Midwives' experience of offering anti-D immunoglobulin to women: The importance of choice

Background: Informed decision-making around anti-D immunoglobulin (Ig) is important but complex, requiring consideration of individual factors to reach the most appropriate choices for individual women. Aims: This research aimed to develop understanding of midwives' practices when offering anti-D Ig to RhD-negative women. Methods: A descriptive, qualitative study was used. Two focus groups were held with 11 midwife participants from two Scottish maternity units. Data were analysed using thematic analysis within a framework approach. Findings: When offering anti-D Ig, midwives were limited in their ability to fully engage with women in a process of individual informed decision-making, due partly to their own knowledge and understanding and partly to organisational culture and support. Conclusions: When interventions are recommended and offered routinely, it is challenging to extend the principles of woman-centred individualised care to facilitate meaningful decision-making. More effort is required to understand the difficulties faced by midwives.