Views of healthcare providers on the provision of continuous care during labour by maternity care assistants in the Netherlands: a qualitative study

Background Continuous care during labour has proven to be beneficial in reducing the need for medical intervention, such as epidural anaesthesia and caesarean sections, but is yet to be implemented on a large scale. The Continuous Care Trial looked at effectivity and costs of continuous care by maternity care assistants. Complementary to the Continuous Care Trial and in the interest of implementation, this study aims to explore the experiences of involved healthcare providers.Methods This is a descriptive qualitative study. Data were collected through individual interviews and focus group discussions based on a semi-structured interview guide with 17 healthcare providers involved in the provision of continuous care. Manifest content analysis was conducted using the methodology of Graneheim and Lundman to extract categories from the data.Findings Three main categories were identified: 'experiences with continuous care by maternity care assistants', 'perceived value of continuous care' and 'suggestions for further implementation'. Participants were positive about the provision of continuous care by maternity care assistants. Reservations about the added value of continuous care depended on professional background and setting. Specific aspects for improvement were training and the collaboration within hospital setting.Discussion The findings advocate for an expansion of preparatory and evaluative activities when implementing continuous care, as acceptance of the intervention by healthcare providers is a major determinant for the implementation, especially in hospitals. The findings of this study are of broader interest internationally, given the rising interest in feasible ways to implement continuous support during birth.Conclusion This study highlights the necessity of improvements in education and collaboration in hospitals to enhance acceptance of implementation of continuous care during labour.