Digital Channels in Healthcare Service Provision: A study of midwives and women's understanding of and engagement with information and communication technologies (ICT)

Abstract

This study is about pregnant women, midwives, and information and communication technologies (ICT) during the provision of primary maternity services. It explored (n=35) midwives and (n=55) pregnant women’s perceptions and lived experiences of information and communication technologies (ICT) within this context, and sought to understand the factors that may influence the use or non-use of these technologies. Using a constructivist grounded theory approach (Charmaz, 2006), midwives and women’s interview data was analysed across the conceptual framework of Assets, Actions and Attitudes.

The findings showed that midwives valued ICT for increased business efficiency and for professional purposes and that they did not feel the need to use ICT to assist their interactions with the women. Midwives felt threatened by ubiquitous information, loss of transparency and the lack of control brought by the internet. The tension between the ‘hands-on’ orientation of midwifery and the virtual orientation of ICTs, and a historical predisposition towards a non-technical birthing environment, were deterrents to midwives using women-centred ICT. Women routinely accessed flows of health information, and valued the internet for recreation and socialisation. Compared with midwives, Generation Z women had new and different digital skills for communicating, with their mobile devices acting as an extension of their selves, as they interacted in virtual spaces. Women valued virtual methods of support while midwives felt digital communication could be ‘dangerous’ as they did not have the digital skills to safely use new media channels. This study offers a theoretical understanding of ICT as understood by key stakeholders within the provision and consumption of maternity services. The substantive theory of ‘unused and underused channels’ contributes to an understanding of factors surrounding midwives’ digital non-engagement with women. Research findings suggest that midwives and their professional organisation’s sub-optimal digital literacy and digital awareness are restricting women’s information and communication choices. By understanding the impediments to providers’ digital engagement, stimulation strategies including dialogue, education, policy changes, resources and support opportunities to foster capability can be considered.