Sally Boyle1, Hilary Thomas2, Fiona Brooks2. 1. School of Health and Social Care, London South Bank University, Southwark Campus, 103 Borough Road, London SE1 0AA, UK. Electronic address: boyles3@lsbu.ac.uk. 2. Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Herts AL109AB, UK.
Abstract
OBJECTIVE: to explore whether the UK Government agenda for partnership working and choice was realised or desired for women during pregnancy and childbirth. DESIGN: a qualitative study was used to explore women's experience of partnership working with midwives. Data was generated using a diary interview method throughout pregnancy and birth. SETTING: 16 women were recruited from two district general hospitals in the South East of England. FINDINGS: three themes emerged from the data: organisation of care, relationships and choice. Women described their antenatal care as 'ticking the box', with midwives focusing on the bio-medical aspects of care but not meeting their psycho-social and emotional needs. Time poverty was a significant factor in this finding. Women rarely described developing a partnership relationship with midwives due to a lack of continuity of care and time in which to formulate such relationships. In contrast women attending birth centres for their antenatal care were able to form relationships with a group of midwives who shared a philosophy of care and had sufficient time in which to meet women's holistic needs. Most of the women in this study did not feel they were offered the choices as outlined in the national choice agenda (DoH, 2007). IMPLICATIONS FOR PRACTICE: NHS Trusts should review the models of care available to women to ensure that these are not only safe but support women's psycho-social and emotional needs as well. Partnership case loading models enable midwives and women to form trusting relationships that empowers women to feel involved in decision making and to exercise choice. Group antenatal and postnatal care models also effectively utilise midwifery time whilst increasing maternal satisfaction and social engagement. Technology should also be used more effectively to facilitate inter-professional communication and to provide a more flexible service to women. Crown
OBJECTIVE: to explore whether the UK Government agenda for partnership working and choice was realised or desired for women during pregnancy and childbirth. DESIGN: a qualitative study was used to explore women's experience of partnership working with midwives. Data was generated using a diary interview method throughout pregnancy and birth. SETTING: 16 women were recruited from two district general hospitals in the South East of England. FINDINGS: three themes emerged from the data: organisation of care, relationships and choice. Women described their antenatal care as 'ticking the box', with midwives focusing on the bio-medical aspects of care but not meeting their psycho-social and emotional needs. Time poverty was a significant factor in this finding. Women rarely described developing a partnership relationship with midwives due to a lack of continuity of care and time in which to formulate such relationships. In contrast women attending birth centres for their antenatal care were able to form relationships with a group of midwives who shared a philosophy of care and had sufficient time in which to meet women's holistic needs. Most of the women in this study did not feel they were offered the choices as outlined in the national choice agenda (DoH, 2007). IMPLICATIONS FOR PRACTICE: NHS Trusts should review the models of care available to women to ensure that these are not only safe but support women's psycho-social and emotional needs as well. Partnership case loading models enable midwives and women to form trusting relationships that empowers women to feel involved in decision making and to exercise choice. Group antenatal and postnatal care models also effectively utilise midwifery time whilst increasing maternal satisfaction and social engagement. Technology should also be used more effectively to facilitate inter-professional communication and to provide a more flexible service to women. Crown