Building positive respectful midwifery relationships: An analysis of women's experiences of continuity of midwifery care in Aotearoa New Zealand

Lesley Dixon; Shanti Daellenbach; Jacqui Anderson; Eva Neely; Arianna Nisa-Waller; Sarah Lockwood

doi:10.1016/j.wombi.2023.06.008

Building positive respectful midwifery relationships: An analysis of women's experiences of continuity of midwifery care in Aotearoa New Zealand

Women Birth. 2023 Nov;36(6):e669-e675. doi: 10.1016/j.wombi.2023.06.008. Epub 2023 Jul 6.

Authors

Lesley Dixon¹, Shanti Daellenbach², Jacqui Anderson², Eva Neely³, Arianna Nisa-Waller⁴, Sarah Lockwood⁵

Affiliations

¹ New Zealand College of Midwives, Christchurch Office, PO Box 21 -106, Christchurch 8140, New Zealand; New Zealand College of Midwives| Te Kāreti o ngā Kaiwhakawhānau ki Aotearoa, New Zealand. Electronic address: practice@nzcom.org.nz.
² New Zealand College of Midwives| Te Kāreti o ngā Kaiwhakawhānau ki Aotearoa, New Zealand.
³ Pūkenga Hāpai Hauora | Health Promotion Victoria University of Wellington\ Te Herenga Waka, New Zealand.
⁴ Te Whare Wānanga o Otago |University of Otago, New Zealand.
⁵ Lockwood Research & Consultancy, New Zealand.

PMID: 37422367
DOI: 10.1016/j.wombi.2023.06.008

Abstract

Problem/background: Respectful woman-centred care is an expectation of the Midwifery Standards of Practice within Aotearoa New Zealand. With both the national and international expectations identifying human rights as a priority in maternity care. Mistreatment can be experienced by women in all socio-political contexts. Identifying women's experiences of their maternity service is vital when assessing the quality of these services.

Aim: To explore women's experiences of continuity of midwifery care in Aotearoa NZ, whether they support the expectations within the Standards of Midwifery Practice and identify the characteristics of care that may contribute to positive or negative experiences of care.

Methods: A retrospective analysis of women's formal online feedback to their midwife using a mixed method design. Feedback forms received from the 1st January 2019 to the 31st December 2019 were analysed using descriptive statistics with free text thematically analysed.

Findings: A total of 7749 feedback forms were received demonstrating high levels of satisfaction overall. Three overlapping themes were identified as being central to both positive and negative feedback. Building a positive relationship involved three steps. These were the establishment and maintenance of trust, honouring decisions and empowerment. Overall, the existence of these relationship characteristics contributed to a valued woman-midwife relationship. Women who gave negative feedback identified a lack of trust and a failure to honour decisions which led to women feeling disempowered contributing to a lack of being valued in the relationship.

Conclusion: Continuity of care in Aotearoa NZ supports the development of a respectful partnership through trust, honouring decisions and empowerment.

Keywords: Advocacy; Continuity of midwifery care; Respectful woman centred care; Standards of Midwifery practice.