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Woman centred care? An exploration of professional care in midwifery practice

Phillips, Mari (2009) Woman centred care? An exploration of professional care in midwifery practice. Doctoral thesis, University of Huddersfield.

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      Abstract

      This thesis explores what ‘woman centred care’ means to both women and
      midwives and how this care is offered by midwives and perceived by women. It is
      set within the context of current health care policy and the way in which this
      impacts on both the organisation and implementation of maternity care.

      A flexible qualitative design was used to explore both women’s and midwives’
      experiences of current maternity care over the full trajectory of maternity
      provision. A modified grounded theory approach was used framed within a
      feminist perspective. The fieldwork was undertaken in two phases. In phase one
      and interviews were undertaken with twelve women in early pregnancy, later
      pregnancy and after the birth; a total of twenty-five interviews with women were
      completed. Nine midwives were also interviewed in phase one. Preliminary and
      tentative categories were identified from both sets of interviews and were used to
      inform phase two of the study.

      Five women participated in the second phase of data collection. This included
      both informal, telephone contact and in-depth interviews spanning from early
      pregnancy until after the birth and included observation of their care in labour.
      The community midwives and delivery suite midwives specifically involved in
      their care were also interviewed.

      The data demonstrated a continued mismatch between the women’s and the
      midwives’ perspectives and it was evident that despite the policy drivers and
      consumerist rhetoric of ‘woman centred care’ and its original underpinning
      principles of continuity, choice and control, that this was not the overriding
      experience for the women who participated in the study. Data analysis
      highlighted some opportunities for negotiation but these were not explicitly
      recognised or realised by the women or midwives and there was little time or
      flexibility in the system to accommodate such opportunities.

      The increasing bureaucracy of the maternity care system also constrains continuity
      of carer over the full spectrum of the childbearing trajectory and reduces the
      potential for women to know the midwife who provided care. Thus for many
      midwives being ‘with the institution’ was more likely than ‘being ‘with woman’.

      Item Type: Thesis (Doctoral)
      Subjects: R Medicine > RT Nursing
      R Medicine > RJ Pediatrics
      Schools: School of Human and Health Sciences
      Depositing User: Graham Stone
      Date Deposited: 02 Oct 2009 15:58
      Last Modified: 28 Jul 2010 19:47
      URI: http://eprints.hud.ac.uk/id/eprint/5764

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