Women's preferences and knowledge about the legal competences of midwives in Brussels, Belgium. A descriptive observational study.

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. Design: a descriptive observational study. Setting: Brussels metropolitan region, Belgium. Participants: women in their reproductive age, living in the Brussels metropolitan region, with Dutch or French as their first language (n = 830). Measurements: 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. Findings: 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. Key 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 un- complicated 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. Implications for practice: 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. [ABSTRACT FROM AUTHOR]