Maternity experiences of mothers with multiple disadvantages in England: A qualitative study.
Jenny McLeish, Maggie Redshaw
PMID 29910026WHAT IT FOUND
Mothers with multiple disadvantages often found maternity care confusing and frightening.
They described feeling safe and in control when care was clear, respectful and continuous. They described distrust when care was rushed, judgemental or unexplained.
Key findings
01Many mothers found maternity services confusing and frightening, and some did not understand how to access care or felt unable to ask questions.
02Mothers described positive experiences when specialist midwives or small teams guided them through care and treated them as individuals.
03Negative staff attitudes, pressure around decisions, unexplained examinations and inconsistent information were described as reducing trust and making mothers feel unsafe.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Findings are from 40 mothers recruited through peer support projects, so they may not represent all mothers with multiple disadvantages, especially those without such support. The study was qualitative and did not compare care models or measure clinical outcomes, so it cannot show that specialist midwifery caused better experiences. Some interviews were shorter because mothers needed to attend to children, and no participant used professional interpreting, which the authors said limited depth. Participants were not specifically asked how care was organised, so comments about continuity and specialist care emerged spontaneously. The researchers acknowledged their own position as White, UK-born women with children, which may shape interpretation.
Declared interests
Funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department. The authors declare no competing interests.
The easy way to misread this
Do not conclude that specialist midwifery improves maternity outcomes. The study asked mothers to describe experiences, did not compare care models or measure clinical outcomes, and the positive reports come from a small purposive sample.