An important task: Midwives' experiences of identifying children at risk of neglect

Abstract

Background: Neglect is a form of child abuse in which the child's basic needs are not met. Early identification of the risk factors and protective factors is key to intervention strategies when a child is at risk of neglect. Few international studies describe midwives' experiences of identifying children at risk of neglect, and no Swedish studies have been found.

Objectives: The aim was to describe midwives' experiences of identifying children at risk of neglect.

Method: A qualitative method with a phenomenological reflective lifeworld approach. Interviews with ten midwives from two hospitals and six antenatal clinics in the western part of Sweden, with six from antenatal care and four from postpartum care.

Results: The essential structure of midwives' experiences is described as an important dimension of their profession that is a difficult, complex, ambiguous, and divided task. There is a fear of losing the relationship with the woman and worry about misinterpreting signals. Professional differences may arise when midwives are questioned by colleagues on decisions they have made when identifying children at risk of neglect. Midwives expressed their desire to work in a cohesive maternity healthcare system so that the women experience continuity during pregnancy, childbirth, and postpartum care.

Conclusions: The study shows how midwives, during both antenatal and postpartum care, have an important but difficult task in identifying children at risk of neglect. During pregnancy and postpartum care, midwives in Sweden meet almost all women and therefore have a unique opportunity for early detection and action.

Keywords: Infants; Midwife; Neglect; Phenomenology; Postpartum; Pregnancy.