Midwives' experiences of caring for women whose requests are not within clinical policies and guidelines

Abstract

This generic qualitative study explores midwives' experiences of caring for women who make choices that fall out of the realms of accepted guidelines and policies. Semi-structured interviews were carried out with ten midwives working within an NHS trust in the south west of England. The interviews were transcribed verbatim and analysed using Thematic Analysis ( Braun and Clarke, 2006 ). Results showed that the women generally requested minimal intervention. Midwives found that they were often unable to utilise all their skills and make full clinical judgements, which made them feel vulnerable and anxious. Midwives tried to negotiate and gain the woman's trust in order to deliver the safest care possible, often adapting their care accordingly and trying to ensure that the women remained engaged with the service. There appeared to be conflict between the professional's and the woman's control and autonomy. The research findings recommend that experience be utilised in giving such care and supporting midwives, particularly junior midwives. A team-based approach to care is given and the experience of the delivery suite co-ordinator and supervisor of midwives is utilised.