References

Bryman A Social research methods.Oxford: Oxford University Press; 2016

Charlick S, Pincombe J, McKellar L, Fielder A Making sense of participant experiences: interpretative phenomenological analysis in midwifery research. Int J Dr Stud. 2016; 11:205-216 https://doi.org/10.28945/3486

Cummins A, Coddington R, Fox D, Symon A Exploring the qualities of midwifery-led continuity of care in Australia (MiLCCA) using the quality maternal and newborn care framework. Women Birth. 2020; 33:(2)125-134 https://doi.org/10.1016/j.wombi.2019.03.013

Davidsen AS Phenomenological approaches in psychology and health sciences. Qual Res Psychol. 2013; 10:(3)318-339 https://doi.org/10.1080/14780887.2011.608466

Changing childbirth: part 2.London: HM Stationery Office; 1993

Ettorre E Embodied deviance, gender, and epistemologies of ignorance: re-visioning drugs use in a neurochemical, unjust world. Subst Use Misuse. 2015; 50:(6)794-805 https://doi.org/10.3109/10826084.2015.978649

European Union Drugs Agency. Women and drugs: health and social responses. 2023. https://www.emcdda.europa.eu/publications/mini-guides/women-and-drugs-health-and-social-responses_en (accessed 7 January 2025)

Finlay L Engaging phenomenological analysis. Qual Res Psychol. 2014; 11:(2)121-141 https://doi.org/10.1080/14780887.2013.807899

Halsall S, Marks-Maran D How prepared are UK midwives for their role in child protection?. Br J Midwifery. 2014; 22:(7)472-478 https://doi.org/10.12968/bjom.2014.22.7.472

Miles M, Chapman Y, Francis K Making a difference: the experiences of midwives working with women who use illicit drugs. Int J Childbirth. 2012; 2:(4)245-254 https://doi.org/10.1891/0886-6708.2.4.245

Miles M, Chapman Y, Francis K, Taylor B Midwives experiences of establishing partnerships: working with pregnant women who use illicit drugs. Midwifery. 2014; 30:1082-1087 https://doi.org/10.1016/j.midw.2013.06.020

NHS England. The NHS long term plan. 2019. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf (accessed 14 January 2025)

Nichols TR, Welborn A, Gringle MR, Lee A Social stigma and perinatal substance use services: recognising the power of the good mother ideal. Contemp Drug Probl. 2021; 48:(1)19-37 https://doi.org/10.1177/0091450920969200

Radcliffe P Substance-misusing women: stigma in the maternity service. Br J Midwifery. 2011; 19:(8)497-506 https://doi.org/10.12968/bjom.2011.19.8.497

Rayment-Jones H, Silverio SA, Harris J, Harden A, Sandall J Project 20: midwives' insight into continuity of care models for women with social risk factors: what works, for whom, in what circumstances, and how. Midwifery. 2020; 84:102654-102654 https://doi.org/10.1016/j.midw.2020.102654

Roddy E, McBride T, McBride A Visual inquiry: a method for exploring the emotional, cognitive and experiential worlds in practice development, research and education. Int Pract Dev J. 2019; 9:(1)1-16 https://doi.org/10.19043/ipdj.91.006

The best start, a five-year forward plan for maternity and neonatal care in Scotland 2017.Edinburgh, Scotland: Scottish Government; 2017

Smith J, Nizza I Essentials of interpretative phenomenological analysis.Washington DC: American Psychological Association; 2021

Smith JA, Flowers P, Larkin M Interpretative phenomenological analysis: theory, method and research.London: SAGE; 2009

Smith JA, Flowers P, Larkin M Interpretative phenomenological analysis: theory, method and research.London: SAGE; 2022

Smith JA, Osborn M Interpretive phenomenological analysis. In: Smith JA (ed). London: Sage Publications Ltd; 2015

Tracy SJ Qualitative research methods: collecting evidence, crafting analysis, communicating impact.Hoboken, NJ: Wiley Blackwell; 2020

Tsang KK, Besley T Visual inquiry in educational research. Bejing International Review of Education. 2020; 2:2-10 https://doi.org/10.1163/25902539-00201002

Tuffour I A critical overview of interpretive phenomenological analysis: a contemporary qualitative research approach. J Healthc Commun. 2017; 2:(4) https://doi.org/10.4172/2472-1654.100093

Weber A, Miskle B, Lynch A, Arndt S, Acion L Substance use in pregnancy: identifying stigma and improving care. Subst Abuse Rehabil. 2021; 12:105-121 https://doi.org/10.2147/SAR.S319180

Whitehead R, O'Callaghan F, Gamble J, Reid N Contextual influences experienced by queensland midwives: a qualitative study focusing on alcohol and other substance use during pregnancy. Int J Childbirth. 2019; 9:(2)80-91 https://doi.org/10.1891/2156-5287.9.2.80

midwives

Exploring safeguarding midwives' experiences of caring for pregnant women with substance dependency

02 February 2025
Research
02 February 2025
Volume 33 · Issue 2

Abstract

Background/Aims

Midwifery research exploring midwives' views and beliefs about pregnant women with substance dependency has centred on those working in clinic or hospital settings. There is little research exploring the relationship between these women and safeguarding midwives providing clinical care via a community-based midwifery-led continuity of care model. This study aimed to explore this relationship.

Methods

Using interpretative phenomenological analysis and visual inquiry techniques, five midwives participated in semi-structured interviews exploring their attitudes and emotions about working with women with substance dependency.

Results

Five superordinate themes were found: transformation, tug of war, reciprocity, proxy parenthood and the midwives' twitch

Conclusions

Midwives' relationships with women with substance dependency are based on partnership, honesty, trust, care and compassion. Midwives' perceptions of these women were transformed through reciprocal relationships facilitated by midwifery-led continuity of care and the women's life stories.

Implications for practice

Midwifery-led care models should be expanded to include women of all risk levels. Additionally, women's narratives should be included when educating student and qualified midwives about substance dependency in pregnancy.

There are gender differences in how society views substance use, with women often being viewed more harshly than men (Ettorre, 2015). This unsympathetic view amplifies when women are pregnant, leading them to be perceived as morally corrupt, scheming and dishonest (Miles et al, 2012; Ettorre, 2015). The societal expectations of ‘the good mother ideal’ can lead to the stigmatisation of women (Nichols et al, 2021), as they are viewed as unable to fulfil their role as good mothers (Weber et al, 2021). This view can be unwittingly reflected in the care provided to women, as some healthcare professionals, including midwives, may find it challenging to distance themselves from negative ingrained attitudes (Nichols et al, 2021). The European Union Drugs Agency (2023) suggests that along with a fear of having their babies removed from them, these attitudes can deter women from seeking help with their addictions.

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Child protection
Interpretive phenomenological analysis
Pregnancy
Safeguarding midwife
Substance dependency