Academie Verloskunde Maastricht

Exnovating for better birth

Back to the overview

Good communication and collaboration are prerequisites for good health outcomes, but guidelines and protocols are not sufficient.

Start date: 2012
End date: 2017

Exnovating for better birth (EBB) was developed by researchers and caregivers from the Academie Verloskunde Maastricht (AVM), Maastricht University, and Verloskundig Consortium Limburg. In addition to the explicit collaboration in the Consortium, EBB focuses on implicit communication and collaboration. Taking into account recommendations for better communication and collaboration between primary, secondary and tertiary care, EBB stresses the importance of reflecting on everyday practice. In daily practice, caregivers already work well together in many respects. Through looking at these cases, EBB can learn from good examples and identify and disseminate tools for further improvement.
A systematic literature review provided further theoretical underpinning for EBB. Then, we perform a qualitative ethnographic study on the communication and collaboration among caregivers and between caregivers and parents (to be). Researchers, caregivers and clients learn together from strengths (and weaknesses) of daily communication and collaboration. We use the video reflexivity method with observations in participating hospitals and midwifery practices and reflective group meetings of caregivers themselves and of caregivers and clients. EBB ends with professional and public deliberation: Based on the insights gained all project participants, members of the Consortium and policy makers formulate joint policy.


To develop ideas for innovation and improvement of collaboration in maternity care from existing practice: exnovation.


While perinatal mortality in nearly all European countries, including the Netherlands, has decreased over the past fifty years, the decline in the Netherlands has been less profound than in other countries. The cause is often sought in a lack of 'good' communication and collaboration among caregivers. In EBB, researchers, caregivers and parents (to be) focus on ingredients of "good" communication and collaboration. Besides further improvement of maternity care practice, this research provides insights into collaborative learning by caregivers and clients, and contributes to theory on communication and collaboration.