Women’s Perception of a Midwife-Led Clinic: A Qualitative Study
DOI:
https://doi.org/10.52609/jmlph.v4i4.134Keywords:
Maternal-Child Health Centres, Maternal-Child Health Services, Nurse-Led Clinic, PerceptionAbstract
Background: While maternal and child health care is a crucial component of every healthcare system, the burden on medical staff in caring for low-risk pregnant patients could be significantly alleviated by recruiting and maintaining a substantial number of midwives.
Objectives: This study aims to understand the perceptions of women recipients of antenatal services provided by midwife-led clinics (MLC).
Method: The study utilised a phenomenological approach with semi-structured interviews to gather information from participants regarding their perceptions of the MLC.
Results: Participants in the survey were women (n=13) who attended the MLC, the majority being over 30 years of age and graduates. The participants believed that the clinic was essential, and felt at ease with the midwife and the services. Most expressed satisfaction with the health education offered by the clinic on the subject of prenatal care, nutrition, exercise, and breastfeeding.
Conclusion: The participants in this study preferred midwife-led clinics because they allowed for better communication, answered queries, and provided significant emotional support. The participants felt comfortable with the midwife, who created a forum for discussion and clarification of doubts.
References
Iida M, Horiuchi S, Nagamori K. A comparison of midwife-led care versus obstetrician-led care for low-risk women in Japan. Women and Birth. 2014 Sep 1;27(3):202-7.https://doi.org/10.1016/j.wombi.2014.05.001
Mortensen B, Diep LM, Lukasse M, Lieng M, Dwekat I, Elias D, Fosse E. Women's satisfaction with midwife-led continuity of care: an observational study in Palestine. BMJ Open. 2019 Nov 1;9(11). http://dx.doi.org/10.1136/bmjopen-2019-030324
Michel-Schuldt M, McFadden A, Renfrew M, Homer C. The provision of midwife-led care in low-and middle-income countries: An integrative review. Midwifery. 2020 May 1;84:102659.
https://doi.org/10.1016/j.midw.2020.102659
Butler MM, Brosnan MC, Drennan J, Feeney P, Gavigan O, Kington M, O'Brien D, Sheehy L, Walsh MC. Evaluating midwifery-led antenatal care: using a program logic model to identify relevant outcomes. Midwifery. 2014 Jan 1;30(1):e34-41.
https://doi.org/10.1016/j.midw.2013.10.003
Symon A, Pringle J, Cheyne H, Downe S, Hundley V, Lee E, Lynn F, McFadden A, McNeill J, Renfrew MJ, Ross-Davie M. Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care. BMC pregnancy and childbirth. 2016 Dec;16(1): 168.DOI 10.1186/s12884-016-0944-6
Murphy A. Antenatal options: developing midwife-led services in Ireland. Midwifery. 2012;20(9).
Ryan P, Revill P, Devane D, Normand C. An assessment of the cost-effectiveness of midwife-led care in the United Kingdom. Midwifery. 2013 Apr 1;29(4):368-76.
Voon ST, Lay JT, San WT, Shorey S, Lin SK. Comparison of midwife-led care and obstetrician-led care on maternal and neonatal outcomes in Singapore: A retrospective cohort study. Midwifery. 2017 Oct 1;53:71-9.https://doi.org/10.1016/j.midw.2017.07.010
Sutcliffe K, Caird J, Kavanagh J, Rees R, Oliver K, Dickson K, Woodman J, Barnett‐Paige E, Thomas J. Comparing midwife‐led and doctor‐led maternity care: a systematic review of reviews. Journal of advanced nursing. 2012 Nov;68(11):2376-86.https://doi.org/10.1111/j.1365-2648.2012.05998.x
Skirrow H, Holder B, Meinel A, Narh E, Donaldson B, Bosanquet A, Barnett S, Kampmann B. Evaluation of a midwife-led, hospital-based vaccination service for pregnant women. Human Vaccines & Immunotherapeutics. 2020 Aug 31:1-0.https://doi.org/10.1080/21645515.2020.1770515
Heale R, James S, Wenghofer E, Garceau ML. Nurse practitioner's perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients. Primary health care research & development. 2018 Nov;19(6):553-60.DOI: https://doi.org/10.1017/S1463423617000913
Ministry of Health. (2006). Statistical Report of Gynecology Obestetrics Departments and Maternal Care in MOH 1427. Retrieved from Saudi Arabia: http://www.moh.gov.sa/en/ministry/statistics/book/pages/default.aspx
Altaweli, R. (2015). Interventions during the second stage of labour: an exploration of what may affect their use in Jeddah, Saudi Arabia. City University London.
General Authority for Statistics. (2016). Demographic Research Bulletin 2016. Retrieved from https://www.stats.gov.sa/en/4522
Young Y, Alharthy A, Hosler AS. Transformation of Saudi Arabia's Health System and Its Impact on Population Health: What Can the USA Learn? Saudi Journal of Health Systems Research. 2021;1(3):93-102.https://doi.org/10.1159/000517488
Altaweli R, Shaban I, Paine P. Report on the Midwifery Workforce in the MOH, Saudi Arabia, for 2019. Practising Midwife. 2020 Sep;23(8).
Chowdhury S, Mok D, Leenen L. Transformation of health care and the new model of care in Saudi Arabia: Kingdom's Vision 2030. Journal of Medicine and Life. 2021 May;14(3):347. doi: 10.25122/jml-2021-0070
Nurunnabi, M. (2017). Transformation from an Oil-based Economy to a Knowledge-based Economy in Saudi Arabia: the Direction of Saudi Vision 2030. Journal of the Knowledge Economy, 8(2), 536-564. doi:10.1007/s13132-017-0479-8
Cachia M, Millward L. The telephone medium and semi‐structured interviews: a complementary fit. Qualitative Research in Organizations and Management: An International Journal. 2011 Nov 15.
Lechuga VM. Exploring culture from a distance: The utility of telephone interviews in qualitative research. International Journal of Qualitative Studies in Education. 2012 May 1;25(3):251-68.
Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative research in sport, exercise, and health. 2021 Mar 4;13(2):201-16. https://doi.org/10.1080/2159676X.2019.1704846
Fugard AJ, Potts HW. Supporting thinking on sample sizes for thematic analyses: a quantitative tool. International Journal of Social Research Methodology. 2015 Nov 2;18(6):669-84.
Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. The psychologist. 2013 Jan 1;26(2).
Cooke HM, Waters DL, Dyer K, Lawler J, Picone D. Development of a best practice model of midwifery-led antenatal care. Australian Midwifery. 2004 Jun 1;17(2):21-5.https://doi.org/10.1016/S1448-8272(04)80006-3
Abdullah P, Gallant S, Saghi N, Macpherson A, Tamim H. Characteristics of patients receiving midwife-led prenatal care in Canada: Maternity Experiences Survey (MES) results. BMC pregnancy and childbirth. 2017 Dec;17(1):164.DOI 10.1186/s12884-017-1350-4
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife‐led continuity models versus other models of care for childbearing women. Cochrane database of systematic reviews. 2016(4). https://doi.org/10.1002/14651858.CD004667.pub5
Jallow IK, Chou YJ, Liu TL, Huang N. Women's perception of antenatal care services in public and private clinics in the Gambia. International journal for quality in health care. 2012 Dec 1;24(6):595-600.https://doi.org/10.1093/intqhc/mzs033
Butler MM, Sheehy L, Kington MM, Walsh MC, Brosnan MC, Murphy M, Naughton C, Drennan J, Barry T. Evaluating midwife-led antenatal care: Choice, experience, effectiveness, and preparation for pregnancy. Midwifery. 2015 Apr 1;31(4):418-25.https://doi.org/10.1016/j.midw.2014.12.002
Onchonga D, Várnagy Á, Keraka M, Wainaina P. Women's experience from midwife-led, integrated pre-birth training; and its influence on childbirth fear. A qualitative interview study. Sexual & Reproductive Healthcare. 2020 Apr 12:100512.https://doi.org/10.1016/j.srhc.2020.100512
Hildingsson I, Haines H, Cross M, Pallant JF, Rubertsson C. Women's satisfaction with antenatal care: comparing women in Sweden and Australia. Women and Birth. 2013 Mar 1;26(1):e9-14. https://doi.org/10.1016/j.wombi.2012.06.002
Maillefer F, de Labrusse C, Cardia-Vonèche L, Hohlfeld P, Stoll B. Women and healthcare providers' perceptions of a midwife-led unit in a Swiss university hospital: a qualitative study. BMC pregnancy and childbirth. 2015 Dec;15(1):1-1.10.1186/s12884-015-0477-4
Esienumoh EE, Okon IE, Ojong IN, Akpan MI, Armon MA, Whiley EE. Perception and practice of midwife-led model of care among skilled birth attendants in selected health facilities in a southern state in Nigeria. Int J Nurs Midwife Health Relate Case. 2015;1:1-6.
Yoder H, Hardy LR. Midwifery and Antenatal Care for Black Women: A Narrative Review. SAGE Open. 2018 Jan;8(1):2158244017752220.
Gu C, Wu X, Ding Y, Zhu X, Zhang Z. The effectiveness of a Chinese midwives' antenatal clinic service on childbirth outcomes for primipare: a randomized controlled trial. International Journal of Nursing Studies. 2013 Dec 1;50(12):1689-97. https://doi.org/10.1016/j.ijnurstu.2013.05.001
Alanazy W, Rance J, Brown A. Exploring maternal and health professional beliefs about the factors that affect whether women in Saudi Arabia attend antenatal care clinic appointments. Midwifery. 2019 Sep 1; 76:36-44. https://doi.org/10.1016/j.midw.2019.05.012
Alanazy W, Brown A. Individual, and healthcare system factors influencing antenatal care attendance in Saudi Arabia. BMC health services research. 2020 Dec 1;20(1):49. https://doi.org/10.1186/s12913-020-4903-6
Baron R, Heesterbeek Q, Manniën J, Hutton EK, Brug J, Westerman MJ. Exploring health education with midwives, as perceived by pregnant women in primary care: A qualitative study in the Netherlands. Midwifery. 2017 Mar 1;46:37-44.https://doi.org/10.1016/j.midw.2017.01.012
Larsson B, Hildingsson I, Ternström E, Rubertsson C, Karlström A. Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study. Women and birth. 2019 Feb 1;32(1):e88-94.https://doi.org/10.1016/j.wombi.2018.04.008
Gholipour R, Shahoei R, Ghader Khani G. The quality of midwifery care from the perspective of healthcare service recipients using the SERVQUAL model in Sanandaj comprehensive health centers in 2018. Journal of Clinical Nursing and Midwifery. 2019;8(2):337-46.
Hildingsson I, Rubertsson C, Karlström A, Haines H. A known midwife can make a difference for women with fear of childbirth-birth outcome and women's experiences of intrapartum care. Sexual & Reproductive Healthcare. 2019 Oct 1;21:33-8. https://doi.org/10.1016/j.srhc.2019.06.004
Eleke C, Agu IS. Patients' Satisfaction With Nurse-Led Care In Selected Government-Owned Primary-Health-Centres In South-East Nigeria.2018. DOI: 10.9790/1959-0704032228
Iida M, Horiuchi S, Nagamori K. A comparison of midwife-led care versus obstetrician-led care for low-risk women in Japan. Women and Birth. 2014 Sep 1;27(3):202-7.https://doi.org/10.1016/j.wombi.2014.05.001
Mortensen B, Diep LM, Lukasse M, Lieng M, Dwekat I, Elias D, Fosse E. Women's satisfaction with midwife-led continuity of care: an observational study in Palestine. BMJ Open. 2019 Nov 1;9(11). http://dx.doi.org/10.1136/bmjopen-2019-030324
Michel-Schuldt M, McFadden A, Renfrew M, Homer C. The provision of midwife-led care in low-and middle-income countries: An integrative review. Midwifery. 2020 May 1;84:102659.
https://doi.org/10.1016/j.midw.2020.102659
Butler MM, Brosnan MC, Drennan J, Feeney P, Gavigan O, Kington M, O'Brien D, Sheehy L, Walsh MC. Evaluating midwifery-led antenatal care: using a program logic model to identify relevant outcomes. Midwifery. 2014 Jan 1;30(1):e34-41.
https://doi.org/10.1016/j.midw.2013.10.003
Symon A, Pringle J, Cheyne H, Downe S, Hundley V, Lee E, Lynn F, McFadden A, McNeill J, Renfrew MJ, Ross-Davie M. Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care. BMC pregnancy and childbirth. 2016 Dec;16(1): 168.DOI 10.1186/s12884-016-0944-6
Murphy A. Antenatal options: developing midwife-led services in Ireland. Midwifery. 2012;20(9).
Ryan P, Revill P, Devane D, Normand C. An assessment of the cost-effectiveness of midwife-led care in the United Kingdom. Midwifery. 2013 Apr 1;29(4):368-76.
Voon ST, Lay JT, San WT, Shorey S, Lin SK. Comparison of midwife-led care and obstetrician-led care on maternal and neonatal outcomes in Singapore: A retrospective cohort study. Midwifery. 2017 Oct 1;53:71-9.https://doi.org/10.1016/j.midw.2017.07.010
Sutcliffe K, Caird J, Kavanagh J, Rees R, Oliver K, Dickson K, Woodman J, Barnett‐Paige E, Thomas J. Comparing midwife‐led and doctor‐led maternity care: a systematic review of reviews. Journal of advanced nursing. 2012 Nov;68(11):2376-86.https://doi.org/10.1111/j.1365-2648.2012.05998.x
Skirrow H, Holder B, Meinel A, Narh E, Donaldson B, Bosanquet A, Barnett S, Kampmann B. Evaluation of a midwife-led, hospital-based vaccination service for pregnant women. Human Vaccines & Immunotherapeutics. 2020 Aug 31:1-0.https://doi.org/10.1080/21645515.2020.1770515
Heale R, James S, Wenghofer E, Garceau ML. Nurse practitioner's perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients. Primary health care research & development. 2018 Nov;19(6):553-60.DOI: https://doi.org/10.1017/S1463423617000913
Ministry of Health. (2006). Statistical Report of Gynecology Obestetrics Departments and Maternal Care in MOH 1427. Retrieved from Saudi Arabia: http://www.moh.gov.sa/en/ministry/statistics/book/pages/default.aspx
Altaweli, R. (2015). Interventions during the second stage of labour: an exploration of what may affect their use in Jeddah, Saudi Arabia. City University London.
General Authority for Statistics. (2016). Demographic Research Bulletin 2016. Retrieved from https://www.stats.gov.sa/en/4522
Young Y, Alharthy A, Hosler AS. Transformation of Saudi Arabia's Health System and Its Impact on Population Health: What Can the USA Learn? Saudi Journal of Health Systems Research. 2021;1(3):93-102.https://doi.org/10.1159/000517488
Altaweli R, Shaban I, Paine P. Report on the Midwifery Workforce in the MOH, Saudi Arabia, for 2019. Practising Midwife. 2020 Sep;23(8).
Chowdhury S, Mok D, Leenen L. Transformation of health care and the new model of care in Saudi Arabia: Kingdom's Vision 2030. Journal of Medicine and Life. 2021 May;14(3):347. doi: 10.25122/jml-2021-0070
Nurunnabi, M. (2017). Transformation from an Oil-based Economy to a Knowledge-based Economy in Saudi Arabia: the Direction of Saudi Vision 2030. Journal of the Knowledge Economy, 8(2), 536-564. doi:10.1007/s13132-017-0479-8
Cachia M, Millward L. The telephone medium and semi‐structured interviews: a complementary fit. Qualitative Research in Organizations and Management: An International Journal. 2011 Nov 15.
Lechuga VM. Exploring culture from a distance: The utility of telephone interviews in qualitative research. International Journal of Qualitative Studies in Education. 2012 May 1;25(3):251-68.
Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative research in sport, exercise, and health. 2021 Mar 4;13(2):201-16. https://doi.org/10.1080/2159676X.2019.1704846
Fugard AJ, Potts HW. Supporting thinking on sample sizes for thematic analyses: a quantitative tool. International Journal of Social Research Methodology. 2015 Nov 2;18(6):669-84.
Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. The psychologist. 2013 Jan 1;26(2).
Cooke HM, Waters DL, Dyer K, Lawler J, Picone D. Development of a best practice model of midwifery-led antenatal care. Australian Midwifery. 2004 Jun 1;17(2):21-5.https://doi.org/10.1016/S1448-8272(04)80006-3
Abdullah P, Gallant S, Saghi N, Macpherson A, Tamim H. Characteristics of patients receiving midwife-led prenatal care in Canada: Maternity Experiences Survey (MES) results. BMC pregnancy and childbirth. 2017 Dec;17(1):164.DOI 10.1186/s12884-017-1350-4
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife‐led continuity models versus other models of care for childbearing women. Cochrane database of systematic reviews. 2016(4). https://doi.org/10.1002/14651858.CD004667.pub5
Jallow IK, Chou YJ, Liu TL, Huang N. Women's perception of antenatal care services in public and private clinics in the Gambia. International journal for quality in health care. 2012 Dec 1;24(6):595-600.https://doi.org/10.1093/intqhc/mzs033
Butler MM, Sheehy L, Kington MM, Walsh MC, Brosnan MC, Murphy M, Naughton C, Drennan J, Barry T. Evaluating midwife-led antenatal care: Choice, experience, effectiveness, and preparation for pregnancy. Midwifery. 2015 Apr 1;31(4):418-25.https://doi.org/10.1016/j.midw.2014.12.002
Onchonga D, Várnagy Á, Keraka M, Wainaina P. Women's experience from midwife-led, integrated pre-birth training; and its influence on childbirth fear. A qualitative interview study. Sexual & Reproductive Healthcare. 2020 Apr 12:100512.https://doi.org/10.1016/j.srhc.2020.100512
Hildingsson I, Haines H, Cross M, Pallant JF, Rubertsson C. Women's satisfaction with antenatal care: comparing women in Sweden and Australia. Women and Birth. 2013 Mar 1;26(1):e9-14. https://doi.org/10.1016/j.wombi.2012.06.002
Maillefer F, de Labrusse C, Cardia-Vonèche L, Hohlfeld P, Stoll B. Women and healthcare providers' perceptions of a midwife-led unit in a Swiss university hospital: a qualitative study. BMC pregnancy and childbirth. 2015 Dec;15(1):1-1.10.1186/s12884-015-0477-4
Esienumoh EE, Okon IE, Ojong IN, Akpan MI, Armon MA, Whiley EE. Perception and practice of midwife-led model of care among skilled birth attendants in selected health facilities in a southern state in Nigeria. Int J Nurs Midwife Health Relate Case. 2015;1:1-6.
Yoder H, Hardy LR. Midwifery and Antenatal Care for Black Women: A Narrative Review. SAGE Open. 2018 Jan;8(1):2158244017752220.
Gu C, Wu X, Ding Y, Zhu X, Zhang Z. The effectiveness of a Chinese midwives' antenatal clinic service on childbirth outcomes for primipare: a randomized controlled trial. International Journal of Nursing Studies. 2013 Dec 1;50(12):1689-97. https://doi.org/10.1016/j.ijnurstu.2013.05.001
Alanazy W, Rance J, Brown A. Exploring maternal and health professional beliefs about the factors that affect whether women in Saudi Arabia attend antenatal care clinic appointments. Midwifery. 2019 Sep 1; 76:36-44. https://doi.org/10.1016/j.midw.2019.05.012
Alanazy W, Brown A. Individual, and healthcare system factors influencing antenatal care attendance in Saudi Arabia. BMC health services research. 2020 Dec 1;20(1):49. https://doi.org/10.1186/s12913-020-4903-6
Baron R, Heesterbeek Q, Manniën J, Hutton EK, Brug J, Westerman MJ. Exploring health education with midwives, as perceived by pregnant women in primary care: A qualitative study in the Netherlands. Midwifery. 2017 Mar 1;46:37-44.https://doi.org/10.1016/j.midw.2017.01.012
Larsson B, Hildingsson I, Ternström E, Rubertsson C, Karlström A. Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study. Women and birth. 2019 Feb 1;32(1):e88-94.https://doi.org/10.1016/j.wombi.2018.04.008
Gholipour R, Shahoei R, Ghader Khani G. The quality of midwifery care from the perspective of healthcare service recipients using the SERVQUAL model in Sanandaj comprehensive health centers in 2018. Journal of Clinical Nursing and Midwifery. 2019;8(2):337-46.
Hildingsson I, Rubertsson C, Karlström A, Haines H. A known midwife can make a difference for women with fear of childbirth-birth outcome and women's experiences of intrapartum care. Sexual & Reproductive Healthcare. 2019 Oct 1;21:33-8. https://doi.org/10.1016/j.srhc.2019.06.004
Eleke C, Agu IS. Patients' Satisfaction With Nurse-Led Care In Selected Government-Owned Primary-Health-Centres In South-East Nigeria.2018. DOI: 10.9790/1959-0704032228
Iida M, Horiuchi S, Nagamori K. A comparison of midwife-led care versus obstetrician-led care for low-risk women in Japan. Women and Birth. 2014 Sep 1;27(3):202-7.https://doi.org/10.1016/j.wombi.2014.05.001
Mortensen B, Diep LM, Lukasse M, Lieng M, Dwekat I, Elias D, Fosse E. Women's satisfaction with midwife-led continuity of care: an observational study in Palestine. BMJ Open. 2019 Nov 1;9(11). http://dx.doi.org/10.1136/bmjopen-2019-030324
Michel-Schuldt M, McFadden A, Renfrew M, Homer C. The provision of midwife-led care in low-and middle-income countries: An integrative review. Midwifery. 2020 May 1;84:102659.
https://doi.org/10.1016/j.midw.2020.102659
Butler MM, Brosnan MC, Drennan J, Feeney P, Gavigan O, Kington M, O'Brien D, Sheehy L, Walsh MC. Evaluating midwifery-led antenatal care: using a program logic model to identify relevant outcomes. Midwifery. 2014 Jan 1;30(1):e34-41.
https://doi.org/10.1016/j.midw.2013.10.003
Symon A, Pringle J, Cheyne H, Downe S, Hundley V, Lee E, Lynn F, McFadden A, McNeill J, Renfrew MJ, Ross-Davie M. Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care. BMC pregnancy and childbirth. 2016 Dec;16(1): 168.DOI 10.1186/s12884-016-0944-6
Murphy A. Antenatal options: developing midwife-led services in Ireland. Midwifery. 2012;20(9).
Ryan P, Revill P, Devane D, Normand C. An assessment of the cost-effectiveness of midwife-led care in the United Kingdom. Midwifery. 2013 Apr 1;29(4):368-76.
Voon ST, Lay JT, San WT, Shorey S, Lin SK. Comparison of midwife-led care and obstetrician-led care on maternal and neonatal outcomes in Singapore: A retrospective cohort study. Midwifery. 2017 Oct 1;53:71-9.https://doi.org/10.1016/j.midw.2017.07.010
Sutcliffe K, Caird J, Kavanagh J, Rees R, Oliver K, Dickson K, Woodman J, Barnett‐Paige E, Thomas J. Comparing midwife‐led and doctor‐led maternity care: a systematic review of reviews. Journal of advanced nursing. 2012 Nov;68(11):2376-86.https://doi.org/10.1111/j.1365-2648.2012.05998.x
Skirrow H, Holder B, Meinel A, Narh E, Donaldson B, Bosanquet A, Barnett S, Kampmann B. Evaluation of a midwife-led, hospital-based vaccination service for pregnant women. Human Vaccines & Immunotherapeutics. 2020 Aug 31:1-0.https://doi.org/10.1080/21645515.2020.1770515
Heale R, James S, Wenghofer E, Garceau ML. Nurse practitioner's perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients. Primary health care research & development. 2018 Nov;19(6):553-60.DOI: https://doi.org/10.1017/S1463423617000913
Ministry of Health. (2006). Statistical Report of Gynecology Obestetrics Departments and Maternal Care in MOH 1427. Retrieved from Saudi Arabia: http://www.moh.gov.sa/en/ministry/statistics/book/pages/default.aspx
Altaweli, R. (2015). Interventions during the second stage of labour: an exploration of what may affect their use in Jeddah, Saudi Arabia. City University London.
General Authority for Statistics. (2016). Demographic Research Bulletin 2016. Retrieved from https://www.stats.gov.sa/en/4522
Young Y, Alharthy A, Hosler AS. Transformation of Saudi Arabia's Health System and Its Impact on Population Health: What Can the USA Learn? Saudi Journal of Health Systems Research. 2021;1(3):93-102.https://doi.org/10.1159/000517488
Altaweli R, Shaban I, Paine P. Report on the Midwifery Workforce in the MOH, Saudi Arabia, for 2019. Practising Midwife. 2020 Sep;23(8).
Chowdhury S, Mok D, Leenen L. Transformation of health care and the new model of care in Saudi Arabia: Kingdom's Vision 2030. Journal of Medicine and Life. 2021 May;14(3):347. doi: 10.25122/jml-2021-0070
Nurunnabi, M. (2017). Transformation from an Oil-based Economy to a Knowledge-based Economy in Saudi Arabia: the Direction of Saudi Vision 2030. Journal of the Knowledge Economy, 8(2), 536-564. doi:10.1007/s13132-017-0479-8
Cachia M, Millward L. The telephone medium and semi‐structured interviews: a complementary fit. Qualitative Research in Organizations and Management: An International Journal. 2011 Nov 15.
Lechuga VM. Exploring culture from a distance: The utility of telephone interviews in qualitative research. International Journal of Qualitative Studies in Education. 2012 May 1;25(3):251-68.
Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative research in sport, exercise, and health. 2021 Mar 4;13(2):201-16. https://doi.org/10.1080/2159676X.2019.1704846
Fugard AJ, Potts HW. Supporting thinking on sample sizes for thematic analyses: a quantitative tool. International Journal of Social Research Methodology. 2015 Nov 2;18(6):669-84.
Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. The psychologist. 2013 Jan 1;26(2).
Cooke HM, Waters DL, Dyer K, Lawler J, Picone D. Development of a best practice model of midwifery-led antenatal care. Australian Midwifery. 2004 Jun 1;17(2):21-5.https://doi.org/10.1016/S1448-8272(04)80006-3
Abdullah P, Gallant S, Saghi N, Macpherson A, Tamim H. Characteristics of patients receiving midwife-led prenatal care in Canada: Maternity Experiences Survey (MES) results. BMC pregnancy and childbirth. 2017 Dec;17(1):164.DOI 10.1186/s12884-017-1350-4
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife‐led continuity models versus other models of care for childbearing women. Cochrane database of systematic reviews. 2016(4). https://doi.org/10.1002/14651858.CD004667.pub5
Jallow IK, Chou YJ, Liu TL, Huang N. Women's perception of antenatal care services in public and private clinics in the Gambia. International journal for quality in health care. 2012 Dec 1;24(6):595-600.https://doi.org/10.1093/intqhc/mzs033
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Copyright (c) 2024 Diana Lalithabai, Faheema Alsomali, Khalid AlGhamdi, Waad ALZahrani
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