A web-based survey of midwives' perception of women using the internet in pregnancy: A global phenomenonLagan BM, Sinclair M, Kernohan WGK (2011) 27: 273-281

Healthcare consumers are turning to the internet for health-related information at an ever increasing rate. This poses a significant challenge to the healthcare providers to improve their literacy in information technology. In midwifery practice this includes use of the internet to search for information, recommending reliable sources of information to pregnant women, as well as keeping up to date with the information women would retrieve from the internet.

This study aimed to assess the views of midwives with regard to their use of the internet as a source of information, to elicit the extent and nature of pregnant women's use of internet from a midwifery perspective, and to explore the midwives' perceptions of pregnant women using the internet as an information source.

A web-based survey with a cross sectional descriptive study design was used. Midwives with direct contact with pregnant women were invited to join the study through suitable midwifery online sites and discussion forums.

An international sample of 303 midwives participated and filled out a web-based questionnaire. Over 90% of respondents had internet access at the workplace. Nearly three-quarters of respondents faced obstacles in using the internet at work with lack of time being the main obstacle. Only 56% of respondents recommended information websites to pregnant women while only 25% admitted to recommending support groups. Though 69% of respondents agreed that they had the confidence to appraise health information on the internet, only 22% were aware of the quality indicators for such evaluations. Over 60% of respondents agreed that the internet was relevant to delivery of midwifery care, improves the quality of practice and performance and should be part of midwifery training. Over 90% of respondents were aware of an increase use of internet by the pregnant women and 91% agreed that information on the internet challenges the midwives to be more up to date with latest knowledge. Many (73%) agreed that it improved the understanding of treatment by the pregnant women and gave women more control over decisions affecting their pregnancy. However, 90% of respondents were concerned about the accuracy of the information women were accessing. Many (86%) of the respondents had experienced a woman discussing information from the internet with them.

This study demonstrated that internet is still used in midwifery practice as a secondary information source and a significant proportion did not recommend it to pregnant women. Though many respondents felt confident in appraisal of available sources, a large proportion were unable to name at least one of quality indicators. This is an area that needs urgent attention and midwives should be educated on appraisals of internet related health information. The study also demonstrates that increased access to the internet challenges the midwives to become more up-to-date with internet based information.

A limitation of this study is in the methodology which creates selection bias, where web-based forums were used to assess the perception of internet use. Therefore, the generalisability of the results may be limited to those who had internet access.