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Trust me I am a midwife

Author:

Marie Lewis

Powys Teaching Health Board, GB
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Abstract

Introduction: This presentation will summarise the general findings from my PhD study exploring individual women’s experience of the concept of trust within the midwife-mother relationship.

Evidence suggests that trust within the midwife-mother relationship is an important element of care provision [DOH 2010, NMC2015], yet it is poorly defined as a concept.

Aim: The aim of the study was to explore the concept of trust within the midwife-mother relationship increasing understanding of the individual women’s experience of trust and its meaning within the caring relationship. The aim includes a broad exploration but no formal research questions were identified as the concept evolves within the process of concept analysis and is responsive to the theory and empirical data over the time of the study.

Methodology: The hybrid model carried out within the Heidiggarian phenomenological approach was used. Phenomenology allowed the concept to be explored within the lived experience of the participants in the natural setting. The hybrid model provides a theoretical framework for incorporating the literature and theory in the developing concept analysis as a continuous concurrent process [Schwartz-Barcott and Kim 1993]. Longitudinal semi-structured interviews were carried out at the beginning of pregnancy, thirty-seven weeks and eight weeks postnatal with a purposive sample of nine women with straightforward pregnancy.

Analysis: Was conducted using Nvivo 9 software to organise. The text was analysed as a whole, by sections of text and by line by line coding examining the participant’s words for meaning. Extracts were coded, clustered and synthesised into overarching themes. Comparison of the themes at each stage assisted in the understanding of the development and changes within the concept being studied over a set period of time. Themes were taken back to participants to guide subsequent interviews clarifying their meaning, authenticity and ensuring that the data gathered reflected their personal insight.

Results: The result was a defined concept analysis combining theoretical literature and the lived experience of the target population.

Discussion: The experience of trust was described as an evolving concept that developed over time as a series of building blocks. The participants described an initial trust associated with an expectation of assumed competence in the midwife but this was then influenced by the developing relationship between midwife and mother. The concept of trust was interwoven with women’s agency, women expressed a desire to develop a two-way trust that included the midwife trusting the woman.

Conclusion: Understanding the concept of trust from the woman’s perspective is important for developing maternity services that meet the needs of women. The important lesson was acknowledging that trust is two way and while this research was limited to the midwife mother relationship in one area the key findings could be useful to any therapeutic relationship or aspects of coproduction. Following on from the study recommendations for further research included looking at models of midwifery care for enhancing trusting relationships, exploring relationships from the midwives perspective and using the hybrid model to explore similar areas of research in other disciplines.

How to Cite: Lewis M. Trust me I am a midwife. International Journal of Integrated Care. 2019;19(4):307. DOI: http://doi.org/10.5334/ijic.s3307
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Published on 08 Aug 2019.

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