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Implementing midwifery units in a European country: Situational analysis of an Italian case study

Batinelli, L. ORCID: 0000-0001-7497-4076, McCourt, C. ORCID: 0000-0003-4765-5795, Bonciani, M. & Rocca-Ihenacho, L. ORCID: 0000-0002-8161-3938 (2023). Implementing midwifery units in a European country: Situational analysis of an Italian case study. Midwifery, 116, article number 103534. doi: 10.1016/j.midw.2022.103534


Strong evidence recommends midwifery-led care for women with uncomplicated pregnancies. International research is now focusing on how to implement midwifery models of care in countries where they are not well established. In Europe, many countries like Italy are promoting midwifery-led care in national guidelines but often struggle to apply this change in practice.

This study collected data on professional, organisational and service users’ levels to conduct a situational analysis of an Italian service which is approaching the implementation of a midwifery unit. Participatory Action Research was used together with the support of the Consolidated Framework for Implementation Research to conduct data collection and analysis.

Forty-eight participants amongst professionals (midwives, obstetricians and neonatologists) and at organisational level (midwifery leaders and medical directors) were recruited; secondary data on service users’ views was analysed via regional online surveys. Barriers and facilitators to the implementation were identified to assess the readiness of the local context.

This study is the first to include professionals, managers and service users in a European context such as Italy. Facilitators to the implementation of the alongside midwifery unit were found in national guidelines, allocated funding, collaborative engagement and medical support. Hierarchical structures, a prevalent medical model and lack of trust and awareness of the evidence of safety of midwifery-led models were main barriers.

Publication Type: Article
Additional Information: © 2023 This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Publisher Keywords: Midwifery units, Midwifery led care, Birth centres, Midwifery centres, Implementation, Situational analysis, Innovation, Change
Subjects: D History General and Old World > DG Italy
R Medicine > RG Gynecology and obstetrics
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:
[thumbnail of SA manuscript FINAL-V9-Authors version_.pdf]
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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