A survey on knowledge and perceptions of Thai pregnant women about the role of the midwife in Thailand

Author: Sudjit Liblub

Liblub, Sudjit, 2020 A survey on knowledge and perceptions of Thai pregnant women about the role of the midwife in Thailand, Flinders University, College of Nursing and Health Sciences

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Midwives have long been recognized to have a major role in maternal care around the world. Despite this, midwives are continuously challenged to re-examine their role and scope of practice. This presentation reports on research which was based on the premise that there may be misunderstandings among pregnant women regarding the role of the midwife in Thailand. Multiple factors were found to influence the utilisation of different health care providers in intrapartum care. Whist it is well-known that the role of the midwife is to conduct normal vaginal delivery, there is limited knowledge of Thai pregnant women’s perceptions of the scope of midwives’ role in the context of intrapartum care. This study is exploring Thai pregnant women’s views about the role of the midwife and identifying the perceptions and views of Thai pregnant women in relation to the selection of intrapartum care providers. A descriptive survey was used to collect Thai pregnant women’s responses through online survey. Respondents answered questions in relation to demographics, pregnancy, and their perceptions of midwives’ role during labour and birth. One hundred and forty-nine participants completed the survey. Findings revealed that most participants were ambivalent about the role of the midwife and were not in contact with a midwife during their pregnancy. The perceptions of the role of the midwife during labour included aspects of offering support, encouraging pushing, and assessing health in the labour room, rather than performing procedures such as normal vaginal delivery. Only one-third of women could identify the midwife’s role with all of the tasks in their scope of practice, such as being qualified to perform normal vaginal delivery, placenta delivery and perineal suturing. In contrast, the majority of pregnant women believed that a physician is qualified to conduct normal vaginal delivery and many other midwifery tasks during labour and birth. These findings were attributed to the cultural norms of midwifery, which remain linked to the midwife’s subordinate position in practice, resulting in the perception that the midwife is merely the physician’s assistant. Even though the majority of the pregnant women perceived the importance of having a midwife present in the labour room, they were likely to be more confident with a physician during labour than a midwife. Encountering previous negative experiences and the poor image of the midwife as the primary carer during labour may jeopardise perceptions of a midwife’s competency in intrapartum care. Understanding the role of the midwife from the perspective of pregnant women in this study informs current midwifery practice in relation to the current lack of visibility of the midwife in Thailand. In the future, it is hoped to further encourage the performance of normal vaginal delivery by midwives, and informing policy changes which can help to reduce the unnecessary caesarean rate in Thailand. Recommendations include awareness of the research to explore the factors that might have an impact on women’s perceptions of the midwife and how best to promote their role in Thai society.

Keywords: The role of the midwife, midwife, midwifery, Thailand, intrapartum healthcare providers, conducting normal vaginal delivery, labour and birth, perception, Thai pregnant women

Subject: Midwifery thesis

Thesis type: Masters
Completed: 2020
School: College of Nursing and Health Sciences
Supervisor: Dr. Lyn Gum