99 4 MODELS OF RISK SELECTION IN MATERNAL AND NEWBORN CARE 2022, 19, 1046 7 of 15 Table 3. Moment of discussion specified for bi-disciplinary and multidisciplinary * discussions (n,%). Bi-Disciplinary Multidisciplinary n(%) n(%) Discussion is only scheduled at request, and not scheduled routinely. 9 (13) 28 (40) Discussion is scheduled at request, and scheduled routinely. 52 (75) 37 (54) Contradictory answers amongst respondents within the MCC *. 1 (1) 2 (3) Variation within the MCC. 6 (9) 0 Unclear. 1 (1) 2 (3) * Bi-disciplinary discussions: discussion between primary care midwives and obstetricians. Multidisciplinary discussions: discussion between primary care midwives and obstetricians and other professionals. Table 4. Routinely scheduled visit to the obstetrician or the primary care midwife (n,%). n(%) One or more visits to the obstetrician are scheduled routinely for all women in primary midwife-led care. 1 (1) One or more visits to the primary care midwife are scheduled routinely for all women in obstetrician-led care. 3 (4) One or more visits to the obstetrician are scheduled routinely for women with a medium or high-risk profile in primary midwife-led care. 11 (16) One or more visits to the primary care midwife are scheduled routinely for all women in obstetrician-led care, and vice versa to the obstetrician for all women in primary midwife-led care. 2 (3) One or more visits to the primary care midwife are scheduled routinely for women in obstetrician-led care, and vice versa to the obstetrician for women with a medium or high-risk profile in primary midwife-led care. 1 (1) Variation within the MCC *. 1 (1) Unclear. 4 (6) Not mentioned in the answers. 46 (67) * MCC = Maternity Care Collaboration. In 75% of the MCCs, the moments of discussion between primary care midwives and obstetricians were routinely scheduled (Table 3). Meetings were scheduled at a certain moment in the care pathway—mostly after the booking appointment (33%)—or with a certain frequency, mostly every six weeks (11%), every two weeks (14%), or weekly (11%). In almost half of the MCCs, the bi-disciplinary discussions were also attended by hospital-based midwives. In 22% of the MCCs, resident obstetricians were also part of these discussions (Table S1). In some of the MCCs, one or more visits were scheduled routinely for women in primary midwifery care to the obstetrician and vice versa (Table 4). Multidisciplinary discussions were scheduled routinely in half of the MCCs (Table 3). Of these, 89% were for women with psychosocial complications. In four (11%) MCCs, all indications requiring a multidisciplinary approach were discussed. In half of the MCCs, the multidisciplinary discussions were scheduled halfway through pregnancy. The professionals most often present at the multidisciplinary discussions were the primary care midwife (95%), the obstetrician (92%), the pediatrician (89%), the social worker (78%), and the child health nurse (49%). In some MCCs, the general practitioner, the psychiatrist, and a representative of the child protection council also attended the multidisciplinary discussions. In one MCC, other professionals only attended if relevant for the discussed case. In three MCCs, other professionals were always present; in one of these MCCs,
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