Midwives and doctors in the delivery room: how does teamwork shape the birthing person’s experience?

The patient hears the team

In the delivery room, a patient hears not only the decision but also how the midwife and doctor reach agreement. If they disagree about the plan in front of her without explaining why, she may not know what will happen next or whom to ask. It is better to say what has already been agreed and be honest about what remains to be decided than to talk over her head. A review of 37 studies on respectful maternity care covered communication, dignity, consent, and privacy. It does not, however, show that a single agreement between team members will improve the patient’s experience: evidence for the effectiveness of interventions was limited, and a correction was noted when the review was published. A practical suggestion for discussion should therefore be kept distinct from the review’s findings.

Who explains the plan?

When the birth plan changes, agreement between the midwife and doctor on what to do is not enough. Before making the change, the team can identify who will tell the patient what will happen and why, and who will answer her questions. If team members hold different views, it also helps to explain who will make the decision and when she can expect it. If someone else takes over the conversation, the birthing person should still be able to ask about the next steps. Dividing up these roles does not mean everyone else must stay silent. The aim is to give the patient a clear explanation rather than leave her to reconcile different messages from staff herself. This is a suggested way to organise the conversation, not evidence that a particular approach is effective.

Privacy when several people are involved

When several people gather at the bedside, it is easy to focus on dividing up tasks and overlook the birthing person’s privacy. Before an examination, it helps to introduce everyone, explain why they are there, and limit the presence of people who are not needed for her care. If the plan is to be discussed at the bedside, the team can ask whether she is comfortable having the conversation there and avoid sharing details in front of others who do not need to know them. Consent should not be assumed simply because she is present; it should be sought whenever the circumstances allow. These small organisational choices show that teamwork includes how the person receiving care is treated, not just how professionals exchange information.

Hierarchy between midwives and doctors

A difference of opinion between a midwife and a doctor need not be framed as a rivalry between professions. Before changing the plan, it helps to make room for the midwife’s observations. If important information has not been heard, she should have an opportunity to raise it again, with a clear point at which the issue must be brought forward for a decision. Professional status can affect whether team members feel safe speaking up. This is suggested by a survey conducted in 23 neonatal intensive care units on hierarchy, inclusive leadership, and psychological safety. These were observational data from a different type of unit, however. They do not establish that a particular way of discussing decisions in the delivery room improves patient outcomes.

A culture that undermines dignity

A birthing person’s dignity also depends on the workplace culture in which midwives and doctors make decisions. A review of 13 studies described factors affecting respectful maternity care from staff perspectives in lower-resource countries. It helps illuminate the role of hierarchy, but does not justify assuming that the practices described occur at the same rate in a Polish hospital or attributing dignity-undermining practices to all midwives or doctors. Rather than assuming a facility knows how patients experience its care, it is worth asking them. Their answers may show whether the problem lies in how decisions are explained, whether they can ask questions, or whether they feel their privacy is respected. Only this local picture provides a starting point for change.

A brief team huddle

A brief huddle between the midwife and doctor before a procedure can clarify the immediate decision: its purpose, the plan, each person’s role, and how to raise concerns. It helps to include an important concern the patient has raised, identify who will explain the decision to her, and agree when the team will reassess the situation. If her condition or the plan changes, the explanation she receives needs updating too. The huddle must not replace a conversation with her or reduce her role to passively hearing what has been decided. It is a practical suggestion for the team, not a method whose effect on the birth experience has been confirmed by these sources. Its purpose is to prepare for a clear conversation with the patient, not simply to hold a meeting.

Reviewing care after birth

After the birth, it is worth asking the patient not only about the care she received, but also whether she understood changes to the plan, knew who made the decisions, and was able to ask questions. Medical outcomes and the experience of being treated with respect are different matters: a good assessment of one should not replace a conversation about the other. The team can separately revisit moments when the midwife and doctor gave different messages and check whether the patient subsequently received a shared explanation. If such discrepancies recur, the facility should improve how decisions are agreed on and communicated. To assess whether a change has helped, patients need to be heard again rather than assuming that introducing a huddle had the intended effect.

A patient hears not only the decision, but also how the team reaches it. Clear roles, room for questions, and respectful discussion help make delivery-room care easier to follow.

Empatyzer in midwife–doctor teamwork during labour

A midwife and doctor are planning a change in care during labour, but so far they have explained it differently to the birthing person. Before speaking with her again, they can use Em to prepare a shared statement about the plan and questions that will help them resolve their differences. In team mode, Em helps them agree on who will explain the decision to the patient and when; the team view can help identify who should lead that conversation. This gives them a shared message instead of improvising two separate explanations at the bedside. If the disagreement arises again, the ‘About me’ view can help each person notice how they tend to react in front of a patient and prepare a way to raise the difference with the other person. Micro-lessons can support practice in giving a brief, consistent summary after the plan changes. These tools help the team prepare to work together; they do not replace a conversation with the birthing person, her questions, or an assessment of how she understood the explanation.