Providing maternity care for disadvantaged women in Aotearoa New Zealand: The impact on midwives |
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| Institution: | 1. School of Health, Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand;2. New Zealand College of Midwives, 376 Manchester Street, Richmond, Christchurch 8014, New Zealand;3. Maternity Equity Action, Hawkes Bay, New Zealand;1. La Trobe University, Melbourne, Australia;2. Australian Catholic University, Melbourne, Australia;3. Western Health, Melbourne, Australia;1. College of Nursing and Health Sciences, Flinders University, Australia;2. Medical Faculty, Cenderawasih University, Papua, Indonesia;3. School of Nursing and Midwifery, Deakin University, Australia;4. School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia;1. NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute — The University of Queensland (MRI-UQ), South Brisbane, Australia;2. Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia;3. Institute for Social Science Research, The University of Queensland, Brisbane, Australia;4. Griffith University, School of Medicine and Gold Coast University Hospital, Gold Coast, QLD, Australia;5. SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia;6. University of Auckland and Counties Manukau Health, Auckland, New Zealand;1. College of Medicine and Public Health, Flinders University, Australia;2. School of Nursing and Midwifery, Deakin University, Australia;3. Centre for Quality and Patient Safety Research, Western Health Partnership, Australia;1. Perinatal and Women’s Mental Health Unit, St John of God Health Care, 23 Grantham St, Burwood, NSW 2134, Australia;2. School of Psychiatry, UNSW Medicine, Sydney 2052, NSW, Australia;3. Royal Hospital for Women, Sydney, Barker St, Randwick, NSW 2031, Australia;4. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, NSW 2522, Australia;5. Drug and Alcohol Services, South Eastern Sydney Local Health District, 591 South Dowling Street, Surry Hills, NSW 2010, Australia;6. Discipline of Addiction Medicine, University of Sydney, Camperdown, NSW 2006, Australia;7. School of Public Health and Community Medicine, Faculty of Medicine, University of NSW, Sydney 2052, Australia;8. Faculty of Nursing, University of Calgary, 2500 University Drive, NW, Calgary, AB T2N 1N4, Canada;1. National Perinatal Epidemiology and Statistics Unit (NPESU), Centre for Big Data Research in Health and School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, 2052 Australia;2. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, NSW 2522, Australia;3. Perinatal and Women’s Mental Health Unit, St John of God Health Care, 23 Grantham St, Burwood NSW 2134, Australia;4. School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia;5. Drug and Alcohol Services, South Eastern Sydney Local Health District, 591 South Dowling Street, Surry Hills, NSW 2010, Australia;6. Discipline of Addiction Medicine, University of Sydney, Camperdown, NSW 2006, Australia;7. School of Public Health and Community Medicine, Faculty of Medicine, University of NSW, Sydney 2052, Australia;8. Faculty of Nursing, University of Calgary, 2500 University Drive, NW, University of Calgary, Calgary, AB T2N 1N4, Canada;9. Royal Hospital for Women, Sydney, Barker Street, Randwick, NSW 2031, Australia |
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| Abstract: | BackgroundHealth inequities and socio-economic disadvantage are causes for concern in Aotearoa New Zealand. Becoming pregnant can increase a woman’s vulnerability to poverty, with the potential for an increase in multiple stressful life events. Providing midwifery care to women living in socio-economic deprivation has been found to add additional strains for midwives. Exploring the perspectives of the midwives providing care to women living with socio-economic deprivation can illuminate the complexities of maternity care.AimTo explore the impact on midwives when providing care for socio-economically disadvantaged women in Aotearoa New Zealand.MethodInductive thematic analysis was used to analyse an open-ended question from a survey that asked midwives to share a story around maternal disadvantage and midwifery care.FindingsA total of 214 stories were received from midwives who responded to the survey. Providing care to disadvantaged women had an impact on midwives by incurring increased personal costs (time, financial and emotional), requiring them to navigate threats and uncertainty and to feel the need to remedy structural inequities for women and their wider families. These three themes were moderated by the relationships midwives held with women and affected the way midwives worked across the different maternity settings.ConclusionMidwives carry a greater load when providing care to socio-economically deprived women. Enabling midwives to continue to provide the necessary support for women living in socio-economic deprivation is imperative and requires additional resources and funding. |
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| Keywords: | Socio-economic deprivation Midwifery care Wellbeing Equity Stress |
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