Article

Exploring Professional Support Offered by Midwives during Labour: An Observation and Interview Study

School of Health and Medical Sciences, Örebro University, 70182 Örebro, Sweden.
Nursing research and practice 12/2012; 2012:648405. DOI: 10.1155/2012/648405
Source: PubMed

ABSTRACT Support in labour has an impact on the childbirth experience as well as on childbirth outcomes. Both social and professional support is needed. The aim of this study was to explore professional support offered by midwives during labour in relation to the supportive needs of the childbearing woman and her partner. The study used a qualitative, inductive design using triangulation, with observation followed by interviews. Seven midwives were observed when caring for seven women/couples in labour. After the observations, individual interviews with midwives, women, and their partners were conducted. Data were analysed using hermeneutical text interpretation. The results are presented with three themes. (1) Support as a professional task seems unclear and less well defined than medical controls. (2) Midwives and parents express somewhat different supportive ideas about how to create a sense of security. (3) Partner and midwife interact in support of the childbearing woman. The main interpretation shows that midwives' supportive role during labour could be understood as them mainly adopting the "with institution" ideology in contrast to the "with woman" ideology. This may increase the risk of childbearing women and their partners perceiving lack of support during labour. There is a need to increase efficiency by providing support for professionals to adopt the "with woman" ideology.

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Available from: Stina Thorstensson, Aug 28, 2015
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    ABSTRACT: Background Women's negative experiences in the delivery room can have significance for later fear of childbirth. Therefore, it is important to critically evaluate the care during childbirth. The aim was to gain a deeper understanding of women's negative experiences in the delivery room. Methods This study is based on original data from three qualitative studies on Swedish women's experiences of fear of childbirth. Data were collected from interviews with 21 women; 15 pregnant women (6 + 9) with intense fear of childbirth, and 6 women who had experienced intense fear of childbirth 7-11 years prior to the interview. The analysis had a hermeneutic approach, with focus on the women's descriptions of their previous negative birth experiences. Findings The interpretation showed that in the delivery room the women were objects of surveillance, and they endured suffering related to the care during childbirth. This involves experiences of midwives as uncaring, feelings of being suppressed, unprotected and lacking safety, of feeling disconnected and of the body as incompetent in giving birth. The birth environments are understood as power structures, containing views of women's birthing bodies as machines, and delivery rooms as surveillance environments, involving interventions such as fetal heart monitoring, induction and augmentation of labour. Conclusions The delivery room was, for these women, a place creating fear of childbirth. To avoid negative birth experiences and future fear, women must be offered not only medical, but also emotional and existential safety in the delivery room.
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