Search

Royal College of Midwives funded research project exploring midwives' experience of professional resilience via a closed online discussion group.

Background: Midwifery is widely acknowledged as emotionally challenging work. Many midwives work in situations of adversity, with negative effects on wellbeing, morale and retention. However, not all midwives respond negatively to adversity. Some describe continued passion for their work, demonstrating resilience: the ability to respond positively and consistently to adversity. \ud \ud Aim: To explore UK midwives’ understanding and experience of resilience and identify factors involved in developing midwifery resiliency. This is the first study to focus directly on midwifery resilience. \ud \ud Method: A self-selected sample of midwives was recruited via the UK Royal College of Midwives (RCM) journal. Inclusion criteria were: participants in clinical practice for 15 or more years and self-identifying as ‘resilient’. A closed online discussion group was conducted between October- November 2012, facilitated by the research team. Eleven midwives actively participated in the discussions. \ud \ud Qualitative data were analysed thematically using NVIVO. Study rigour was enhanced by independent cross-checking of coding, and an Expert Group consultation assisted data interpretation and concept modelling.\ud \ud Ethical approval was obtained from School Research Ethics Committee at Cardiff University. Participation was voluntary. Participants received study information prior to consent and were guaranteed anonymity throughout.\ud \ud Key findings: Four major themes were identified: Challenges to resilience; Managing and coping; Self-awareness and self-identity; Building resiliency. This paper focuses on Self-awareness and Self-identity, which featured strongly in the data. Participants perceived that resilience could be developed over time; key factors in building resiliency were ‘knowing oneself’ and having well-integrated professional and personal identities. \ud \ud Implications: Insights from ‘resilient’ midwives indicate that it may be possible to develop educational and practice-based strategies to facilitate resiliency. This in turn should help midwives to manage the emotional demands of their work and may improve workforce retention. This has potential benefits for midwifery internationally.

Gaining large amounts of weight during pregnancy may contribute to development of obesity and is associated with poor outcomes. Therefore managing gestational weight gain is important to reduce the risk of complications. This thesis aims to explore clinical and personal management of gestational weight gain and to discover how pregnant women can be best supported to maintain physical activity and healthy dietary behaviours. This is achieved through a programme of research comprising three related studies. \ud Study One explored the antenatal clinical management of weight and weight gain through one-to-one interviews with Antenatal Clinical Midwifery Managers across Wales (n=11). Findings showed wide variation in management of weight from unit to unit. Although midwives believed pregnancy to be a perfect opportunity to encourage healthier behaviours, many identified barriers preventing them discussing weight with women.\ud In Study Two semi-structured interviews with pregnant women (n=15) investigated views on personal weight management during pregnancy. Again pregnancy was seen as an ideal time to improve health behaviours due to a perceived increase in motivation and many women identified specific goals. However, in the face of various barriers, it was apparent that the motivation which initially identified healthy lifestyle goals was unable to sustain this behaviour throughout the pregnancy. \ud Finally Study Three looked at the feasibility and acceptability of a midwife-led intervention informed by the two preliminary studies. The ‘Eat Well Keep Active’ intervention programme designed to promote healthy eating and physical activity in pregnant women (n=20) was based upon the Self Determination Theory framework for enhancing and maintaining motivation and utilised motivational interviewing. Results indicated that the intervention was received well by participants who reported that it positively influenced their health behaviours. The ‘Eat Well Keep Active’ programme may be a suitable intervention to encourage and facilitate women to pursue a healthier lifestyle throughout their pregnancy.