Perinatal women's perceptions about midwifery led model of care in secondary care hospitals Karachi, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Historically, the midwifery led model of care (MLC) has been termed as a women centered model of care. In MLC, women find midwives as their primary care providers during the antenatal, intranatal, and postnatal periods. MLC exists in various forms, from strong to weak presence of midwives, in maternity care settings in Pakistan. In 2010, four hospitals dealing with women and child care were merged with the Aga Khan University (AKU), and these facilities are called the secondary sites. Out of these, at 2 sites, the Aga Khan Hospital for Women, Garden and Kharader (AKHW, G & K), MLC is provided; and, this is the first time that an MLC study has been undertaken. The purpose of this study is to explore the perceptions and experiences of perinatal women who have availed MLC at AKHW, G and K. Ten women, who received MLC, were enrolled in this study. A semi-structured interview guide was used for data collection and in-depth interviews were conducted in the Urdu language. Interviews were audio recorded, and verbatim were transcribed in the Urdu language. The data from Urdu was translated into the English language for analysis. The analysis of the data was done by using the six steps given by Creswell (2003). Based on the data analysis "women's satisfaction with MLC" emerged as the main theme and, under this theme, the six categories that emerged were (1) admiring kabiliyat [capability] and maturity of midwives, (2) affording midwifery services, (3) apnapun ka rishta [personalized relationship], (4) empowered women to make decision, (5) presence, and (6) voiced concern regarding lack of marketing of MLC. The overall findings revealed that women had a feeling of satisfaction with the maternity care provided by the midwives. Mostly, women appreciated midwives' expertise in providing maternity care. A majority of the women acknowledged the continuous presence of the midwives during child birth. In addition, women shared that they were empowered to make decisions related to their care. Most of the women indicated that marketing for MLC is scarce and not sufficient. A majority of the women are even not aware about this model; therefore, it is imperative to create awareness and to provide MLC access to women through robust marketing. This study lays emphasis on MLC and recommends different marketing strategies to promote access to cost-effective maternity care for Pakistani women. The study findings indicate implications for midwifery education, practice, policy makers, and research. In addition, recommendations have been provided to enhance the marketing of MLC; some of the recommendations are also about midwifery education, and research.

This document is available in the relevant AKU library