The experiences of midwives when caring for obese women in labour, a qualitative study

Singleton, Gillian; Furber, Christine

Abstract

Background
maternal obesity is a significant public health challenge for maternity services, especially those in developed countries. Obesity presents an increased risk of mortality and morbidity during the childbearing continuum.

Caring for the obese woman in labour is challenging for midwives and there is a dearth of qualitative research which examines their experiences.

Objectives
to explore the experiences of midwives caring for obese women in labour.

Design
a qualitative, phenomenological approach was used to enable in-depth exploration of midwives' experiences.

Setting
one maternity centre in the North of England.

Participants
a purposive sampling approach was used.

Eleven midwives who had experience of caring for obese women in labour were interviewed using in depth, digitally recorded semi-structured interviews for data collection.

Methods
interpretative Phenomenological Analysis was performed, and underlying themes emerged from the data resulting in an exhaustive description of midwives' experiences of caring for obese women in labour.

Findings
the heart sinking phenomena when caring for obese women in labour emerged from the data from these midwives. Midwives were faced with a constant challenge to promote normality during childbearing in a medicalised environment. Mobilisation of the obese woman was a significant factor for midwives who were striving for normality for the woman. A sense of loss of control and helplessness underlying their care provision was apparent. Perceptions of obesity differed, with confusion between embarrassment and empathy emerging. Difficulties of how and when is the best opportunity to address obesity with the women arose. Different provisions of care amongst midwives were discussed.

Key conclusions
the findings suggest that midwives have different levels of understanding of the complexities associated with the condition. There was a sense of frustration at the ‘loss’ of normality for this group of women. Different provisions of care emerged with the need for more explicit guidelines to guide and support midwives. Communication and education were identified as key concepts when addressing the increasing prevalence of obesity.

Citation

Singleton, G., & Furber, C. (2014). The experiences of midwives when caring for obese women in labour, a qualitative study. Midwifery, 30(1), 103-111. https://doi.org/10.1016/j.midw.2013.02.008

• Journal Article Type: Article
• Acceptance Date: Feb 24, 2013
• Publication Date: 2014-01
• Deposit Date: Dec 24, 2023
• Journal: Midwifery
• Print ISSN: 0266-6138
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 1
• Pages: 103-111
• DOI: https://doi.org/10.1016/j.midw.2013.02.008
• Keywords: Maternity and Midwifery; Obstetrics and Gynecology