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Women's experience of trust within the midwife-mother relationship

Lewis, Mari, Jones, Aled and Hunter, Billie 2017. Women's experience of trust within the midwife-mother relationship. International Journal of Childbirth 7 (1) , pp. 40-52. 10.1891/2156-5287.7.1.40

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Abstract

This article summarizes the main findings from my PhD study exploring individual women’s experiences of trust within the midwife–mother relationship. Evidence suggests that trust is an important element of care provision (Department of Health, 2010; Nursing and Midwifery Council, 2015), yet it is poorly defined as a concept. AIM: The aim of the study was to explore the concept of trust within the midwife–mother relationship increasing understanding of individual women’s experience of trust and its meaning to them within the caring relationship. No specific research questions were identified at the outset as congruent with the hybrid methodological approach used. METHODOLOGY: A hybrid model approach was used, underpinned by a Heideggerian phenomenological approach. The hybrid model provides a theoretical framework for incorporating the literature and theory in the developing concept analysis with empirical data as a continuous concurrent process (Schwartz-Barcott & Kim, 1993). Longitudinal semi-structured interviews were carried out at three time points: in early pregnancy, at 37 weeks of pregnancy, and 8 weeks postnatal with a purposive sample of nine women experiencing straightforward pregnancy. Phenomenology allowed the concept to be explored within the lived experience of the participants in the natural setting. ANALYSIS: Thematic analysis was conducted, supported by Nvivo 9. The text was analyzed as a whole, by sections of text and by line-by-line coding examining the participant’s words for meaning. Extracts were coded, clustered, and synthesized into overarching themes. Comparison of the themes at each stage assisted in the understanding of the development and changes within the concept being studied over time. Themes were taken back to participants to guide subsequent interviews clarifying their meaning, authenticity, and ensuring that the data gathered reflected their personal insight. FINDINGS: The experience of trust was described as an evolving concept that developed over time as a series of building blocks. The participants described an initial trust associated with an expectation of assumed competence in the midwife, but this was then influenced by the developing relationship between midwife and mother. The concept of trust was interwoven with women’s agency; women expressed a desire to develop a two-way trust that included the midwife trusting the woman. This article reports on the overall findings, concentrating on the development of trust and key themes relevant to clinical midwifery practice: need, expectation, the midwife–mother relationship, and impact of continuity of carer and the importance of women’s agency. IMPLICATIONS: Understanding the concept of trust from the woman’s perspective is important for developing maternity services that meet the needs of women.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Healthcare Sciences
Publisher: Ingenta
ISSN: 2156-5287
Last Modified: 15 Jul 2019 08:31
URI: http://orca.cf.ac.uk/id/eprint/101412

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