Mother-newborn couplet care and the expectations, concerns and educational needs of healthcare professionals: a qualitative study

Objectives: Our aim was to explore healthcare professionals' (HCPs) expectations, concerns and educational needs regarding preparing for implementing the concept of couplet care, keeping newborns in need of intensive care together with their mothers in need of obstetrical care.

Design: A qualitative focus group study based on semistructured interviews. We analysed the data using reflexive thematic analysis. This study is part of a comprehensive research project and pre-implementation based on curriculum development principles and implementation theory.

Setting: We conducted four focus group interviews from May to June 2023 at a tertiary referral university hospital in Denmark.

Participants: Neonatologists, obstetricians, midwives and nurses (n=21) were recruited from neonatal and obstetric departments.

Inclusion criteria: Neonatologists, obstetricians, midwives and nurses with various levels of postgraduate experience.

Results: We identified the overarching theme of building bridges in relation to HCPs' expectations, concerns and educational needs and five subthemes: Enhancing meaningfulness through increased teamwork; compromising or improving patient safety; challenging professional comfort zones; encountering other cultural and ethical values; and recognising educational requirements.

Conclusions: HCPs widely support mother-newborn couplet care and emphasise the need for closer collaboration between neonatal and obstetric departments. Implementing couplet care is seen as meaningful, potentially enhancing the well-being of mothers and newborns and positively impacting HCPs' job satisfaction. Key concerns include patient safety, quality of treatment and care and the well-being of HCPs navigating their skills, psychological safety and professional boundaries. While the importance of couplet care for early closeness and connection is acknowledged, challenges arise in meeting diverse maternal and neonatal needs. Additional research, especially in highly specialised settings, is necessary to understand the complexities associated with changing the care paradigm for newborns and mothers to be cared for together and in implementing couplet care. We found focus groups useful as a tool for needs assessment and uncovering and adapting practices to address challenges in implementing couplet care.