A Hermeneutic Phenomenological Study Into the Midwife-Woman Relationship
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Research shows that the midwife-woman relationship is important. Taking a hermeneutic phenomenological approach this study drew on the work of Heidegger and Gadamer to uncover understandings of the professional relationship between caseloading midwives and the women for whom they care. The Aotearoa New Zealand context of government funded caseloading midwifery care makes this a unique study. Data were collected through interviews with nine midwives and eight women who were recruited through purposeful sampling and snowballing. The interviews were crafted into stories which were reviewed by the participant to verify the information. Analysis considered what was said, but also pondered that which was unsaid. The method of analysis involved writing and rewriting to surface interpretive insights. The findings revealed that both the midwife and woman came with expectations of how the relationship may play out, formed through previous experiences. The woman sought a relationship where she could trust the midwife and feel confident in her care. The ‘right’ midwife had relational attributes and was responsive to the woman’s needs. Such relationships could be transformational for the woman. If the relationship did not feel right, some women would seek another midwife, while others would carry on hoping a connection would come. Regardless, they trusted that the midwife would enact her professional responsibilities and keep them safe. On the other hand, the midwives demonstrated a responsibility of care by proceeding with the relationship, even if they discerned it may not be easy. They set out to gain the woman’s trust by engaging in conversation that could open the way to a shared understanding. They came to attune to the woman and in doing so were able to interpret what was important to her. When the woman respected the midwife’s boundaries and heeded her advice, trust was likely to develop. In some relationships, it was only after the midwife had proved herself, perhaps after the birth, that the woman was able to trust. If trust did not develop by the end of the episode of care, the midwife was reluctant to care for the woman another time. It became clear that trust underpins effective relationships. However, trust is a complex phenomenon that needs ongoing care and attention from both the midwife and the woman.