Exploring working relationships between midwifery support workers and midwives in a community setting

This qualitative study explores the working roles and relationships that exist between midwifery support workers (MSWs) and midwives in a community setting. This research is distinctive from previous studies, as it offers alternative perspectives examining how the role and identity of midwifery support workers were perceived by practitioners involved directly in integrating this new role into an established midwifery service.
In recent years the employment of midwifery support workers in the community has become commonplace, seemingly in response to the reducing numbers of practicing midwives, the economic climate and the need to reduce employment costs within the National Health Service (NHS), balanced against the increasing demands placed on NHS maternity service provision by the UK’s policymakers and the increasing expectations of child-bearing women.
A flexible qualitative design was required to explore midwifery support workers and midwives’ experiences and opinions of their prevailing relationships. The study assumes a feminist perspective that is used to frame the accounts of the midwifery support workers and midwives. One midwifery support worker and one midwife participated in the pilot study that informed the main study. The remaining four midwifery support workers and a further six midwives agreed to participate in the main study. Semi-structured interviews were used to gather the data. The recorded words of the midwifery support workers and midwives were transcribed and analysed using Mauthner and Doucet’s ‘Listening Guide’, based on their original voice-centred relational methodology.
The data revealed the complex issues of integrating a new role into an established service and the impact on the lives of the midwifery support workers and midwives involved directly in these changes. Issues of power, professionalism and patriarchy featured as a new occupational group aligned itself alongside an established professional group and began to carve out its own areas of practice and define its boundaries. Interviews supported by a feminist perspective enabled the midwifery support workers and midwives to describe and provide details about their experiences of their roles and relationships, thus aligning with the study’s qualitative approach.