Women's experiences of transfer from Midwifery Led to Consultant Led care

The philosophy of Midwifery Led Care (MLC) has a distinct identify which centers on the normality of childbirth, with an emphasis on a social rather than a medical model of care. To access MLC women must first meet strict... [ view full abstract ]

The philosophy of Midwifery Led Care (MLC) has a distinct identify which centers on the normality of childbirth, with an emphasis on a social rather than a medical model of care. To access MLC women must first meet strict eligibility criteria, with guidance for transfer to CLC during pregnancy and in labour. The transfer from MLC to CLC can be a traumatic experience for women particularly if the transfer happens during late pregnancy or labour.
Aim
To explore women’s experiences of transfer from MLU to CLU during late pregnancy or in labour, including what makes the experience unique and individual to them.

Methodology
Ethical approval was sought and granted by the HSE ethics committee and the Academic Institution ethics committee. An Interpretative Phenomenological Analytical (IPA) Design was utilised to explore how the transfer process is experienced by individual women. IPA is closely aligned to psychology attempts to explore the processes participants use to make sense of their experience.

Sampling:
A self selecting convenience sample of 11 participants participated in the study. In depth interviews were conducted at a venue of the participant’s choosing, appropriate to the theory and philosophy of IPA.

Analysis of data

Data was analysed thematically using a phenomenological framework which is philosophically and methodologically aligned to IPA.

Findings.

Most women who transferred from MLU to CLU were first time mothers who were transferred during labour. Most women were anxious because they feared for the wellbeing of their baby. However, the actions of staff and supportive care helped them to feel safe even at a time of stress and worry. The first theme ‘Loss’ was interpreted as part of the process. This theme was identified from sub themes related to autonomy and feelings of control.


Discussion
A sense of urgency to expedite the birth intensified women's fears and feelings of anxiety. Actions of staff , support and discussion following the birth helped women to rationalise their feelings of loss.

Application
The study identifies important issues for women during the transfer process which may lead to amendments to clinical practice during and after such an event.