156 Chapter 6 APPENDIX 1 Supplement material 1 – Initial programme theory in the form of ‘If…then’ statements If midwives work in a bigger organisation (hospital or big group practice), then it is more likely that they are less motivated to provide MLCC, because they feel less involved in the organisation they work in and feel less involved with the clients they care for. If midwives are not in a permanent employment, then it is more likely that they feel that their input does not matter, because they feel less involved in the organisation they work in, which makes them feel less responsible for taking on non-client-oriented tasks and do not make suggestions for other possibilities in the organisation of care. If midwives provide MLCC they really get to know their clients, and then they will find caring for them during consultations, labour and birth to be less stressful because they understand each other and have developed good communication. If midwives do not have sufficient knowledge of scientific evidence, then they feel insecure in their collaboration and they will adopt a dependent position towards obstetricians, leading towards more obstetrician-led care. If midwives do not have a clear vision regarding their professional role and have insufficient knowledge regarding the added value of their view on quality of care for women and families, then they will easily adopt someone else’s viewpoints and will be easily influenced. If there are strong inter-organisational relationships, then midwives value and care for each other and will feel supported, and then they will collaborate to ensure a good work life balance. If community midwives feel observed and judged by secondary care providers, then they do not feel welcome to stay in the hospital with their client during labour and birth in case of a medical indication, because there is no trusting relationship. If community midwives feel observed and judged by the secondary care providers, then they will feel defensive, undermined and unable to seek help or support when necessary, which makes them feel unsafe. If maternity care providers meet each other on a regular basis, then they get to know each other, leading to compassion for each other’s work. This leads to a feeling of mutual trust, and will have a positive influence on their collaboration, and they will easily consult or refer to each other. If maternity care providers establish strong collaborative trusting relationships, then this can ensure smooth transitions and shared-care in case of medium or high-risk pregnancies, allowing MLCC to be available for all pregnant women.
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