My experience of conducting primary research
By Rachel Housego, RM, MPH, Lecturer in midwifery at the University of Suffolk on 30 January 2023 Maternity Services RCM Research
With hindsight, I can appreciate the value research has on my professional development and my clinical practice. I started my master’s programme with King’s College London with the aim of furthering my knowledge in public health and this is something I have achieved. What I didn’t expect was to find myself not only a more rounded individual, but also an increasingly reflective practitioner with a more holistic understanding of maternity care.
While studying a sociology module, I considered the phenomenon of medicalisation and linked this to the birth continuum. This inspired the primary research I conducted for my dissertation, pertaining to the factors that influence midwives’ ability to practice midwifery-led care. The notion of midwifery-led care is to be ‘with woman’; not only promoting a physiological approach, where appropriate, but also championing women, supporting them in their choices and advocating for them.
I have come to realise, through this primary research, that workplace environment, clinical experience, and individual experience and wellbeing, impacts care provision and midwives’ ability to be ‘with woman’. This affects women’s, and neonates, long term physical and psychological health, as well as midwives’ health.
With most of my experience having fallen within an obstetric-led setting I have become acutely aware of the ways in which my clinical experience influenced the way I perceived pregnancy and birth, therefore affecting my practice. This has caused me to reflect on the way I was practicing and change some fundamental aspects of care; I have considered skills ranging from communication to birthing positions.
Primary research has influenced the way I speak to families, my clinical practice, my treatment of colleagues, and my perception of the structure of NHS maternity services. The qualitative research I conducted has provided me with an insight into the mindset of different midwives and highlighted the passion midwives have for midwifery-led care. Nonetheless, there are barriers that prevent us from providing this care. I now have context, which in the face of the current maternity crisis, highlights significant areas for concern.
Primary research has allowed me to immerse in practice, understand other midwives, and shown me areas for improvement within maternity care; structural, financial, epidemiological, and ultimately societal barriers are central to issues within maternity care. Ultimately, failings of maternity services, negative workplace cultures, and lack of midwifery-led philosophy could be addressed. However, lack of insight into individual practitioners’ experience, thoughts, and perspectives means we often gloss over some of the key issues within maternity care. This, to me, highlights a need for more qualitative research in maternity care.
In summary, research has made me a better midwife, a better educator, and a more understanding and compassionate person. I can now resonate with clinical practice and understand service failings at a deeper level. Going forward I aim to address the root cause of issues, rather than fire fight the outcomes and I can attribute this change in mentality to conducting research.