The Midwife's coracle: a phenomenological study of midwives' experiences of emotionally supporting motherhood.

Abstract

Background An initial review of the literature pertaining to the emotional health of women in their transition to motherhood was undertaken. It became clear that this is an emotional time for women where they are particularly at risk of becoming distressed (Drift 2004) and if women are emotionally distressed at this time it may have long term implications for mother (Drift 2004), baby (Miller et al 1993, Lemaitre-Sillere 1998, McMahon et a1200l) and family (Burke 2003, Tammentie et al 2004a, Tammentie et al 2004b). This understanding led to an exploration of who might provide for the emotional health needs ofwomen at this time. Midwives were identified as key professionals because of their regular contact with women through pregnancy, labour, birth and early childcare. The literature review indicated that midwives were providing for the emotional needs of women but there was no indication of how, despite the recent studies conducted into the emotion work of midwives by Hunter and her colleagues (Hunter 2001,2005,2006, Hunter and Deery 2009). Design This study has been conducted using the Husserlian philo.sophical approach with Giorgi's psychological method (Giorgi 1985). Eight community midwives were recruited following a presentation at their community midwifery team meeting at a local NHS Trust and subsequent 'snowballing'. Unstructured interviews were conducted with them in 2004 in order to explore their experiences ofproviding emotional support to women who were becoming mothers. Findings A general structure was developed along with four constituents: these were 'tipping the balance to showing emotionally supportive care', 'showing emotionally supportive care', 'struggles in showing emotionally supportive care' and 'emotional experiences'. The descriptions of experiences shared by the midwives led to an understanding that emotional support is a special type of care. This occurs in an intimate relationship supported by a 'circle of care'. The midwives use their communication skills with the aim of facilitating comfort and ameliorating emotional distress. To give this care, midwives needed to go through a process of 'tipping the balance' but even after this was enacted, they still struggled in providing this care. They appeared to particularly struggle with maintaining their 'with woman' ideology within their current professional culture. Recommendations There is a need for midwifery to consider how midwives might manage their 'with woman' care within health and social care services. For the midwives in this study, having the autonomy to manage their own diaries and caseloads along with good working relationships with their colleagues was facilitative. This was a small study in one geographical area but it clearly indicates the need for further research in this area.