Edinburgh Napier University

  Background
Informed decision making around anti-D immunoglobulin (Ig) is important but complex, requiring consideration of individual factors to reach the most appropriate choices for individual women. This research aimed to develop understanding of midwives’ practises when offering anti-D Ig to RhD negative women.
Design
A descriptive, qualitative study was used. Two focus groups with 11 midwife participants from two Scottish maternity units were held. Data were analysed using thematic analysis within a framework approach.
Findings
When offering anti-D Ig, midwives were limited in their ability to fully engage with women in a process of individual informed decision making, partly due to their own knowledge and understanding, and partly due to organisational culture and support.
Conclusion
When interventions are ’recommended’ and offered routinely it is challenging to extend the principles of woman-centred individualised care in order to facilitate meaningful decision making. More effort is required to understand the difficulties faced by midwives.