What Works Well at the Interface of Midwifery Care Handover
Midwives have the necessary skills to provide care during normal childbirth. There can be times however during the birth, when the woman requires an intervention, which involves secondary services. It is at this point, that this midwife needs to consider transfer of clinical responsibility to an obstetrician as per the Ministry of Health (2012) Referral Guidelines. This transfer of clinical responsibility to the obstetric team may include a midwifery care handover to another midwife, who will then continue to provide the ongoing midwifery care to the woman in collaboration with the Obstetrician. This research is focusing on what works well at the interface of that midwifery care handover. It is paramount that we get the midwifery care handover right, not only for the midwives involved in the process but also for the women, their babies and family/ whanau. Childbirth is at times an unpredictable journey and when the unexpected transfer of care happens, and the LMC midwife requests a midwifery care handover, the first step is to get the interface between the midwives right. This qualitative study, using Appreciative Inquiry methodology, has been conducted to look at what works well for the midwives at the interface of midwifery care handover. Appreciative Inquiry was preferred, as it actively searches out the best of a situation, with a focus on what is good, strong and already working and what has been achieved. This methodology best fitted with the intent and approach needed to research the question: what works well at the interface of midwifery care handover. Seven midwives participated in the study and the criteria for eligibility was that they had experienced handover of midwifery care more than once. These midwives were interviewed, and asked what they thought worked well for them at the interface of midwifery care handover. Using thematic data analysis, the following themes were identified; professional relationships, trust and respect between midwives, working collaboratively and effective communication. The midwives also highlighted that processes that were in place such as having one point of contact and the use of a communication tool to support effective communication. This all supported the interface of midwifery care handover. This research was looking for answers from the midwives themselves, to gain an understanding of what worked well for them at the interface of midwifery care handover, so that this information could then benefit midwives, women and inform service provision. What this research found was that the values of trust and respect amongst the midwives were the key elements to build the professional relationships that supported good communication and encouraged collaborative working relationships in the provision of safe midwifery to the women and their families/whanau.