96 Chapter 4 Abstract Background Intervention rates in perinatal care vary between and within countries, without populations’ characteristics as a full explanation. Research suggests that one factor in this variation might be the attitude of perinatal healthcare providers. Systematic knowledge on the background of midwives’ attitudes and how this influences the use of interventions is limited. Aim To explore experiences, beliefs, and values that influence midwives’ attitude towards interventions in perinatal care. Methods A qualitative study using in-depth interviews with primary care midwives (n=20) in the Netherlands. The interviews were performed in June 2019 and combined a narrative approach with a semi-structured interview guide. Inductive content analysis was applied. Findings We identified two main themes: attitude towards interventions and influences on midwives’ attitudes. The midwives in our study described their attitude towards interventions either as one oriented towards wait and see or as one oriented towards check and control. Care based on wait and see displayed a more supportive style of behavior, and care based on check and control appeared to display a more directive style of behavior. In the theme influence on midwives’ attitudes three subthemes emerged: experiences in collaboration, trust and fear, and woman centeredness. Conclusion Midwives with a wait and see attitude seem to have a more restricted approach towards interventions compared to midwives with a check and control attitude. Midwives need to be aware how their experiences, beliefs, and values shape their attitude towards use of interventions. This awareness could be a first step towards the reduction of unwarranted interventions.
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