Midwives experiences of removal of a newborn baby in New South Wales, Australia: Being in the ‘head’ and ‘heart’ space

Abstract

Background: A newborn baby is removed from his or her mother into formal care when he/she is considered at risk of serious harm and it is not in the best interests to go home with their parent(s) or carer(s). In New South Wales (NSW), this removal is known as an "assumption of care". This process is challenging for all involved especially when it occurs soon after birth. There is very limited research to inform midwives in this area of practice. Aim:To explore the experiences of midwives who had been involved in the assumption of care of a baby soon after birth or in the early postnatal period.Method: A qualitative descriptive approach was used. Ten midwives involved with the assumption of care of a baby were interviewed. A thematic analysis was undertaken.Findings: There were two overarching themes. "Being in the head space" represented the activities, tasks and/or processes midwives engaged in when involved in an assumption of care. "Being in the heart space" described the emotional impact on midwives, as well as their perceptions on how women were affected. Conclusion:Midwives described feeling unprepared and unsupported, in both the processes and the impact of assumption of care. They were confronted by this profound emotional work and described experiencing professional grief, similar to that felt when caring for a woman experiencing a stillbirth. In the future, midwives need to be provided with support to ensure that they can effectively care for these women and also manage the emotional impact themselves.

Working with Vulnerable Pregnant Women Who Are At Risk of Having their Babies Removed by the Child Protection Agency in New South Wales, Australia

“…This paper describes how midwives worked with vulnerable pregnant women who were subject to child protection orders and faced the possible removal of their baby at birth. The findings are part of a qualitative study that explored ten Australian midwives' experiences of a newborn being removed from his/her mother, commonly referred to as an assumption of care (Everitt et al ., ). The study addresses a significant gap in both the Australian and international literature.…”

“…Upon contact with the research team, midwives were provided with information about the study. Once midwives confirmed their willingness to participate, a convenient time and location were organised to conduct the one‐off face‐to‐face interview (see Everitt et al ., , for a more detailed description of the research design).…”

“…The findings presented in this paper focus on midwives' experiences of working with vulnerable pregnant women who are subject to child protection orders and face the possible removal of their baby at birth. This work is part of a study that aimed to explore and describe midwives' experiences of assumption of care (Everitt et al ., ).…”

Introduksjon

“…Jordmødre som har deltatt i akutt omsorgsovertakelse ved fødsel, rapporter misnøye med arbeidet, sinne, skyldfølelse, frustrasjon og tanker om å gi opp sitt yrke (Marsh et al, 2014). Jordmødre blir involvert i handlinger som oppleves i strid med deres faglige oppgave om å gi pleie og omsorg, og oppfølgingen av foreldre etterpå oppleves som mangelfull (Everitt, Fenwick & Homer, 2015). Hvordan dette oppleves for andre yrkesgrupper som involveres, for eksempel fastlege, psykisk helsevern og politi, er i svaert liten grad studert.…”

Social Worker and Midwife Decision Making Regarding Child Protection Risk and the Unborn Baby: A Qualitative Study

“…The professional engaging in the decision-making process must take account of the relevant statutes, regulations, guidance, standards, policies and procedures (Everitt et al, 2015). They must seek a practical way forward for the family and the care of the baby in keeping with professional and other ethical standards (Everitt et al, 2017), ever mindful of protecting the unborn baby from serious harm yet aware of promoting family life where possible (Duffy et al, 2006) and operating within the relevant governance arrangements (Taylor and Campbell, 2011).…”