Journal of Qualitative Research in Health Sciences

Authors

1 Shahid Beheshti University of Medical Sciences

2 Arak University of Medical Sciences

Abstract

Introduction: The relationship that develops between the midwife and women is at the core of human care. However, there is a lack of knowledge about the communication features of midwifes and mothers in various situations and settings. Thus, their experience in the delivery room can be the basis for the body of knowledge in their profession and provide a clear and comperhensive concept of their relationship based on the prevailing sociocultural context.

Method: The present qualitative content analysis was conducted on 32 participants who were selected through purposive sampling. The participants consisted of 16 midwifes and 16 mothers hospitalized in the postpartum ward of a hospital affiliated to Arak University of Medical Sciences in 2013. Data were gathered through unstructured and semi-structured interviews. Interviews were transcribed verbatim and analyzed using the conventional content analysis approach. Sampling ceased when data saturation was achieved.

Results: The data analysis revealed 2 themes that encompassed the midwife-mother relationship. The 2 themes were communication as the essence of midwifery care and reflection of communication. Each theme consisted of clasifications and main codes.

Conclusion: According to the results, the concept of the midwife-mother relationship in the delivery room was identified as therapeutic alliance. The findings enhanced understanding of the meaning and dimensions of the midwife-mother relationship beyond the traditional meaning. This study offers evidence of the essence of this relationship and may go some way towards the creation of a written body of midwifery knowledge. The results can assist midwives in providing holistic and high quality care to mothers during labour, and thus, provide positive outcomes in normal child birth.

Keywords

1. Shakerinia I. [Doctor-patient communication and its role in satisfaction of treatment process]. Iranian J of Medical Ethics and History of Medicine. 2009; 2(3):9-16. 2. Asemani O. [A review of the models of physician-patient relationship and its challenges]. Iranian J of Medical Ethics and History of Medicine. 2011;5(4):44-57. 3. Brown LD, Negri BD, Hernandez O, Dominguez L, Sanchak JH, Roter D. An evaluation of the impact of training Hunduran health care provider in interpersonal communication. Int J of Quality in Health Care. 2000;12:495-501. 4. Aghabarary M, Mohammadi E, Varvani-Farahani A. Barriers to Application of Communicative Skills by Nurses in Nurse-Patient Interaction: Nurses and Patients’ Perspective. J of Nursing Midwifery Iran University of Medical Sciences. 2009;22(61):19-31. 5. Health care and human services D. Healthy people 2010. understanding and improving health. 2end ed. Washington, D.C: Government printing office; 2000. 6. Rowe RE, Jo Garcia BA, Macfarlane AJ, Davidson LL. Improving communication between health professionals and women in maternity care: a structured review. Health Expectations. 2002;5:63-83. 7. Alimoradi Z, Taghizadeh Z, Rezaypour A, Mehran A. Evaluation of midwives’ communication skills. African J of Midwifery and Women’s Health. 2013;7(1): 19-24. 8. Vincent P. Baby catcher: Chronicles of a modern midwife. J of the Association for Research on Mothering. 2002; 5(2):189. 9. Nicholls L, Webb C. What makes a good midwife? An integrative review of methodologically-diverse research. J of Advanced Nursing. 2006;56:414-29. 10. Thachuk A. Midwifery, informed choice, and reproductive autonomy: A relational approach. Feminism and Psychology. 2007;17: 39-56. 11. Sharpe M, . Intimate business: Woman-midwife relationships in , Canada. Ontario: 2004 2346B Contract No.: 766114851. 12. Rossiter L. The development Midwife-Mother Relationship Questionnaire (MMRQ). . Regina Canada: University of Regina; 2008. 13. Parratt J, Fahy K. Trusting enough to be out of control: A pilot study of women's sense of self during childbirth. Australian J of Midwifery. 2003;16:1-15. 14. Lundgren I, Dahlberg K. Midwives ‘experience of the encounter with women and their pain during childbirth. Midwifery. 2002;18:155-64. 15. Biro M, Waldenstrom, U., Pannifex, J. . Team midwifery care in a tertiary level obstetric service: a randomized controlled trial. Birth. 2000;27: 168-73. 16. Leap N, Sandall J, Buckland S, Huber. Journey to confidence: women’s experiences of pain in labour and relational continuity of care. J of Midwifery and Women’s Health. 2010;55:234-42. 17. Bakker D, A., Fitch, M.,I., Gray, R., Reed, E., Bennett, J. . Patient-health care provider communication during chemotherapy treatment: the perspective of women with breast cancer. Patient Educ Couns. 2001;43(1):67-71. 18. Khadivzadeh T, Katebi M, S.,, Sepehri Shamloom Z, Esmaily H. Assessment of Midwives’ Communication Skills at the Maternity Wards of Mashhad Teaching Hospitals in 2014. Jl of Midwifery and Reproductive Health. 2015;3(3):394-400. 19. Taghizadeh Z, Razaie poor, A., Mehran, A., Alimardani, Z . Communication skills by midwives and their relationship to patient satisfaction. J of Hayat. 2007;4(2):44-57. (persian). 20. Pakgohar M, Rahimikian, F. , Mehran, A. , Mohammadi, T. Quality assessment of family planning counseling in health and treatment centers, affiliated to Tehran University of Medical Sciences. Hayat. 2002;15:62-71.(In Persian). 21. Moshrefi M. Assess the performance of midwives in providing family planning services at health centers of Tehran University of Medical Sciences. Tehran: Tehran University of Medical Sciences; 1996. 22. Lundgren I, Berg M. Central concepts in the midwife-woman relationship. Scand J Caring Sci. 2007;21:220-8. 23. Newman I, Lim, J., Pineda, F. . Content Validity Using a Mixed Methods Approach: Its Application and Development Through the Use of a Table of Specifications Methodology. J of Mixed Methods Research. 2013a;7:1-18. 24. Doherty ME. Therapeutic Alliance: A Concept for the Childbearing Season. J Perinat Educ. 2009;18(3):39-47. 25. Morgan R, Luborsky L, Crits-Christoph M, Curtis H, Solomon J. Predicting the outcomes of psychotherapy by the Penn Helping Alliance Rating Method. . Archives of General Psychiatry. 1982;39 (4):392-402. 26. Askari F, Atarodi AT, S., Delshad Noghabi A, Sadegh Moghadam L, R. R. [Women’s labor experience: A phenomenological study]. Ofogh-e-Danesh GMUHS Journal. 2010;16 (1):39-47. 27. Waldenstrom U, Hildingsson I, Rubertsson C, Radestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004; 31:17-27. 28. Mirmolai T., Mehran A., Rahimi Gasabeh S. Mother's opinions concerning the importance of and their satisfaction with support received in the labor and delivery rooms. Hayat. 2003;9(2 and 1):41-8. 29. Moslemabadi Farahani S, Malekzadegan A, Mohammadi R, Hosseini F. [Effect of the one to one midwifery care during labor on modes of delivery]. Iran J Nursing. 2005;18(43):71-82. 30. Lyberg A, Severinsson E. Midwives’ supervisory styles and leadership role as experienced by Norwegian mothers in the context of a fear of childbirth. J of Nursing Management. 2010;18:391-9. 31. Sengane M. Mothers’ expectations of midwives’ care during labour in a public hospital in Gauteng. Curationis 2013; 36(1):1-9. 32. Fenwick J, Hauck Y, Downie J, Butt J. The childbirth expectations of a self-selected cohort of Western Australian women. Midwifery Journal 2005;21(1):23-35. 33. Lundgren I, Karlsdottir S, Bondas T. Long-term memories and experiences of childbirth in a Nordic context- a secondary analysis. International J of Qualitative Studies on Health and Well-being. 2009;4:115-28. 34. Grean J, Amis D, Hotelling B. Care Practice #3: continuous labor support. The J of Perinatal Education. 2007;16(3):25-8. 35. Carolan M, Hodnett E. With women’s’ philosophy: examining the evidence, answering the questions. Nursing Inquiry. 2007;14:140-52. 36. Low N. The nature of labor pain. Am J Obstet Gynecol 2002;186(supp1 Nature 5):16-24 37. Halldorsdottir S, Karlsdottir S. The primacy of the good midwife in midwifery services: an evolving theory of professionalism in midwifery. Scand J Caring Sci. 2011;25:806-17. 38. Adams ED, Bianchi AL. A practical approach to labour support. J of Obstetric, Gynecologic & Neonatal Nursing. 2008;37(1):106-15. 39. Pascalo Bonaro D, Kroger M. Continuous female companionship during child birth: a crucial resource in time of stress or calm. J Midwifery Women Health. 2004;4(suppl 1):19-27. 40. Hunter L. Being with women: A guiding concept for the care of laboring women. J Obstet Gynecol Neonatal Nurs. 2002;31 (6):650-7. 41. Ahmadi Afshar Z. [Evaluation of the effect of continouse midwifery support on pain intensity in labour and delivery]. J of Medical Sciences University of Rafsanjan 2010;9(4):293-304. 42. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth (Review). Cochrane Database of Systematic Reviews [Internet]. 2013; 5(7). 43. Hunter LP, Lauren P. A descriptive study of being with women during labour and birth. J Midwifery Women Health 2009;56:111-8. 44. Ahmadi Afshar Z. Evaluation of the effect of continouse midwifery support on pain intensity in labour and delivery. J of Medical Sciences University of Rafsanjan. 2010;9(4):293-304. (In Persian). 45. Dahlberg U, Aune I. The woman’s birth experience-the effect of interpersonal relationships and continuity of care. Midwifery. 2013;29:407-15. 46. Hunter B. The importance of reciprocity in relationships between community based midwives and mothers. Midwifery Journal. 2006;22(4):308-22. 47. Nilsson C, Lundgren I. Women’s lived experience of fear of childbirth. Midwifery. 2009; 25:e1-e9. 48. Hassan Zahraee R, Fahami F, Yazdani M, Ahmadi Z, Bashardoost N. [Supportive role of the midwife in preventing post partum depression]. The J of Qazvin Univ of Med Sci. 2003;25:19-24.