Access & Utilization of Midwife Care in Switzerland
Midwife-led care models offer a wide range of benefits but are rarely used in Switzerland despite existing services. The project is investigating how access to and use of these models can be improved.
Factsheet
- Schools involved School of Health Professions
- Institute(s) Midwifery
- Funding organisation Others
- Duration (planned) 01.01.2026 - 31.12.2029
- Head of project Fanny Mewes-Toumi
- Project staff Prof. Dr. Susanne Grylka
- Partner Stiftung Amaari
- Keywords Midwife-led care; maternity care; access to health care; models of care; health professionals; Switzerland
Situation
Midwife-led care models are associated with better maternal and neonatal outcomes, fewer obstetric interventions and more positive birth experiences. In Switzerland, there are various forms of midwife-led care, such as home births, birth centres and midwife-led departments in hospitals. However, only a small proportion of women have used these services to date. This discrepancy between existing structures and low utilisation raises key questions about access and utilisation. Studies show that the use of midwife-led models is influenced by a complex interplay of organisational conditions, women's individual perceptions and professional attitudes. However, there is currently a lack of systematic data on the specific design and utilisation of existing models in Switzerland. Similarly, there is only limited knowledge about women's expectations, experiences with information and counselling, and the attitudes and counselling practices of health professionals. This project addresses these gaps and examines access to and use of midwife-led care models in Switzerland from a structural, individual and professional perspective.
Course of action
The aim of this research project is to systematically examine access to and use of midwife-led models of care in Switzerland and to identify facilitating and hindering factors at the structural, individual, and professional levels. A multimethod design comprising three interconnected studies is employed. The first study provides the first nationwide mapping of organisational models of midwife-led care in Switzerland. Secondary data are analysed and complemented by a national telephone survey of hospitals, birth centres, and self-employed midwives to generate an overview of structures, services, and utilisation. The second study investigates women’s perspectives through a national online survey, collecting data on sociodemographic characteristics, used models of care, experiences of information and counselling, attitudes, preferences, and perceived access barriers. The third study consists of qualitative semi-structured interviews with midwives and specialists in gynaecology and obstetrics from across Switzerland, focusing on professional attitudes, counselling practices, and perceived facilitators and barriers. The project is theoretically grounded in Levesque’s model of access to health care, which conceptualises access and use as the interaction between structural conditions and individual capacities.
Result
The project will provide a systematic, nationwide overview of the organisational design and utilisation of midwife-led models of care in Switzerland. It is expected to generate detailed insights into which models exist, how they are organised, and to what extent and by whom they are used. At the individual level, different utilisation profiles will be identified, illustrating which social, individual, and structural factors are associated with the choice or non-choice of midwife-led care. This will highlight which groups benefit most from these models and which women currently have limited access. The qualitative study complements these findings by incorporating the perspectives of health professionals, illustrating how midwife-led models are perceived in professional practice. By combining the three studies, the project allows structural, professional, and individual determinants to be examined in relation to one another, enabling the clear identification of existing barriers as well as facilitating conditions.
Looking ahead
The results of this project will provide a solid empirical foundation for the further development of maternity care in Switzerland. They enable the formulation of evidence-based recommendations to improve access to midwife-led models of care and to strengthen existing structures in a targeted manner. For clinical practice, the findings can support the alignment of information and counselling processes more closely with women’s needs and contribute to the further development of professional interfaces between health care providers. At the structural level, the results will offer insights into the conditions under which midwife-led care is readily accessible and how existing services can be better utilised. In addition, the project is relevant to health policy debates on the quality and sustainability of maternity care. In the long term, it has the potential to reduce inequalities in access and to strengthen women’s choice. The findings are also relevant to other countries with comparable health care systems and provide a basis for future research.
