An ethnographic study of women's experience of partnership caseload midwifery practice: the professional as a friend

Abstract

Objectives: to explore the experience of a known midwife for labour and birth as provided through the partnership caseload model of care in women who had a previous baby under an alternative system of care. Design: a qualitative study using an ethnographic approach. Data were collected by tape-recorded interviews. Setting: the maternity unit at Leicester Royal Infirmary NHS Trust, Leicester, UK in 1998. Participants: 10 multiparous women cared for by Birth Under Midwifery Practice Scheme (BUMPS) midwives were interviewed between eight- and 12 weeks' postpartum. Key findings: women's perceptions and experiences were predominantly influenced by the relationships they had with their midwives who they described as ‘friends’. All other themes were filtered through these relationships, including previous negative experiences of maternity care, the valuing of a known midwife for labour and birth, their positive birth experiences, expressions of delight at their care, their liking of home antenatal care, and the appreciation of their existing children and partners meeting their midwives. Implications for practice: partnership caseload midwifery practice has significant positive impact on women's experience of childbirth. The midwife/woman relationship that has evolved in this context is highly valued by women and challenges traditional professional roles. The model should be explored in other settings to see if its benefits to women are transferable.