Speaker: Lia Brigante
Facilitator: Caroline Maringa
Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives.
Design: Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women’s experiences (POPPIE) trial.
Findings: Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control.
Key conclusions: Recognising that known midwives were ‘there all the time’ made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
Recording: https://youtu.be/iK-Cr2puBZg
Title: When art and science collide: towards a political philosophy of humanised birth
Speaker: Elizabeth Newnham
Facilitator: Red Miller
In this presentation I draw together the various threads of my work to propose a political philosophy of birth space and practice. I first examine how the ‘science’ (of knowledge production) affects the ‘art’ (of midwifery practice) using the example of epidural analgesia, water immersion and constructions of ‘safety’ in obstetric discourse. From this, I introduce the conceptual framework of the ‘institutional paradox’ – the framing of particular practices as safe or risky, the effects of ‘institutional momentum’, and the precarious positioning of midwives as ‘guardians of normal’ within a system that views birth as, at best, risky, at worst, pathological. I then show how the influence of this institutional paradox leads to a form of rhetorical informed consent that enables dehumanising birth practices, before using the lens of care ethics to turn to the work of humanising birth, with a focus on relationality and the concept of attentiveness.
Recording: https://youtu.be/AshmJUtO7nI
