Exploring Perspectives of Parturient Women and the Obstetric Team: Towards an Integrative Obstetric Care Model

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Abstract
Objectives: Integrative medicine programs are increasingly being implemented in clinical settings, including gynecology and obstetrics. This study explores an integrative obstetric and maternity care (IObM) model designed for real-life peri-labor settings, comparing perspectives among parturient women to obstetric healthcare professionals (HCPs) regarding operative components of the model. Methods: A 26-item questionnaire was prospectively administered to women hospitalized from the 22nd week of gestation (antenatal, early labor, or immediate postpartum) and to obstetric HCPs, primarily obstetricians and nurse-midwives, in three obstetric wards. Four core items addressed key aspects of the IObM model: the source of and indications for referral to IObM treatments, preferred IObM modalities, and willingness to receive care from uncertified IObM providers. Results: The two respondent groups (63 parturient women and 60 HCPs; response rate 95 and 100%, respectively) showed similar patterns regarding language, religiosity, spiritual relatedness, prior complementary medicine use (>66%), and perceived effectiveness and risks during pregnancy and labor. Internal consistency within each of the four core items was moderate and acceptable (parturients, α = 0.61–0.69; HCPs, α = 0.62–0.68). HCPs showed greater support than parturients for nurse-midwife referrals (p = 0.002) and mind-body trained therapies (p = 0.002). Both groups recommended labor-related indications for IObM referral, primarily labor pain, anxiety, and labor progression. Parturients were more supportive of nurse-provided IObM care (p = 0.012). Conclusions: Exploring expectations of parturient women and HCPs is essential when designing IObM models of care. Four core aspects should be prioritized: source of and indication for the referral to IObM treatments and mapping of preferred IObM modalities and providers. These findings reflect acceptability, expectations, and preferences in a single center with an established integrative service and should not be read as evidence of clinical effectiveness or of successful implementation. Further prospective research should explore implementation of these models in real-life practice, assessing effectiveness, risks, and birth experience.

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