An integrative review of supportive relationships between child-bearing women and midwives.
Hadeer Almorbaty, Lyn Ebert, Eileen Dowse and 1 others
PMID 36349710WHAT IT FOUND
Midwives and maternity nurses built supportive relationships with child-bearing women through trust, respect, partnership and communication, but workload, documentation and cultural mismatch strained them.
Continuity of care helped; little evidence shows how to build relationships without it.
Key findings
01Human interaction factors were mentioned in 14 studies and included trust and respect, midwives' attitudes and beliefs, partnerships, and effective communication skills.
02Cultural factors were discussed in five studies, with subthemes of women's health beliefs and family involvement.
03Organizational factors were identified in ten studies; continuity of care was reported as facilitating supportive relationships in eight studies, while time, workload, paperwork and electronic records were barriers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Synthesises qualitative and mixed-methods perceptions rather than testing an intervention, so it cannot show that relationship-building causes better birth outcomes. The final number of studies is unclear: the methods say 25 studies were included, then 14 articles were reviewed. 450 of 762 participants were midwives and 78 were maternity nurses, compared with 172 child-bearing women and 101 mothers, so provider views may dominate. One included study was rated low quality but was kept because of relevance. Non-English and non-Arabic studies were excluded, and the included literature was from seven countries, mostly Western cultures. Little detail is given about how to build supportive relationships when continuity of care is not available.
Declared interests
The supplied text reports that this was part of a PhD project at the University of Newcastle, with a scholarship from Prince Sultan Military College of Health Sciences, Medical Services Division, Armed Forces, Ministry of Defence, Kingdom of Saudi Arabia. It does not list a commercial conflict.
The easy way to misread this
Do not read the themes as proof that communication training or continuity of care improves birth outcomes. This review describes perceptions and barriers; it does not test an intervention, and it gives little detail on how to build supportive relationships when continuity is not available.