No one asked us: Understanding the lived experiences of midwives providing care in the north west suburbs of Melbourne during the COVID-19 pandemic: An interpretive phenomenology

Abstract

Problem Within the Victorian healthcare system, a rapid response to the COVID-19 pandemic has necessitated frequent and ongoing changes to midwifery practice. Background Midwives are a vital workforce at risk of burnout, attrition, and trauma. Emotional consequences of the pandemic for midwives remain largely unknown. Aim To understand the lived experiences of midwives providing care in the north west suburbs of Melbourne, Victoria during the pandemic. Methods Purposive and snowball sampling facilitated the recruitment of eight midwives in the north west suburbs of Melbourne, Victoria. Semi-structured interviews were audio recorded and transcribed, occurring via telephone or video between September and October 2020. Interpretive phenomenology was the methodology used, informed by the writings of Heidegger and Gadamer. Findings Insights gleaned from the data embody a range of understandings. The unknown cost of change and adaptation; waves of the virus; balancing risk; telehealth; personal protective equipment; stripping away support; the privilege of abiding by the restrictions; separation, distress, uncertainty; and, professional strength. Discussion Experiences of midwives during the pandemic are characterised by sensations of voicelessness and professional invisibility. Distinctive differences in personal wellbeing and professional satisfaction exist between midwives working with and without continuity of care. Conclusion This paper voices the lived experiences of Victorian midwives, in the midst of an extended lockdown, during the COVID-19 pandemic. Knowledge obtained from this research provides important understandings for leaders, policymakers, and healthcare systems, in planning a long-term response to the pandemic that supports the wellbeing and longevity of a vital workforce.

Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study

“…In the Australian context, a number of qualitative studies have been performed to date from the perspective of midwives regarding provision of maternity care (20-22) and of women regarding their maternity care experiences (23,24). These largely align with the more general findings of this study, with midwives reporting challenges to provision of woman-centered care (20, 22), and difficulties coping with rapid changes to care (including telehealth) and "COVID-19 causing chaos" (20)(21)(22). As in this study, "silver linings" included the perceived positive impact of visiting restrictions on postnatal care (20,22).…”

“…Regarding mental health and/or DFV specifically, our findings suggest that changes in maternity care delivery in Australia, with face-to-face visits later in pregnancy and fewer in number, are likely to compound the perinatal mental health and DFV impact of the pandemic, through delay in screening and care, and in some cases missed screening altogether. This issue was also noted by Hearn et al in their study of midwives in Melbourne, Australia, who repeatedly voiced concerns around screening for family violence and noting how unsafe this was to do by telephone ( 21 ). Our findings also suggest a disparity in screening and care impacts for women from diverse backgrounds, as the unit with the highest proportion of overseas-born and non-English speaking women had a significantly higher staff perception of negative impact of the pandemic on DFV and mental health screening and care.…”

Gaza Midwives’ Lived Experience of Providing Maternity Care During COVID-19

“…Fear and anxiety from a new experience, as well as worry of unexpected results during care provision, infection, and death, as well as concern of maternal implications, social consequences of working in quarantine hospital, were all expressed by midwives in the current study. Previous studies have also shown these emotional manifestations [17][18][19] .…”

“…Midwives in this study found difficulties when providing care because they did not feel qualified and lacked expertise. Previous studies have shown that these emotional manifestations exist 18 , 22 .…”

Self-Reported Experiences of Midwives Working in the UK across Three Phases during COVID-19: A Cross-Sectional Study

“…Stress impacts both midwives and the women they care for. The provision of woman-centered care is central to the practice of midwifery [ 12 ] and some of the restrictions and changes in practice arising from the COVID-19 pandemic have been reported to compromise this care, leading to professional stress and personal conflict [ 12 , 13 , 14 , 15 ]. Fear of contracting COVID-19 and the need to protect their own families have been noted to give rise to significant stress for many midwives [ 14 , 16 , 17 , 18 ].…”