Missed midwifery care during labor and birth

DESCRIPTION OF TOPIC Missed midwifery care is any aspect of required care expected for women, babies, and families that is delayed, unfinished, or completely omitted. Missed midwifery care is associated with poor midwifery-sensitive outcomes, such as lower breastfeeding initiation rates, negatively affecting women, newborns, and families’ health and well-being. Overall, the most common reasons for missed care include communication problems and inadequate staffing and resources. In Italy, missed midwifery care is underreported due to the lack of a measurement tool. Thus, this study performed a psychometric testing of the Italian version of the Perinatal Missed Care Survey to measure missed midwifery care of women during labor and birth. In accordance with the original English version, the I-PMCS comprises two sections (i.e., required midwifery care and potential reasons for missing care) composed of 25 and 16 items, respectively. The evidence resulting from this study is integrated in a clinical practice context in which most midwifery interventions are not reported, undermining the chance to provide evidence on the effectiveness and quality of care. To highlight the impact of midwifery missed care – as well as delivered care – this study boosts the need for quality indicators tailored to current international midwifery care standards of practice. Future studies on implementing a standardized taxonomy of midwifery interventions delivered and not (i.e., missed care) will corroborate the interaction between these and the midwifery-sensitive outcomes. RELEVANCE TO MIDWIFERY • Missed midwifery care is a crucial public health issue due to its impact on women, infants, and families at large. • Detecting missed midwifery care in clinical practice is essential to boost targeted strategies, enhancing the quality and safety of midwifery care. • The Italian Perinatal Missed Care Survey (I-PMCS) is a valid and reliable tool to evaluate missed maternity care during labor and birth.