Inter-professional collaboration in delivery suite: a qualitative study

Background: Communication problems between clinicians are the most common cause of preventable adverse events in hospitals. In spite of these known risks the 'turf wars' between midwives and doctors continue unabated.

Question: What factors affect inter-professional interactions in birthing units?

Participants: 9 doctors and 10 midwives from 10 Australian maternity units.

Methods: Interpretive Interactionism was the research design. Probing in-depth interviews were conducted to elicit stories of inter-professional interactions and their perceived effects on birthing outcomes. Analysis resulted in two theoretical models of inter-professional interaction: one positive and the other negative.

Findings: Midwives and doctors agree that positive interactions are collaborative, include the woman and her partner and are associated with the best possible outcomes and experiences possible. In contrast, they agree that negative interactions involve power struggles between the professionals and these are associated with adverse outcomes. All participants are able to demonstrate emotional and social competence when interacting and applied those skills sometimes. Factors related to the organisational culture within the 'birth territory' of a particular maternity unit seem to be predictive of the type of interactions that are likely to occur there.

Conclusion: Interventions to enhance inter-professional collaboration should be directed first at changing organisational structures and policies to promote easy opportunities for natural dialogue between doctors and midwives.