title: Women's preferences and knowledge about the legal competences of midwives in Brussels, Belgium. A descriptive observational study.
abstract: OBJECTIVE
  to explore women's preferences with regard to their preferred health professional during labour and childbirth in case of an uncomplicated pregnancy, and to gain insight into women's knowledge of the legal competences of midwives.
  
  
  METHODS
  a descriptive observational study.
  
  
  METHODS
  Brussels metropolitan region, Belgium.
  
  
  METHODS
  women in their reproductive age, living in the Brussels metropolitan region, with Dutch or French as their first language (n=830).
  
  
  METHODS
  a ten-item standardized questionnaire'Midwife Profiling Questionnaire' (MidProQ) was developed to determine which health professional respondents would prefer to assist them during labour and childbirth if there were no complications and to assess their knowledge about midwives' legal competences during pregnancy, labour and childbirth. Descriptive statistics were used to report the findings. To identify relationships between the socio-demographic variables of the women and her preferences, knowledge and opinion Chi² analysis were used.
  
  
  RESULTS
  For 68.0% of the participants in an uncomplicated labour (n=564) and 66.3% of the participants with an uncomplicated childbirth (n=550), a midwife is the preferred health professional. Brussels women prefer an obstetrician in an uncomplicated labour (n=730, 88%) and for uncomplicated childbirth (n=756, 91.1%). Only 20.2% of the respondents (n=168) consider midwives to play a central role in an uncomplicated pregnancy. The knowledge of Brussels women about midwives' legal competences during pregnancy, labour and childbirth is rather poor, especially in youngsters and women who have never given birth.
  
  
  CONCLUSIONS
  In general, for Brussels women, midwives are not the first preferred health professional for an uncomplicated labour or for childbirth, and they do not consider midwives to play a central role in an uncomplicated pregnancy. The legal competences of midwives are not known very well, especially by youngsters and women who have never given birth. The Belgian medical model of maternity care and women's experiences affect their preferences and knowledge about the legal competences of midwives and their opinion about the central health professional in an uncomplicated pregnancy.
  
  
  CONCLUSIONS
  To enhance more women-centred care and initiate change in the current maternity care culture in Belgium, public education, structural changes in maternity services and strategies to inspire public opinion to initiate cultural change are suggested. Involvement of midwifery organisations, other health professionals in maternity services and policy-makers with women's groups and potential service users is key.
authors.affiliation: Erasmus University College Brussels, Department Health Care, Knowledge Centre Brussels Integrated Care, Midwifery Section, Belgium. Electronic address: joeri.vermeulen@ehb.be.
authors.forename: Joeri
authors.initials: J
authors.lastname: Vermeulen
authors.affiliation: Erasmus University College Brussels, Department Health Care, Knowledge Centre Brussels Integrated Care, Midwifery Section, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Belgium.
authors.forename: Eva
authors.initials: E
authors.lastname: Swinnen
authors.affiliation: Erasmus University College Brussels, Department Health Care, Knowledge Centre Brussels Integrated Care, Midwifery Section, Belgium.
authors.forename: Florence
authors.initials: F
authors.lastname: D'haenens
authors.affiliation: Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Department of Biostatistics and Medical Informatics, Belgium.
authors.forename: Ronald
authors.initials: R
authors.lastname: Buyl
authors.affiliation: Erasmus University College Brussels, Department Health Care, Knowledge Centre Brussels Integrated Care, Midwifery Section, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Department Medical Sociology, Belgium; University Hospital Brussels, Nursing and Midwifery Research Unit, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Beeckman
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium; D005260:Female; D005554:Forensic Medicine / Q000379:methods*; D006801:Humans; D009721:Nurse Midwives / Q000592:standards*; D024802:Nurse's Role / Q000523:psychology; D010465:Perception; D011247:Pregnancy; D014930:Women / Q000523:psychology*
keywords: Competences of midwives; Maternity care culture; Midwifery; Perceptions about midwives’ roles; Uncomplicated pregnancy, labour and childbirth; Women's preferences