Norwegian community midwives'experience of interdisciplinary collaboration in care of pregnant women with vulnerabilities

Aim: The aim of this study was to investigate Norwegian community midwives(CMs) experience of collaboration when caring for pregnant women with vulnerabilities. We wanted to determine which professionals and services are considered important and with whom they have written agreements and good lines of communication. Furthermore, which tools are used in collaboration and if any background factors enhance collaboration. Background: Vulnerable pregnant women may require more than standard antenatal care, involving interdisciplinary collaboration. Outcomes can improve if vulnerable pregnant women are offered additional support. The introduction of multi-disciplinary teams in Norway has shown promising results, as in many other countries. A Norwegian report concluded that there is need for more research to improve the quality and availability of interdisciplinary care. Methods: A cross-sectional, descriptive study, using data from a questionnaire that approximately 700 CMs in Norway were invited to answer online from May-August 2020. Data were analysed using the statistical software SPSS 26. Results: One third (257) of the invited CMs participated in the survey. They reported that professionals involved in standard antenatal care, such as those at the maternity unit and PHNs, were the most important collaborative partners when caring for vulnerable pregnant women. The CMs reported poor communication with general practitioners, child welfare-, drug welfare- and mental health-services. The most frequent methods for accessing collaboration were phoning and electronically through patient record systems, while there was limited use of the personal care plan, patient coordination meetings and regular meetings with collaborative partners/services. CMs with more than ten years as a CM and "Early Start" training were more frequently involved in patient coordination meetings and counselling and debriefing sessions compared to inexperienced CMs who had not attended a special training program. Conclusion: Experience and completed the Early Start education/training increased the use of interprofessional collaborating meetings including CMs. This study suggests interdisciplinary training programmes to improve collaboration, which are expected to benefit vulnerable pregnant women, their babies and families. Implication for practice and research: We recommend education and training in both the educational system and among involved professionals in communities to improve collaboration in the care of vulnerable women. In order to measure the effectiveness of collaboration in the care of vulnerable pregnant women, both the targeted group and the collaborating professionals should be asked to provide feedback. More research on communication and collaboration is needed.