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The midwife-woman relationship in a South Wales community: a focused ethnography of the experiences of midwives and migrant Pakistani women in early pregnancy

Goodwin, Laura 2016. The midwife-woman relationship in a South Wales community: a focused ethnography of the experiences of midwives and migrant Pakistani women in early pregnancy. PhD Thesis, Cardiff University.
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Abstract

Background In 2014, 27.0% of births in England and Wales were to mothers born outside of the UK. Compared to their white British peers, minority ethnic and migrant women are at a significantly higher risk of maternal and perinatal mortality, along with lower maternity care satisfaction. Although existing literature highlights the importance of midwife-woman relationships in care satisfaction and pregnancy outcomes health professionals report difficulty in providing services to minority ethnic and migrant women. However little research has explored the factors contributing to the midwife-woman relationship for migrant and minority ethnic women. Research Aims To explore relationships between migrant Pakistani women and midwives in South Wales; focusing on the factors contributing to these relationships, and the ways in which these factors might affect women’s experiences of care. Method A focused ethnography in South Wales; semi-structured interviews with 10 migrant Pakistani participants (eight pregnant women, one husband and one mother) and 11 practising midwives, fieldwork in the local migrant Pakistani community and local maternity services, observations of antenatal booking appointments, and longitudinal reviewing of relevant media outputs, such as UK news reports of issues relating to migrant people. Data were analysed concurrently with collection using thematic analysis. Findings The midwife-woman relationship was important for participants’ experiences of care. A number of social and ecological factors influenced this relationship; including family relationships, culture and religion, differing healthcare systems, authoritative knowledge, and communication of information. However, differences were seen between midwives and women in the perceived importance of these themes. Findings therefore suggest that in order to understand how midwife-woman relationships are created and maintained, more needs to be done to recognise and address these differences. Due to the complexity of the relationships between themes a social ecological model of relationships is forwarded as a means of visually capturing the complexity of the findings, as well as potentially shaping midwifery education and clinical midwifery practices. Conclusions and Implications Findings from this study provide new theoretical insights into the complex social and ecological factors at play during maternity care for migrant Pakistani women. These findings can therefore be used to create meaningful dialogue between women and midwives, encourage collaborative learning and knowledge production, and facilitate future midwifery education and research.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Healthcare Sciences
Subjects: H Social Sciences > HQ The family. Marriage. Woman
H Social Sciences > HT Communities. Classes. Races
R Medicine > RG Gynecology and obstetrics
R Medicine > RT Nursing
Uncontrolled Keywords: Maternity, midwifery, ethnicity, migration, immigration, inequalities, mortality, morbidity, relationships, midwife-woman, pregnancy, healthcare
Date of First Compliant Deposit: 25 October 2016
Last Modified: 04 Jun 2017 09:28
URI: http://orca.cf.ac.uk/id/eprint/95597

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