Stakeholder Perspectives on Implementation of Continuous Care by Maternity Care Assistants During Labor in The Netherlands

Author(s): Amber J.C. Scheenen, BSc, Karina V. Chaibekava, MD, Marianne J. Nieuwenhuijze, PhD, MPH, RM, Hubertina C.J. Scheepers, MD, PhD.

The results of the Continuous Care Trial suggest that continuous care by trained maternity care assistants reduces the need for epidural and other anesthesia and caesarean sections, making the intervention effective and not more costly than conventional care. Despite good results in several trials and WHO’s recommendations, continuous care is not implemented on a large scale. The aim of this brief report is to present the perspectives of various stakeholders that are essential for the construction of an implementation strategy for continuous care by maternity care assistants in The Netherlands. A stakeholders meeting was attended by 13 stakeholders with different backgrounds. The meeting was conducted online and transcribed verbatim. Thematic qualitative content analysis of the stakeholders meeting resulted in four overarching themes: facilitating factors, hindering factors, prerequisites and suggestions for continuation. Despite improving outcomes without increasing costs, the major challenge for further implementation of continuous care is funding due to the current Dutch financing structure of healthcare. Possible pathways must be further explored in order to arrange financing on a national level. Furthermore the prerequisite of sufficient available maternity care assistants, with clear task descriptions and demarcations, must be met. Hereafter tailored regional implementation can be initiated.