing abundant and accurate information, and developing decision aids.