Integrated maternity care in Finland: mothers’ experiences and professionalś perceptions

BACKGROUND: Divided responsibility to organise primary and specialised maternity care is common. In Finland, this has caused increasing number of visits and poor information flow between the care sectors. Some counties have had vertically integrated care sectors for a few years. Thus, we aim to study mothers’ experiences on care in counties with integrated care (IC) and non-integrated care (NIC), as well as perceptions of maternity care managers about the integration. METHODS: FinChildren Survey data 2020 on mothers with small babies (N = 8,923) and qualitative thematic interviews for maternity care managers (N = 8) were used. IC-counties were compared to NIC-counties adjusting for confounders in logistic regression. Over 30 indicators on motherś experience were used as outcome measures. The qualitative data were analysed with content analysis. RESULTS: Mothers were often more satisfied with care in IC- than in NIC-counties. 72% of first-time mothers in IC-counties compared to 66% in NIC-counties considered visits in antenatal clinics customer-oriented (adjusted OR 1.30 (1.05-1.63)). 87% of mothers in IC- and 81% in NIC-counties received adequate professional support for personal coping during pregnancy (OR 1.57 (1.08-2.27)). 64% of mothers in IC- and 56% in NIC-counties found prenatal classes beneficial for fear of childbirth (OR 1.44 (1.04-1.98)). However, part of the indicators did not show difference in motherś experience on care between IC- and NIC-counties. Maternity care managers felt that the fragmented structures within maternity care together with organisational boundaries pose a challenge to integrated care. Shared structure, management and information systems were seen as promotors for integration. CONCLUSIONS: Integration of maternity care is to some extent associated with positive experience. However, maternity care should be better integrated in terms of structures, resources and management, to guarantee continued care and support for mothers and families. KEY MESSAGES: • Integrated maternity services are essential from the perspective of pregnant mothers. • Shared organisational systems are needed to ensure sustainable care for mothers and families.