Working with pregnant women who use illicit drugs: The experiences of midwives

Abstract

The aim of this PhD study was to explore midwives experiences of working with pregnant women who use illicit drugs. A hermeneutic phenomenological methodology was used to gain deeper understanding and meaning of this phenomenon. Twelve (N=12) midwives were interviewed. Each interview was audiotaped, de-identified and transcribed. A systematic analysis of these data realised a number of related themes which in turn providedmeaningof the experience for themidwives. Thekeyfindings included that birth is an important event in most women’s and families’ lives, because it brings hope and dreams for the future.However thevulnerableanddisadvantagedoftenfindthemselves disempowered and fear their ability to mother. Pregnant women who use illicit drugs present midwives with particular challenges The midwives in this study found the work rewarding and satisfying and at times challenging and highly emotional. Three major themes emerged from the data; making partnerships, making a difference, and learning to let go. Partnerships were extremely important to the midwives; although their experience with pregnant women was often brief, they saw it as ‘a window of opportunity’ to engage thewomen and develop respectful partnerships. They demonstrated genuine regard for the women for their strength and resilience, and the midwives ability to make a difference sustained them. Learning to ‘let go’, required development of skills and boundaries that kept them safe from the emotional assault. The insights gleaned from this research may resinate with midwives who work with vulnerable women and their families. Further, the findings highlight that significant components of midwifery work with women requires revisiting if the needs of this vulnerable population of women are to be met.