The Landscape of Caring for Women: A Narrative Study of Midwifery Practice

Abstract

Our purpose was to expand knowledge on the process and outcomes of midwifery care. Narrative analysis was used to interpret stories provided by midwives to illustrate their practice and recipients of midwifery care about their experience. A purposive sample of 14 midwives and four recipients of midwifery care was recruited as a subsample from a prior Delphi study on midwifery practice. Three broad themes were identified: 1) the midwife in relationship with the woman, 2) orchestration of an environment of care, and 3) the outcomes of care, called "life journeys" for the woman and the midwife. The findings are discussed from the perspectives of therapeutic landscapes described in cultural geography and prior research on midwifery practice. The challenge is to confirm the associations between the processes of care identified in these narratives with both short- and long-term outcomes in the health of women and their families. These appear to go well beyond the usual perinatal measures currently used in health care research and hold implications for how care is delivered, measured, and evaluated.

Long-term memories and experiences of childbirth in a Nordic context—a secondary analysis

“…There is a lot of research describing the significance of the midwife support, information, comfort and encouragement to the woman (Berg, Lundgren, Hermansson & Wahlberg, 1996;Blix-Lindströ m, Christensson & Johansson, 2004;Fowles, 1998;Gibbins & Thomson, 2001;Halldorsdottir & Karlsdottir, 1996b;Hodnett et al, 2007;Kennedy et al, 2004;Kirkham, 2000;Lundgren & Berg, 2007;Matthews, 2004;Tarkka & Paunonen, 1996;Waldenströ m, 2004). This is also shown in extensive reviews of studies from 1985 to 2000 (Hunter, 2002) and 1990 to 2001 (Bowers, 2002).…”

“…It changes life forever in a process that is renewed with every child that the woman gives birth to (Bondas-Salonen, 1995;Bondas, 2005), and extends far beyond the specific experience in birth (Brathwaite & Williams, 2004;Simkin, 1991Simkin, , 1992. A transformative experience implies victories and strength, healing and short-and long-term outcomes (Kennedy, Shannon, Chuahorm & Kravetz, 2004). A traumatic birth experiences could have a long lasting effect on the woman's health and well-being and the relationship to the baby (Beck, 2006).…”

“…Women's overall experiences are an important outcome of labour (Waldenströ m, 2003). Features, such as pregnancy-related factors, complications, expectations, pain, the organisational form of care, and support, all influence women's experience of childbirth (Gibbins & Thomson, 2001;Halldorsdottir & Karlsdottir, 1996a;Kennedy et al, 2004;Lundgren, 2002;Parrat & Fahy, 2003). All in all, the most pivotal factor for a positive childbirth experience is support (Hodnett, Gates, Hofmeyr & Sakala, 2007).…”

Experiences of South African student midwives in following up on the care of a pregnant woman from pregnancy until 6 weeks after delivery

“…According to Hunter, [10] 'presence' involves a willing interaction between the midwife and the woman, which requires trust on the part of the woman, and the giving of self (engagement, attentiveness, time and awareness of the encounter) by the midwife. This has also been recognised by Kennedy et al, [11] who consider the art of midwifery as being present without interfering; as long as the process is working as it should, midwifery is the art of 'doing "nothing" well' .…”

Therapeutic Alliance: A Concept for the Childbearing Season

“…A phenomenological study by Berg, Lundgren, Hermansson, and Wahlberg (1996) described the essential structure of women's experiences with midwives during labor as ''presence,'' which included three themes: to be seen as an individual, to have a trusting relationship, and to be supported and guided on one's own terms. Similarly, midwives in a study by Kennedy, Shannon, Chuahorm, and Kravatz (2004) emphasized the importance of developing a relationship based on mutuality and the importance of creating an environment of care in which the choices of birthing women are honored. Hunter (2006) conducted an ethnographic study to explore the relationship of community-based midwives and clients.…”