Australian midwives and clinical investigation: Exploration of the personal and professional impact |
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| Institution: | 1. The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia;2. University of the Sunshine Coast, Sippy Downs, Qld 4558, Australia;1. School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia;2. Transforming Maternity Care Collaborative, Australia;1. UNFPA, Sexual and Reproductive Health Branch, New York, United States;2. UNFPA, Asia and Pacific Regional Office, Bangkok, Thailand;3. UNFPA, Office of Geneva, Geneva, Switzerland;4. UNFPA, Arab States Regional Office, Cairo, Egypt;5. UNFPA, East and Southern Africa Regional Office, Johannesburg, South Africa;1. School of Nursing and Midwifery, Locked Bag 1797, Penrith South, NSW 2751, Australia;2. Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith South, NSW 2751, Australia;1. Rosemary Bryant AO Research Centre, Clinical and Health Services, University of South Australia, North Terrace, Adelaide, SA 5000, Australia;2. Clinical and Health Services, University of South Australia, North Terrace, Adelaide, SA 5000, Australia;1. Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium;2. Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium;3. Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK;4. Department of Health Services Research, University of Liverpool, Liverpool, UK;5. Federal Public Service, Health, Food Chain Safety and Environment, Brussels, Belgium;6. Clinique Saint-Jean, Brussels, Belgium;7. Paramedical Department Sainte-Elisabeth, University College of Namur-Liège-Luxembourg, Namur, Belgium;8. Centre Hospitalier du Bois de l’Abbaye, Seraing, Belgium;9. Belgian Midwives Association, Antwerp, Belgium;10. Midwifery Practice InTeam, Hoeilaart, Belgium;11. Flemish Professional Association of Midwives, Antwerp, Belgium;12. Care4Education, Boortmeerbeek, Belgium;13. School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK;1. Public Hospital in Gauteng Province, South Africa;2. Sefako Makgatho Health Sciences University, The School of Health Care Sciences, Department of Nursing Sciences, PO Box 142, Medunsa 0204, South Africa |
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| Abstract: | BackgroundThe purpose of regulation of health professionals is public protection. Concerns regarding professional conduct or midwifery care can lead to clinical investigation. Midwifery literature reveals midwives feel ill-equipped and unprepared for clinical investigation and experience stress and abreaction.AimTo explore the lived experience of clinical investigation and identify the personal and professional impact on Australian midwives.MethodSemi-structured interviews of a purposive sample of Australian midwives. Data analysis was informed by a phenomenological conceptual framework derived from Husserl, Heidegger and Merleau-Ponty.FindingsTwelve midwives were interviewed, with seven under current investigation. Discussion involved personal and professional experiences of three or more investigations each, over a period of three to five years. Most investigations were instigated by hospitals with two complaints from women. Seven participants were alleged negligent following adverse neonatal outcomes and five had misconduct allegations. Midwives were employed or in private practice and half provided homebirth services. Themes included being safe, being connected, time and being, perception and well-being.DiscussionThe investigative process involves different health services, state and national bodies using varying powers and processes over protracted time periods. Participants discussed aspects such as disrespect, inequity, powerlessness, silence and ostracization. Midwives who successfully navigated clinical investigation developed resilience through reflection on clinical practice in a culture of safety.ConclusionThe process of regulating midwives, designed to protect the Australian public, may be harming investigated midwives. Understanding the personal and professional impact of clinical investigation needs to underpin midwifery education, clinical practice, inform policy and regulatory reform. |
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| Keywords: | Investigation Misconduct Negligence Litigation Midwives |
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