Maternity experiences of mothers with multiple disadvantages in England: A qualitative study.
Disadvantaged
Maternal health services
Midwifery
Pregnant women
Vulnerable populations
Journal
Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
22
06
2017
revised:
14
03
2018
accepted:
29
05
2018
pubmed:
19
6
2018
medline:
18
6
2019
entrez:
19
6
2018
Statut:
ppublish
Résumé
Disadvantaged mothers and their babies are at increased risk of poor perinatal outcomes and have less positive experiences of maternity care. To explore the maternity care experiences of mothers with multiple disadvantages. A qualitative descriptive study based on semi-structured interviews with 40 mothers with multiple disadvantages, using thematic analysis. Four themes emerged: 'A confusing and frightening time', 'Longing to be respected as an individual', 'The importance of choice and control', and 'Needing trust to feel safe'. Mothers brought feelings of powerlessness and low self-esteem to their encounters with maternity professionals, which could be significantly worsened by disrespectful care. They needed support to navigate the complex maternity system. Positive experiences were much more likely where the mother had received continuity of care from a specialist midwife or small team. Mothers with multiple disadvantages value being treated as an individual, making informed choices, and feeling safe, but they may lack the confidence to ask questions or challenge disrespectful treatment. Training and supervision should enable maternity professionals to understand how confusing maternity care can be to very disadvantaged mothers. It should emphasise the need to provide accessible and empowering information and guidance to enable all mothers to make choices and understand the system. Leaders of maternity services need to do more to challenge negative staff attitudes and ensure that that all mothers are treated at all times with kindness, respect and dignity. Specialist midwives can deliver a high quality service to mothers experiencing multiple disadvantages.
Sections du résumé
BACKGROUND
BACKGROUND
Disadvantaged mothers and their babies are at increased risk of poor perinatal outcomes and have less positive experiences of maternity care.
AIM
OBJECTIVE
To explore the maternity care experiences of mothers with multiple disadvantages.
METHODS
METHODS
A qualitative descriptive study based on semi-structured interviews with 40 mothers with multiple disadvantages, using thematic analysis.
FINDINGS
RESULTS
Four themes emerged: 'A confusing and frightening time', 'Longing to be respected as an individual', 'The importance of choice and control', and 'Needing trust to feel safe'. Mothers brought feelings of powerlessness and low self-esteem to their encounters with maternity professionals, which could be significantly worsened by disrespectful care. They needed support to navigate the complex maternity system. Positive experiences were much more likely where the mother had received continuity of care from a specialist midwife or small team.
DISCUSSION AND CONCLUSION
CONCLUSIONS
Mothers with multiple disadvantages value being treated as an individual, making informed choices, and feeling safe, but they may lack the confidence to ask questions or challenge disrespectful treatment. Training and supervision should enable maternity professionals to understand how confusing maternity care can be to very disadvantaged mothers. It should emphasise the need to provide accessible and empowering information and guidance to enable all mothers to make choices and understand the system. Leaders of maternity services need to do more to challenge negative staff attitudes and ensure that that all mothers are treated at all times with kindness, respect and dignity. Specialist midwives can deliver a high quality service to mothers experiencing multiple disadvantages.
Identifiants
pubmed: 29910026
pii: S1871-5192(17)30275-5
doi: 10.1016/j.wombi.2018.05.009
pmc: PMC7074001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
178-184Informations de copyright
Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
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