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69
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Introduction
Claire Lauren Feeley has recently gained her doctorate at the School of Community and Midwifery, University of Central Lancashire. Her PhD work related to the project 'Practicing ‘outside of the box’ whilst within ‘the system’. A narrative inquiry of NHS midwives supporting women’s unconventional birth choices in the UK.'
Additional affiliations
April 2016 - present
January 2012 - September 2015
Publications
Publications (69)
Problem/Background: Midwifery retention is a global issue, but less is known regarding what motivates midwives’ intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated.
Aim: To explore the views of midwive...
Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and midd...
This chapter explores the first element of a skilled heartfelt midwifery practice which focuses on the study participants’ values, attitudes, beliefs and philosophy. These factors coalesce and contribute important insights as to why the midwives were willing to support and facilitate alternative physiological birth choices. First, this chapter expl...
This chapter reintegrates the components that make up the concept of skilled heartfelt midwifery practice explored in chapters ‘Recognising Ourselves: The Role of Beliefs, Values, Attitudes and Philosophy on Birthing Choices’, ‘Cultivating Emotional Safety, the Cornerstone of Safe, Relational Care’ and ‘Moving from a Rule-Based Practice to Expert C...
This chapter explores the third and final element of skilled heartfelt midwifery practice focusing on expert clinical skills—an essential component of safe care. First, this chapter explores and critiques the increasing trend towards a ‘rule-based’ practice that contradicts the autonomous, professional practice midwives are qualified for. This cont...
This chapter explores the second element of skilled heartfelt midwifery that focuses on the midwives’ centring, valuing and provision of relational care. This was central to the midwives’ support and facilitation of alternative physiological births and crucially, it underpinned the provision of safe care. First, this chapter explores the common con...
Aims
To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives.
Design
A systematic integrated mixed methods review was conducted.
Data sources
MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April...
Background
The COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England which we map against a pre-developed ASPIRE framework to establish the potential...
LEARNING OUTCOMES
After reading this chapter, you will be able to:
1. Appreciate the complexities surrounding the
concept of ‘choice’ and how they may be perceived
by childbearing women, birthing people, and
midwives
2. Evaluate the meanings of choice in the context of
birth at home, midwifery-led units, obstetric
consultant-led units, and birthing...
Background:
Evidence from high-income countries demonstrate improvements in maternal and neonatal health with midwife-led care. Midwife-led care is pivotal to meet the United Nations' Sustainable Development Goals. Despite this, successful implementation of midwife-led care in low- and middle-income countries (LMICs) has been limited. It is theref...
Highlighting the experiences of midwives who provide care to women opting outside of guidelines in the pursuit of physiological birth, Claire Feeley looks at the impact on midwives themselves, and explores how teams and organisations support or discourage women’s birth choices.
This book investigates the processes, experiences and sociocultural-po...
Background:
The COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England.
Methods:
We undertook a mixed-methods system-wide case study using quantitative...
Objectives:
Water immersion during labour using a birth pool to achieve relaxation and pain relief during the first and possibly part of the second stage of labour is an increasingly popular care option in several countries. It is used particularly by healthy women who experience a straightforward pregnancy, labour spontaneously at term gestation...
Background
The national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how simil...
Over the past two decades there has been a developing staffing crisis in British maternity services. A 2021 Health and Social Care Committee Expert Panel report described “persistent gaps in all maternity professions” and proposed that “current recruitment initiatives do not consider the serious problem of attrition in a demoralised and overstretch...
Background
Patient and public involvement (PPI) has become increasingly important in the development, delivery and improvement of healthcare. PPI is used in healthcare innovation; yet, how it is used has been under‐reported. The aim of this scoping review is to identify and map the current available empirical evidence on the role of PPI during diff...
This article presents the ASSET model, a pneumonic that highlights what midwives need to support alternative physiological birth choices, with applications to all birth choices and midwifery practice. The model was developed following the data collection and analysis of a large qualitative study that focused on how NHS midwives supported these birt...
Background
Some childbearing women/birthing people prioritize out of maternity care organizational guidelines’ approaches to childbirth as a way of optimizing their chances of a normal physiological birth. Currently, there is little known about the experiences of midwives who support their choices.
Aim
To explore the experiences of UK midwives emp...
The research midwives at Lancashire Teaching
Hospitals NHS Foundation Trust, in collaboration
with the University of Central Lancashire (UCLan),
conducted a series of 55 staff and service user
interviews for the ASPIRE (Achieving Safe and
Personalised maternity care In Response to
Epidemics) COVID-19 study. We fully engaged
with this opportu...
This is the first article in a series reflecting on the role of research midwives in the ASPIRE (Achieving Safe and Personalised maternity care In Response to Epidemics) study. In this article we introduce ASPIRE and provide an overview of the study. We also reflect on what makes ASPIRE uniquely midwifery-led within the National Institute for Healt...
Water immersion for labour and/or birth can be a supportive low-cost, low-tech intervention that enhances women’s experiences of their labour and with positive outcome benefits. In a previous article,1 we highlighted the current evidence in favour of water immersion that demonstrated the positive impact upon women’s and birthing people’s physical a...
Background:
Parents of infants born premature and/or sick and who require neonatal care are at risk of poor mental health. Currently, there is no comprehensive knowledge about interventions (ie, types, evidence, resources) that have been exclusively designed to improve the psychosocial well-being of this population group.
Purpose:
To undertake a...
Reducing the chances of women suffering from perineal trauma during birth is a hot topic in maternity care. Perineal trauma is assessed as a range of classifications relating to the severity of tearing (first to fourth degree).1 Third and fourth-degree tears pose the most significant concerns as women may suffer ongoing pain, incontinence and sexua...
Plain language summary During the late stages of childbirth, complications can occur which require rapid birth of the baby. This can be facilitated with instruments (usually forceps or a suction cup) or by surgery (caesarean section). In some circumstances, instrumental birth (also termed assisted vaginal delivery, AVD) may be a better option than...
As the ninth article in our normal birth series, we highlight the key evidence around birthing pool use: a tool for optimising labour and birth physiology. Drawing upon our collective clinical and research-based experience, we provide practice tips for intrapartum care in water.
Aims
To gather, quality assess, synthesize and interpret the views, feeling, and experiences of women who used water immersion during labour and/or birth.
Design
A systematic meta‐thematic synthesis and GRADE‐CERQual.
Data sources
We searched MEDLINE, CINHAL, PsychINFO, AMED, EMBASE (MIDIRS only), LILACS, AJOL. Additional searches were carried ou...
UK legislation and government policy favour women’s rights to bodily autonomy and active involvement in childbirth decision-making including the right to decline recommendations of care/treatment. However, evidence suggests that both women and maternity professionals can face challenges enacting decisions outside of sociocultural norms. This study...
ORCID id Monitoring the fetal heart rate via intermittent auscultation (IA) during labour is a core midwifery skill and component of clinical practice. While it is not a diagnostic tool, i.e. it cannot predict future outcomes, it does guide clinical care and decision-making regarding the risk of fetal hypoxia.1 Fundamental to good IA is the underst...
In this chapter we draw on our research exploring ten women’s motivations to freebirth in the UK (Feeley, Thomson, 2016b, Feeley, Thomson, 2016a). First, we provide an overview of the context of birth and maternity care in the UK and discuss issues related to ‘birth choice’ within a lens of rhetoric versus reality. Such context provides valuable in...
Normal Birth Position Statement
Here at All4Maternity: The Practising Midwife and The Student Midwife, we are strong advocates of women and birthing people’s rights to make and enact their preferred birthing decisions. We are, however, concerned with the lack of equitable services meeting the needs of women seeking a normal physiological birth. Compelling evidence highlights the...
Some women opt for birth choices that are ‘outside guidelines’, with the aim of seeking a physiological birth. Some choices might be a little ‘nudge’ outside of guidelines, others may be more complex. To deliver appropriate woman-centred care, it is vital that midwives are able to learn from colleagues who have supported women outside of the guidel...
Childbirth is a liminal life experience; a transcendental journey through which a mother and baby are born. However, as with other significant life transitions, childbirth can be experienced on a spectrum from an inherently positive and empowering event to one that is deeply distressing, with short and long-term implications for maternal wellbeing,...
Some women opt for birth choices that are ‘outside guidelines’, with the aim of seeking a physiological birth. Some choices might be a little ‘nudge’ outside of guidelines, others may be more complex. To deliver appropriate woman centred care, it is vital that midwives are able to learn from colleagues who have supported women outside of the guidel...
Some women opt for birth choices that are ‘outside guidelines’, with the aim of seeking a physiological birth. Some choices might be a little ‘nudge’ outside of guidelines, others may be more complex. To deliver appropriate woman-centred care, it is vital that midwives are able to learn from colleagues who have supported women outside of the guidel...
Now published within my new monograph, this model depicts the sociocultural-political influence and impact upon midwives' who were willing to facilitate 'out of guidelines' physiological birth care.
https://doi.org/10.4324/9781003265443
Background:
Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women's views is important for good quality maternity care provision. We undertook a qualitative evi...
This article provides a brief overview of the historical, sociocultural issues regarding the of women's childbearing bodies. Exploring both sides of the feminist debate, a humanised approach to childbearing is presented as a way forward to achieving meaningful woman-centred care. Rather than either 'normal' or 'medical' birth, maternity care needs...
This article provides a brief overview of the historical, sociocultural issues regarding the of women’s childbearing bodies. Exploring both sides of the feminist debate, a humanised approach to childbearing is presented as a way forward to achieving meaningful woman-centred care. Rather than either ‘normal’ or ‘medical’ birth, maternity care needs...
Aim
This study explored women's reasons for and their experiences of decision making that related to the phenomenon of freebirthing within the United Kingdom. Freebirthing is the active choice to birth without a health professional present, even where there is access to maternity care.
Methods
In total, 10 women were recruited to participate in a...
Introduction: Women can face opposition when exerting autonomous decision-making regarding their birth choices, particularly when the decisions involve going against medical advice and/or outside of national guidelines. Termed ‘unconventional birth choices’, some research has explored women’s reasons and experiences of making such choices, but less...
Objectives
Unconventional birth choices can be characterised as birth choices that go outside of national guidelines and/or when women decline recommended are. The aim of this study was to explore the views and experiences of midwives who self-define as facilitators of women’s unconventional birth choices, whilst working within the NHS. By use of p...
This article revisits some key concepts within maternity care: women’s choice, autonomy, decision-making and consent through basic legal and ethical frameworks. It is intended as a ‘beginner’s guide’: a starting point into the tricky terrain to provide a basic platform for readers to conceptualise these ideas, and is by no means exhaustive.
Midwifery practice, care giving and women’s subsequent experiences of birth are often implicitly or explicitly governed by the guidelines, which can be a source of tension for both midwives and women. This article will discuss key issues, such as the conflation of policies, protocols and guidelines, the impact on midwifery practice and the historic...
Water immersion for labour and birth is a powerful, low cost intervention that facilitates physiological birth. However, for some midwives – students or qualified – a lack of exposure to water births can create fearful perceptions and reduce their willingness to support women in water. This article explores the nature of this fear, and how it was o...
Current changes in midwifery raise concerns about the erosion of women’s choices and midwives’
autonomy.This article is an exploration of women’s legal rights that relate to consent and declining care.
Using examples of poor practice, women’s negative experiences are highlighted. However, this article
demonstrates how midwifery practice can be grou...
Freebirthing can be a difficult issue for midwives to manage. Claire Feeley and Gill Thomson explore why women choose to do it and how midwives can handle such a scenario.
Background:
the concept of choice is a central tenet of modern maternity care. However, in reality women's choice of birth is constrained by a paucity of resources and dominant medical and risk adverse discourses. In this paper we add to this debate through highlighting the tensions and conflicts that women faced when enacting a freebirthing choic...
Background
Freebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth exp...
Background. Freebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision.
Aim. To integrate the findings of the current literature on the phenomenon of freebirthing, asking the question: ‘Why do some women choose to freebirth?’
Design. A meta...
Questions
Question (1)
Hi, I am now at the initial stage of my narrative inquiry study. My reading so far indicates that (as per Clandinin and Connelly) that prior to starting it is prudent to write an autobiographical self study to explore the three 'justifications' personal, practical and social to answer the so what and who cares? Whilst, I feel I understand the concept, does anyone have any guidance on this? Advice, or steps to take? I do have a few ideas but it would be good if anyone could share what and how they have done it. Many thanks in advance.
