What are the factors that improve how midwives interact with women in the antenatal appointment?

Alison Teate, Hannah G. Dahlen, Nicky Leap, Virginia Schmied

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Midwifery Continuity of Care (MCOC) demonstrates improved outcomes, which are linked to positive midwife-woman relationships that develop during the antenatal period. Aim: This study examined midwife-woman interactions in antenatal appointments in MCOC and Standard Midwifery Care (SMC) in order to discover what works well in the antenatal appointment and improve the care women receive. Methods: This feminist ethnographic study took place between 2012 and 2015 after ethical approval was received. Antenatal appointments were videoed, focus groups took place with midwives and managers and interviews with midwives and women. Data were analysed thematically and descriptively. Results: 18 midwife-woman pairs were video-recorded and observed during a 36 week appointment, at two hospital sites and in women’s homes. Worry was a significant part of the antenatal appointment and was affected by time, environment and midwife investment. Worry was transformed to shared hope when these factors were optimal. Investment was seen in the midwife-woman interaction when they shared communications with ‘storytelling’ and ‘discussing’ rather than a one-sided action of the midwife ‘telling’ the woman, which moderated and was moderated by time and environment. Midwives and women shared stories to share their knowledge, reciprocate and reassure, enabling connection. Conclusion: Shared storytelling in the antenatal appointment was facilitated by MCOC and some individual midwives and was important to women, as it engendered compassion, enhanced healthcare messages, moderated worry and created hope. Implications: How midwives interact with women in antenatal appointments matters. Antenatal care is improved when it occurs in women’s homes and non-clinical environments. Repeated and ongoing time with the same midwife (MCOC) facilitates storytelling and enables the worry of childbirth to be transformed to shared hope.
Original languageEnglish
Pages (from-to)25-26
Number of pages2
JournalWomen and Birth
Volume30
Issue numberSuppl. 1
DOIs
Publication statusPublished - 2017

Keywords

  • midwifery
  • midwives
  • prenatal care

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