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Title: Are you listening to me? : an exploration of the interactions between mothers and midwives when labour begins : a feminist participatory action research study
Author: Shallow, Helen E. D.
ISNI:       0000 0004 6495 2641
Awarding Body: University of the West of Scotland
Current Institution: University of the West of Scotland
Date of Award: 2016
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Many mothers are told they are 'not in labour' when they know otherwise, and admission to their chosen maternity facility to give birth is deferred. For some mothers, who report significant pain, this results in repeated pre-admissions, which increases their anxiety and distress. Some mothers stay at home or go home reluctantly and return to the maternity unit in advanced labour, and some mothers do not make it back to the hospital in time, and give birth unexpectedly out of hospital. These mothers are denied the pain relief and support and fetal surveillance that they had been assured of throughout pregnancy and this is a safety and quality issue. The main aim of this research was to explore the interactions between mothers and midwives after labour onset to determine what factors contributed to or inhibited satisfactory interactions between mothers and midwives. The study also sought to increase awareness of the significance of these interactions, and seek ways of interacting differently, by providing participants with opportunities to engage with the research findings. I chose feminist participatory action research for its emancipatory and collaborative potential. This approach has not been used before in midwifery. Participants' active involvement gives voice to their issues within the context of contemporary NHS maternity care provision. After a series of separate interviews and focus groups, first with mothers and then midwives, participants came together in a one-day workshop to consider preliminary findings. Together they were asked to consider a co-constructed narrative of their accounts and explore ideas for improvement. Later, the voice-centred relational method of analysis known as the 'Listening Guide' was used for interview analysis and overall interpretation. The main findings showed that where mothers found interactions perfunctory, midwives described unreasonable workload pressures, which resulted in taking calls amongst other tasks. Where mothers said personal interactions were fragmented, midwives described being overwhelmed. Midwives described rationing care to all, in order for all mothers to receive some care. Mothers' subjective experiences of labour did not accord with the midwives' objective diagnosis of labour. This conflict resulted in mothers subjugating their embodied knowledge in deference to professional knowledge. Overall, cognitive dissonance theory became the theoretical framework upon which to understand the conflicts between mothers and midwives and between groups of midwives themselves. Processing mothers, whilst at the same time gatekeeping admissions, has serious implications for the future integrity of midwifery as a caring profession in general, and as a safe profession within the context of midwifery-led care in midwifery units as well as in obstetric labour wards. Recommendations from this study centre on raising awareness about a gap in service provision and how overall maternity service provision is affected by political influences, which have resulted in marginalising UK NHS midwifery and childbearing mothers.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available