Background
Methods
Search strategy
Inclusion criteria | Exclusion criteria |
---|---|
• Primary qualitative, quantitative studies about the personal pregnancy and birth experiences of midwives • Studies must include participants who are midwives or nurse-midwives in their sample • Articles published in English • Research and anecdotal records must be published in peer-reviewed or non-peer reviewed professional journals | • Studies that reported the pregnancy and birth experiences of student midwives, birth assistants, doulas, or obstetric nurses • Published in a language other than English • Anecdotal and research papers reporting birth experiences of women before they completed their midwifery training • Conference abstracts and letters to the editor that did not publish results • Birth stories published on website blogs |
Search results
Evaluation of the literature
CASP Item | CASP Key | Church (2014) [28] | Redwood (2008) [25] |
---|---|---|---|
1 | Was there a clear statement of the aims of the research? | Yes | Yes |
2 | Is a qualitative methodology appropriate? | Yes | Yes |
3 | Was the research design appropriate to address the aims of the research? | Yes | Yes |
4 | Was the recruitment strategy appropriate to the aims of the research? | Uncleara | Yes |
5 | Was the data collected in a way that addressed the research issue? | Unclearb | Unclearb |
6 | Has the relationship between the researcher and the participants been adequately considered? | Yes | Unclear |
7 | Have ethical issues been taken into consideration? | Yes | Unclearc |
8 | Was the data analysis sufficiently rigorous? | Yes | Yes |
9 | Is there a clear statement of findings? | Uncleard | Yes |
10 | How valuable is the research? | Clear | Clear |
CASP Item | CASP Key | Battersby (2002) [29] | Leinweber et al. (2017) [30] | McMulkin & Malone (1994) [31] | Toohil et al. (2019) [32] |
---|---|---|---|---|---|
1 | Did the study address a clearly focused issue? | Yes | Yes | Yes | Yes |
2 | Were the participants recruited in an acceptable way? | Yes | Yes | Yesa | Yes |
3 | Was the exposure accurately measured to minimise bias? | N/A | N/A | N/A | N/A |
4 | Was the outcome accurately measured to minimise bias? | Unclear^ | Yes | Unclearb | Clear |
5a | Have the authors identified all important confounding factors? | N/A | N/A | N/A | N/A |
5b | Have they taken account of the confounding factors in the design and/or analysis? | N/A | N/A | N/A | N/A |
6 | A) Was the follow up of subjects complete enough? B) Was the follow up of subjects long enough? | N/A | N/A | N/A | N/A |
7 | What are the results of this study? | Clear | Clear | Clear | Clear |
8 | How precise are the results? | Unclear | Clear | Unclear | Clear |
9 | Do you believe the results? | Yes | Yes | Unclear | Yes |
10 | Can the results be applied to the local population? | Yes | Yes | Yes | Yes |
11 | Do the results of the study fit with other available evidence? | Yes | Yes | Yes | Yes |
12 | What are the implications of this study for practice? | Clear | Clear | Clear | Clear |
Data extraction, reduction and analysis
Author | Year (Location) | Title | Record type | Study design | Sample | Data collection |
---|---|---|---|---|---|---|
Battersby [29] | 2002 (UK) | Midwives' embodied knowledge of breastfeeding | Non peer-reviewed research | Descriptive explorative quantitative study | 410 midwives (results are based on the 307 midwives who reported personal experience of breastfeeding) | Surveys |
Church [28] | 2014 (UK) | Midwives' personal experiences of pregnancy and childbirth: Exploring issues of autonomy and agency in relation to the use of professional knowledge | Peer-reviewed research | Qualitative reflexive auto/biographical study | Nine midwives who had completed their training prior to becoming mothers | Interviews |
Leinweber, et al [30] | 2017 (AUS) | A socioecological model of posttraumatic stress among Australian midwives | Peer-reviewed research | Descriptive cross-sectional study | 601 midwives | Survey |
McMulkin & Malone [31] | 1994 (UK) | Breastfeeding—midwives' personal experiences | Non peer-reviewed research | Descriptive cross-sectional quantitative study | 210 midwives who had personal experience of breastfeeding | Questionnaire (structured and semi-structured questions) |
Toohill et al [32] | 2019 (AUS) | Trauma and fear in Australian midwives | Peer-reviewed research | Descriptive cross-sectional quantitative study | 249 midwives | Online survey containing fixed response and free text questions |
Redwood [25] | 2008 (UK) | Exploring changes in practice: when midwives and nurses become mothers | Peer-reviewed research | Qualitative phenomenological study | Phase one: 22 midwives and nurses in their second and third trimesters of pregnancy. Phase two: interviews conducted at 12 months following childbirth (20 participants had returned to work by then) | Interviews |
Author Year/Location | Title | Number of births | Mode of birth | Place of birth | Maternity care provider | Experience with maternity provider(s) | Overall birth experience |
---|---|---|---|---|---|---|---|
Berkley 2002 (UK) [33] | A midwife's reflection on a homebirth: thoughts of a midwife becoming a mother | 1 | NVB | Home | Homebirth midwives | Positive | Positive |
Burlow 1999 (UK – Scotland) [34] | A midwife to myself | 1 | NVB | Home | Community midwives (Hospital midwives)a | Negative | Traumatic |
Constable 2011 (UK) [35] | Switching off the ‘Midwife’ | 1 | NVB | Home | Homebirth midwife (also a friend) | Positive | Not stated |
Cooke 2010 (location unknown) [36] | A better midwife? | 1 | NVB | Hospital | Hospital midwives | Not stated | Positive |
Duggan 1997 (UK -England) [37] | Professional: How will it change your practice? | 1 | NVB | Home | Midwife friends | Positive | Positive |
Hinsliff 2010 (location unknown) [38] | Torn in two: birth decisions after a third degree tear | 2 | NVB (unplanned). Planned elective caesarean birth | Not stated | Not stated | Not stated | Positive |
Elective caesarean | Hospital | Hospital midwives and private obstetrician | Positive | Positive | |||
Jennings 2005 (UK) [39] | Midwife as mother, midwife as client | 1 | NVB | Home | Homebirth midwives | Positive | Positive |
Knapp 2013 (CAN) [40] | Rebirth | 2b | NVB (VBAC) | Home | Homebirth midwives | Positive | Positive |
Lee-Ribas 2008 (USA) [41] | Face to Face: A Midwife’s Birth Story | 1 | NVB | Home | Homebirth midwives | Negative | Traumatic |
Moes 2004 (USA) [42] | Giving birth: A Midwife’s Faith in Birth is Reborn | 1 | NVB | Home | Homebirth midwives (also her friends) | Positive | Positive |
Neiger 2004 (UK) [43] | Choices and Changes | 1 | NVB | Home | Independent homebirth midwives | Positive | Positive |
South 2016 (UK) [44] | Birthing Instincts or a Midwife’s Intuition? | 1 | NVB | Home | Homebirth midwives (also her friends) | Positive | Positive |
Tennant 1982 (location unknown) [45] | Never the Same Again | 1 | Not stated | Hospital | Hospital midwives | Not stated | Positive |
Wilde 2004 (location unknown) [46] | Only Connect | 2 | NVB | Home | Homebirth midwives | Positive | Positive |
NVB | Hospital | Hospital | Negative | Neutral |
Results
Theme 1: Insider knowledge plays a role in decision making
Choosing a mode of birth
Choosing a carer
Choosing the model of care
Choosing to birth at home
Theme 2: Navigating the childbearing journey
Taking advantage of insider knowledge to achieve agency
Difficulty achieving agency
Managing the midwife brain – the internal dialogue
“At 17 weeks I had a small post-coital bleed and this was the first time I really discovered the internal argument between the midwife part of my brain and the paranoid pregnant woman side” ([35] p15).
‘As my birth approached, I was caught between my knowledge of all the things that can happen, my belief that attended birth is safer and my instinct to crawl into a hole and have my baby without anyone around” ([41] p26).
“…when I had that bleed …. that was the one time when I thought ‘oh gosh, I wish I didn’t know what I know, because I think I could, you know, imagine all the problems that were going on with that bleed’….” ([28] p233).
Theme 3: impact of care on the birth experience
Positive relationships lead to positive birth experiences
“When I lost faith during transition I needed, as an anchor, Sarah's quietly expressed belief in my body and the birth process: she held my belief for me when I could not” ([37] p25).
Disrespectful care may lead to birth trauma
“I never felt completely relaxed or safe, and during the transitional stage, rather than feeling encouraged and supported, supported in feeling the overwhelming emotions which overtook me, I felt that I must do as I was told and not ‘lose control’” ([46] p25).
Theme 4: From midwife to mother
Unprepared for childbirth and motherhood
“How could I, how could I have stood beside those women, so many of them, calmly breathing, murmuring ‘you can do it. You are doing it,’” “Letting them trust me. I knew nothing. I did not deserve their trust” ([41] p27).
“My experience as a midwife did very little to prepare me for motherhood. Did I expect it to? Well, yes, on reflection I thought it would. The first day at home with my son James made me realise how mistaken I had been!” ([45] p438).