Background Midwives and nurses appear vulnerable to moral distress when caring for women whose babies are removed at birth. They may experience professional dissatisfaction and their relationships with women, families and colleagues may be compromised. The impact of moral distress may manifest as anger, guilt, frustration, anxiety and a desire to give up their profession. While there has been much attention exploring the concept of moral distress in midwifery, this is the first study to explore its association in this context. Aim This article explores midwives’ experiences of moral distress when providing care to women whose babies were removed at birth and gives valuable insight into an issue nurses and midwives encounter in their profession. Methods Four mothers and eight midwives took part in this research. Narrative inquiry incorporating photo-elicitation techniques was used to generate data; mothers were interviewed face to face and midwives through focus groups. The images and audio data were collected, transcribed and analysed for emerging themes. For the purpose of this article, only the midwives’ stories are reported. This research received a favourable ethical opinion from the University of Surrey Ethics committee. Ethical considerations This study received a favourable ethical approval from a higher education institutes ethics committee. Results Midwives who care for women whose babies are removed at birth report it as one of the most distressing areas of contemporary clinical practice. Furthermore, they report feelings of guilt, helplessness and betrayal of the midwife–mother relationship. Many of the midwives in this study state that these experiences stay with them for a long time, far more than more joyful aspects of their role. Conclusion Midwives experience moral distress. Support systems, education and training must be available to them if we are to reduce the long-term impact upon them, alleviate their distress and prevent them from leaving the profession.
It is evident from a review of the literature that looking after the psychological and emotional needs of women who have their baby removed at birth is a vital part of midwifery care in the childbirth continuum. This review reports on the experiences of midwives who have provided care and emotional support to mothers who have had their baby removed at birth and the challenges they have encountered from doing so. BNI, CINAHL, EMBASE, Google Scholar, Maternity and Infant Care and PsycInfo were searched for articles published until January 2014 and findings suggest that providing care and emotional support to women who have had their babies removed at birth remains one of the most challenging aspects of contemporary midwifery practice. It is anticipated that this study will raise awareness of the challenges associated with providing care and emotional support for women whose babies have been removed at birth and contribute to the evidence base for best practice.
Background -There is growing evidence in the UK that some National Health Service improvements, particularly in the postnatal period, are having an impact on the quality and variety of student midwives' clinical experiences, making it challenging for them to meet the standards set by the regulatory body for midwives and receive a licence to practice. A possible solution to this may be the introduction of a Student Midwife integrated Learning Environment (SMiLE) focusing upon the delivery of postnatal care (PN) through a student run clinic Objective -To identify the current state of knowledge, regarding the educational outcomes of students who engage with student run clinics (SRC) and the satisfaction of patients who attend them Search strategy -BNI, CINAHL, EMBASE, MEDLINE were searched for articles published until April 2014.Selection criteria -Studies nationally and internationally, that were carried out on healthcare students running their own clinics. Outcome measures were the evaluation of educational outcomes of students and client satisfaction were included Data collection and analysis -Data were extracted, analysed and synthesised to produce a summary of knowledge, regarding the effectiveness of SRC's Main results -6 studies were selected for this review Authors conclusions -The findings that SRC can offer advantages in improving educational outcomes of students and provide an effective service to clients is encouraging. However, given the limited number of high-quality studies included in this review, further research is required to investigate the effectiveness of SRC
Background: Diversity exists in how storied data gathered in narrative inquiry is analysed and represented, more so when there is a need to combine multiple data collection methods, including photographs. Aim: This paper discusses the use of an analytical framework entitled LEARNS developed as part of a PhD study that has potential to fill this gap. Results: The step-by-step framework presented in this paper was developed in order to analyse the data collected in this research study and gives understanding and insight into the experience of mothers whose babies are removed at birth. The LEARNS framework provides transparency and credibility; it also negates the need to restrict findings to broad themes via content/thematic analysis. Conclusions: LEARNS could offer other researchers a reliable framework to use for future social science research.
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