Abstract
BackgroundMidwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care.AimThis research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings.SettingMidwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital.MethodsA convenience sample of midwives (N = 10) were interviewed. An exploratory and descriptive design, with individual semi-structured interviews conducted, asked a primary question: ‘How is it for you to be a midwife in South Africa?’ Transcribed interviews were analysed using thematic coding.ResultsFive themes were found: proud to be a midwife, regulations and independent function, resource availability, work burden and image of the midwife.ConclusionMidwives struggle within systems that fail to allow independent functioning, disallowing a voice in making decisions and creating change. Regardless of practice setting, midwives expressed frustration with policies that prevented utilisation consistent with scope of practice, as well as an inability to practice the midwifery model of care. Those in public settings expressed concern with restricted resource appropriation. Similarly, there is clear need to upscale midwifery education and to establish care competencies to be met in providing clinical services.ContributionThis research provides evidence of the midwifery experience with implications for needed health policy change.
Highlights
Midwives are an essential part of healthcare who offer timely, effective and family-centred services
Private and independent settings, midwives often face varied challenges including overcrowded labour wards, a lack of resources, misutilisation and a shortage of health personnel. These challenges correspond with growing reports by labouring women of substandard midwifery care in South Africa, in public hospital settings (Human Rights Watch 2011), and escalating global recognition of neglectful, abusive and disrespectful treatment of women during childbirth, in low income, low resource countries (Bohren et al 2015)
Midwives’ relationship with the childbearing woman is a major source of job motivation and satisfaction (Curtis, Ball & Kirkham 2006:29). This relationship is the very essence of midwifery care and defines its distinctive nature (Leinweber & Rowe 2010:82–83), little is known about how midwives experience midwifery practice under varied circumstances
Summary
Midwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care. Aim: This research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings. Setting: Midwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital
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