RESEARCH PAPER
Enhancing person-centered obstetric care: A qualitative grounded theory study on perception formation and sense-making during childbirth
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1
Center for Health Services Research and Communication, Department for Psychosomatic
Medicine and Psychotherapy, Faculty of Medicine, University Hospital Bonn, Bonn, Germany
2
Chair of Health Services Research, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
3
Chair of Quality Development and Evaluation in Rehabilitation, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of
Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
4
Management and Health Services Research, Business School and School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK
5
Lake Cook Behavioral Health, Evanston, USA
Submission date: 2026-07-05
Final revision date: 2026-07-19
Acceptance date: 2026-08-06
Publication date: 2026-09-04
Corresponding author
Mi-Ran Okumu
Center for Health Services Research and Communication, Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Bonn, Venusberg-Campus 1, Building 02, 53127 Bonn, Germany
Eur J Midwifery 2026;10(September):41
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Quality of obstetric care comprises both provision and experience of care, yet patient experiences have received less attention. Person-centered care seeks to tackle this gap by attributing equal significance to clinical outcomes and care experiences. Individual experiences vary despite similar treatments because subjective appraisals differ. Understanding this process can help to enhance person-centered care in obstetrics. The
study’s aim is to explore how birthing persons perceive and make sense of obstetric care
experiences.
Methods:
The qualitative study adopted a grounded theory approach according to Corbin and Strauss, utilizing 12 narrative interviews with mothers who gave birth in a hospital a maximum 12 months prior. They were recruited through iterative theoretical sampling through the project Instagram channel between March and August 2023. The iterative process of data collection, analysis and constant comparison resulted in a theoretical model explaining how parturients experience obstetric situations.
Results:
During analysis, sense of coherence (SoC) emerged as core category shaping how parturients perceive and make sense of obstetric situations: negative experiences related to low manifestations of SoC and positive experiences to high SoC. A subsequent literature review linked these empirical findings to Antonovsky’s SoC which was contextually adapted to the perception of obstetric situations shaped by comprehensibility, perceived manageability and contextual framing factors.
Conclusions:
Recognizing how parturients construct meaning through their situational SoC, may offer a basis for reflections on interaction with them. Though not allowing for direct generalization, the findings may offer a theoretical concept for further research targeting situational SoC during care processes or piloting feasible measures for real-time assessment.
ACKNOWLEDGEMENTS
We would like to thank our interview participants for sharing their experiences with us.
CONFLICTS OF INTEREST
The authors have each completed and submitted an ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. L. Bach, L. Haid-Schmallenberg, M. R. Okumu, N. Scholten, A. Volkert report that since the initial planning of the work they had support for
the present manuscript from the Federal Ministry of Research, Technology and Space (BMFTR) under grant number 01GY2110
and that for the past 36 months had grants from the Federal Ministry of Research, Technology and Space (BMFTR) under grant
number 01GY2110.
FUNDING
The project was funded by the Federal Ministry of Research, Technology and Space (BMFTR: 01GY2110). The funding body
played no role in the design of the study nor in the collection, analysis, interpretation, or writing of the manuscript.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval was obtained from the Medical Faculty of the University of Cologne (Approval number: 22–1260; Date: 9 February 2023). Participants provided informed consent.
DATA AVAILABILITY
Due to the study’s sensitive nature and the assurance of anonymity, the data are not publicly available.
AUTHORS' CONTRIBUTIONS
NS, LB and MRO: conceptualization and methodology. MRO, LB and LHS: acquisition, analysis, visualization. All authors:
interpretation. MRO: writing of original draft. LB, LHS, LM, UK, NRS and AV: writing, reviewing and editing of the manuscript.
MRO and LB: project administration. NS: funding acquisition, supervision. All authors read and approved the final version of the
manuscript.
ADDITIONAL INFORMATION
SUPPLEMENTARY FILE DISCLAIMER
The content has been provided by the author(s) and has not been reviewed, verified, or endorsed by European Publishing. It may not have undergone peer review. The views, opinions, and recommendations expressed are solely those of the author(s) and do not necessarily reflect the position of European Publishing. European Publishing accepts no responsibility or liability for any consequences arising from the use of, or reliance on, this content.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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