INDEPENDENT MIDWIFERY PRACTICE IN POLAND – LEGAL CONSIDERATIONS VERSUS REALITY

Abstract

Objective. To assess the readiness of midwives in regards to carrying out complex independent care for expecting families during physiological pregnancy, delivery and puerperium; to evaluate the role of midwifery practice during individual preparation of a woman (and her spouse) for childbirth; to define the elements of health education included in preparation for childbirth.

Material and method. Design - questionnaire survey. Setting - eight types of hospitals located in and outside of Warsaw. Participants - 291 practicing midwives with current or past practice in the delivery room.

Findings. The majority of midwives (232; 80%) declared their readiness to provide complex care to expecting families and offered individual preparation of women (and their spouses) for delivery. Most state obstacle is the lack of practice, the need to improve skills and prevent system. The majority of midwives practice individual preparation of women for childbirth (172; 59%).

Midwives complementary education for masters, much less frequently (72; 47%) operate this type of care than the other (76; 71%) - p = 0.001. This form of practice is implemented by the midwives hot properties (25; 83%) - p = 0.017. The most frequent components of prenatal health education included: biological aspects of pregnancy, delivery and puerperium, followed by psychological aspects, hygiene, diet, physical activity and prenatal communication with the child.

Conclusions and implications for practice. Independent midwifery practice is not limited by Polish law. The obstacles faced by independent midwives are associated rather with the healthcare system and the mentality of its workers. The profession of midwifery should be strengthened by extensive media campaigns promoting the competency of this professional group, along with the completion of graduate and postgraduate education curricula in aspects useful for running independent practice.