A new way of being: an autoethnographic account of an academic journey exploring continuity of midwifery care.

Abstract

This autoethnographic thesis is a deep reflection on my journey through a clinical academic training pathway in which the experiences of midwives who work in a continuity of care model were explored. It is a story of adaptation and survival, and reflects a postgraduate research journey in which many challenges have been overcome. Within this postgraduate research programme, I designed two qualitative studies which aimed to generate enhanced knowledge about the implementation of continuity of care models in NHS settings. A study employing Participatory Action Research aimed to engage with my colleagues in a continuity of care team, fostering an iterative cycle of engagement, learning and improvement. In response to changes in the clinical area, a redesigned study based on an Appreciative Inquiry methodology considered how midwives who are employed on a part-time basis can be facilitated to provide continuity of care. Developments at local and national levels meant that these research studies were not feasible to run within the confines of the postgraduate research pathway. My own experience as a midwife providing of continuity of care, as a mother receiving maternity care through two pregnancies, and as a clinical academic, provided rich understanding of the context of the research. These multiple identities were at times in tension with each other and this supported critical reflection on the complexities of providing maternity care which can meets the diverse needs of women and midwives, and the possibilities for organisational development and implementation of new models of care within the NHS healthcare system. A pragmatic recommendation to implement a part-continuity model is drawn, but the limitations of this are recognised from a personal and professional perspective.