The midwives' and women's interaction study

Alison Teate, Hannah Dahlen, Virginia Schmeid, Julie Swain

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Cochrane reviews report better outcomes for women receiving midwife-led care but these do not explain the nature or components midwifery continuity of carer (MCOC) interactions that achieve improved results. Aim: To gain greater understanding of midwife-woman interactions in antenatal appointment in order to identify facilitators and inhibitor of exemplary practice and translate this knowledge into improved midwifery care. Method: A critical feminist ethnography was used. Data collection included videoed observations of midwife-woman interactions in late pregnancy antenatal appointments, interviews and focus groups with women, midwives and managers. Ten midwife-woman pairs from Midwifery Group Practice (MGP) and from Standard Midwifery Care (SMC) and four managers from two Sydney, suburban hospitals participated. Thematic and descriptive analysis was used. Findings: Factors enhancing the woman's experience included midwife communication style, appointment environment, midwife investment in the woman's care and repeated antenatal appointment encounters between the same midwife and woman in MGP. Shared storytelling was identified as important to women's experiences, engendering compassion and enhanced healthcare messages. Environmental influences included appointment location, room setup and midwife strategies to engage with the woman. Factors inhibiting woman-centred care included a lack of acute-care hospital system knowledge about midwife-led care and MCOC. Conclusion: Concepts of respect; trust; protection of women's autonomy; flexibility; time and access to continuity of care were more evident in MGP. Conversely, the acute-care hospitals demonstrated they struggled to establish MGP and more ‘woman centred’ programs because focusing on these concepts was ‘at odds’ with the fragmented organisation of healthcare. Strategies identified to improve midwifery care include: more community-based and home-based antenatal care; more midwifery-led care programs offering MCOC; training strategies focused on midwifery communication and knowledge of woman-centred care; and support for hospitals to provide woman-centred healthcare.
Original languageEnglish
Pages (from-to)S54-S55
Number of pages2
JournalWomen & Birth
Volume28
Issue numbersuppl. 1
Publication statusPublished - 2015

Keywords

  • midwives
  • women
  • communication

Fingerprint

Dive into the research topics of 'The midwives' and women's interaction study'. Together they form a unique fingerprint.

Cite this