Components of Care Expected from Midwives by Women with Twin Pregnancies After the Use of Assisted Reproductive Technology: A Cross-Sectional Study

Use of assisted reproductive technology (ART) to bear children has in recent years become widespread in Japan. While midwives are required to understand the experiences of individual women and provide ongoing support for them, implementing respectful care that meets the needs of women using ART remains challenging. This study therefore aimed to explore the specific care components expected of midwives for women with twin pregnancies after ART. A cross-sectional questionnaire survey was conducted through Google Forms on 273 women with twin pregnancies, of whom 85 had conceived twins through ART. Women were recruited through national multiple birth support groups and midwifery centers providing postnatal care. Data were collected from July 2021 to December 2022, and care expectations were rated on a 5-point Likert scale. Factor analysis was performed to identify care components, and reliability was evaluated using Cronbach’s alpha. Among the participants, 41.2% were between 36 and 40 years of age. Seven primary care factors were identified: comprehensive parenting support for twins, addressing concerns regarding the sudden death of twins, interdisciplinary medical collaboration, connecting women with twin pregnancies, understanding post-delivery physical pain, providing continuity before and after delivery, and supporting the development and well-being of the twins. The findings emphasize the importance of understanding individual ART histories and providing tailored care to respond appropriately to women’s needs during pregnancy, childbirth, and the postpartum period. The identified components provide an empirical foundation for integrating these perspectives into routine midwifery care and educational programs for women with ART-conceived twin pregnancies.