Central concepts in the midwifewoman relationship

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Central concepts in the midwife-woman
relationship
Ingela Lundgren and Marie Berg
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Lundgren I, Berg M. Central concepts in the
midwife-woman relationship. Scand J Car Sci. In
press for July 2007
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Why study the relationship between midwife and
woman?

• Childbirth experiences follow women throughout
  life and the overall experience is an important
  outcome of labour
• Support is the most pivotal factor for a positive
  childbirth experience
• Central to the support is the midwife-woman
  relationship

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Method

• Secondary analysis
• Thorne 1994, Heaton 2005
• condensation of quantitative or qualitative
  studies

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Method

• Reusing existing data
• New questions or verifying previous results
• Ethical issues

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Method

• 8 qualitative studies by one or both authors (IL,
  MB)
• Life-world perspective in original studies
• Pregnancy and childbirth
• Normality or high-risk

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Method

• 96 participants
• Women (Göteborg) or midwives (Sweden)
• Antenatal care unit, Birth centre, high-risk
  maternity ward, normal delivery ward
• Diaries and interviews

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Method

• New research question
• What components are central for the
  midwife-woman relationship in relation to
  childbearing in normal as well as high-risk
  situations?
• - what is essential in the womens experiences?
  (in normal as well as in high-risk situations)
• -what is the needed response from the midwife?

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Data-analysis

• Analysis together (IL, MB)
• Reading the results and original texts to gain a
  general sense
• New reading focusing the research question
• Marking meaning units, sorted in
• Clusters
• Synthesis of a common description of
  midwife-woman relationship

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Central concepts in the woman-midwife
relationship
Availability
Surrendering
Trust
Mediation of trust
Participation
Mutuality
Loneliness
Confirmation
Differenceness
Support uniqueness
Create meaning
Support meaningfulness
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Result
Midwife
Woman
Surrendering
Availability

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Result
Midwife
Woman
Mediation of trust
Trust

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Result
Midwife
Woman
Participation
Mutuality
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Result
Barnmorska
Woman
Loneliness
Confirmation

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Result
Midwife
Woman
Differenceness
Support uniqueness

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Result
Midwife
Woman
Create meaning
Support meaningfulness

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Central concepts in the woman-midwife relationship
Availability
Surrender
Trust
Mediation of trust
Participation
Mutuality
Loneliness
Confirmation
Differenceness
Support uniqueness
Create meaning
Support meaningfulness
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Conclusion

• Common essential concepts in normal as well as
  high risk situations
• Consistency with other midwifery theories
• Central concepts in childbearing women are
  surrendering, trust, participation, loneliness,
  differenceness and creation of meaning
• Midwifes responsibility is to be available
  according to womans needs and desires, to
  mediate trust, mutuality and confirmation, to
  support the uniqueness and meaningfulness

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Consequences for praxis

• Important to give space for these dimensions in
  modern care
• The woman-midwife relationship occurs in an
  influencing world of other interactions
• Without obtaining prerequisites in the
  organisation where the care is provided, it is
  impossible for the midwife to meet the womans
  needs
• This demands improvements on both political,
  organisational and relational levels
• More studies are needed on the influence of
  organisation and context on the woman-midwife
  relationship