Midwives´ experiences of action research and the nature of the first encounter on a hospital based labour ward in Sweden

• Introduction: An Action research study was undertaken with midwives based on one Swedish labour ward, to improve the quality of the first encounter with women and their partners. Aim of presentation: To describe 1) the Ar process 2) midwives' responses to a changed approach in the initial labour ward encounter. Research methodology: An insider action research design included several planning meetings with the midwives, agreeing on change, implementing the changes together, and evaluating the effects. To meet the woman's and partner's need for support even in the first encounter the ambition was to stay with the woman and partner while the fetal heart monitoring was running. The researcher kept a research journal documenting thoughts, reactions, reflections and the development of the Ar process. Thirty seven out of 57 midwives working on the labour ward were interviewed about their experiences. Interviews were tape recorded, transcribed and analysed using interpretive description. Ethical approval Ethical approval was received Study findings: The Ar started 2010. Initially, midwives found it most difficult to change their routine of starting the fetal heart monitoring when women first arrived in labour, and then leaving to read the woman's medical record and notes. Through the debates in the Ar meetings, more midwives moved towards spending time in the room with the woman and partner, talking with them, thereby creating meaningful relationships from the outset. The midwives' reflexive responses in the interviews illuminate their initial reluctance to respond to the Ar process, but also, the value of reflecting beyond routines to build a lingering presence in the first labour encounter. Conclusions: Examination of the three years of insider Ar process through qualitatively analyse clinical documents, the researcher's journal including notes of observations and interviews revealed the complexity and the difficulty of providing time to manage reflection in a large organization. To a greater or lesser extent, midwives had integrated relatively impersonal system-wide technocratic norms of childbirth into their belief systems and behaviors. The Ar study design enabled midwives reflect on routines and start the transformation of tacit use-inaction to reflection-in-action.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)

Nyckelord

the Ar

midwives

Publikations- och innehållstyp

vet (ämneskategori)

kon (ämneskategori)