Access to midwifery care – the perspective of women in life situations with psychosocial stress factors

Background: Women living with complex psychosocial needs have higher support requirements but less access to midwifery services than those with fewer needs. The determinants of the inequalities in service access remain unexplored. Aim: This study aimed to explore what determines access to outpatient midwifery services for women with complex psychosocial needs. Methodology: Semi-structured interviews (n=13) were conducted with two pregnant women and 11 mothers. These were analysed using content analysis. Categories were formed using a framework for access to healthcare. Results: Women with complex psychosocial needs described accessing outpatient midwifery services as primarily determined by chance and seen as good fortune. Fundamentally, the provision of midwifery care is associated with well-being and an increase in self-competence for the women interviewed. However, negative experiences with midwives may lead to a sense of rejection and refusal of the services offered. Discussion/conclusions: The lack of availability of midwifery care for women with complex psychosocial needs should be addressed to ensure that the access gained does not lead to the experience of powerlessness.