Connecting with Women: The Working Lives of Independent Midwives and Their Perceptions of the Mother-Midwife Relationship
This study aimed to explore the lived experience of the working lives of midwives in the UK who practice independently of the NHS. It was designed to understand their motivations for working in this way and to explore their beliefs and values about midwifery care with particular emphasis on their perceptions of building and maintaining relationships with childbearing women. Hermeneutic phenomenology informed the methodology for the study and an adapted biographical narrative interpretive method (Wengraf 2001) was used for data collection. In depth qualitative interviews were carried out with twenty Independent midwives in the UK between 2007 & 2009. Data were analysed using Ricoeur’s theory of interpretation (Ricoeur 1981). Keys findings indicate that motivated by a very strong sense of what it means to be “with woman”; these midwives initially chose a career path in the NHS that enabled them to better enact this philosophy. However, constraints on their ability to enact this philosophy in the NHS combined with a desire to form more meaningful relationships with childbearing women and to support their individual needs informed a final move from the NHS into independent practice. Independent midwifery is experienced as very positive career move which results in considerable job satisfaction and an opportunity to use the full range of midwifery skills. Formation of the mother midwife relationship is perceived as a pivotal midwifery tool which facilitates understanding of individual childbearing women and their needs. Ricoeur’s theory of interpretation (1981) is utilized to explain how Independent midwives form relationships with their clients in this context. The concepts of “time”, “autonomy” and “risk” are discussed in the light of study findings, contributing a unique insight into the working lives of Independent midwives, the mother midwife relationship and enactment of the “with woman” philosophy in this context. The study also demonstrates that whilst there are many positive aspects of working as an Independent midwife there are also several constraints and potential vulnerabilities. These include the blurring of work/life boundaries, financial insecurity and the consequences of working with clients who often have very complex needs and particular expectations of the midwife-client relationship. Supporting women’s choices, working flexibly to meet the needs of clients and respecting their right to autonomous decision making can place Independent midwives in a position of potential vulnerability and leave them subject to professional criticism.
- PhD