A Study on the Construction of a Core Midwife-Led Total Maternal Care Program for High-Risk Pregnancies

Abstract

Objective: To analyze the care needs of high-risk pregnant women during pregnancy, delivery, and postpartum hospitalization. Additionally, to gather obstetrics staff’s suggestions for improving a total care program with core midwives leading. Methods: The study conducted semi-structured interviews with 20 high-risk pregnant women and 10 obstetricians at a tertiary hospital from August 2021 to October 2022. A descriptive qualitative study assessed their care needs and current care models. An evidence-based approach was used to evaluate guidelines and develop a draft care plan. Finally, the Delphi method refined the core midwife-led total care program. Results: The study formulated a draft for a core midwife-led care program, integrating literature and expert feedback. This program defined midwife roles with 7 service standards and 6 qualification standards. The care practice included 3 level 1, 19 level 2, and 58 level 3 entries. Management of common risk factors had detailed entries for conditions like gestational diabetes, advanced maternal age, abnormal early pregnancy weight, hypertensive disorders, and scarred uterus. Conclusion: The study offers a qualitative exploration of high-risk pregnant women’s care needs and suggests improvements based on healthcare professionals’ experiences. It provides a foundation for a midwife-led care program and proposes new research directions. The methodology combines the Ottawa research application model, evidence-based approaches, and theoretical analysis to support this program’s development.