Factors influencing the implementation of the woman-centred care model for pregnant women in a hospital setting: an integrative review

Background: The term “Woman-Centred Care” focuses on the individual needs, aspirations and expectations of the woman herself rather than the needs of the healthcare system or professionals. The principles on which this model of care is based, are the control, choice, and continuity of care for women. Objective: The objective of this review would like to explore and summarise the evidence currently available on the factors which influence the implementation of the care model for pregnant women in a hospital setting. Methods: An integrative review was conducted using the method of Whittemore and Knafl and the PICOT search strategy. The Medline, PubMed and CINAHL databases were examined to identify primary studies that, between 2013 and July 2024, investigated factors influencing the implementation of women-centred care models in hospital settings. The inclusion/exclusion process and reporting followed the PRISMA 2020 guidelines. The qualitỳ of the studies was assessed according to the criteria of the Mixed Method appraisal tool. Findings: 411 studies were eligible and 16 of those included. A total of 16 records were included. Four themes and four sub-themes influencing the implementation of Woman-Centred Care were identified: the perspective of the midwives; the care model; communication and collaboration (relationships with colleagues; relationship with women and empowerment) and, resources and support (organisation and stakeholders; management). Discussion: The implementation of the “Woman-Centred Care" model is strongly influenced by organizational policies and midwives' awareness of their role as guarantors of "natural" childbirth. Conclusion: The lack of a shared understanding of what Woman-Centred Care actually means can contribute to the confusion and definition with which it is proposed.