"Running on goodwill and fairydust" - Midwives' experiences of facilitating and delivering local breastfeeding support via Facebook groups: A qualitative descriptive study.

Abstract

Background: Facebook groups providing breastfeeding support are widespread. Some are created and/or facilitated by midwives, but little is known about their motivations or experiences. The present study aimed to examine how midwives involved in providing breastfeeding support via local Breastfeeding support Facebook (BSF) groups perceive the value of this provision and their experiences of creating these services and engaging with mothers online.

Methods: Participants were recruited through Facebook advertising and snowballing techniques. UK registered midwives with experience of providing breastfeeding support via Facebook groups were eligible. Semi-structured interviews were conducted using Microsoft Teams/Zoom with nine midwives between July and September 2021. Reflexive thematic analysis was conducted.

Results: Three themes, each with three subthemes, were identified: (1) Imperatives and Value; (2) Goodwill & Lack of Resources; and (3) Community of Practice. Theme 1 described groups as necessary for meeting current mothers' needs and improving low breastfeeding rates. Theme 2 highlighted that BSF groups rely on voluntary work by midwives and peer supporters, with sustainability and recognition of their efforts being major concerns. Theme 3 showed that BSF groups function as communities of practice, offering social learning opportunities and benefits for midwives.

Conclusions: Midwives became involved in delivering online support motivated by a belief in the value of this provision, but acted as volunteers and felt unsupported by wider services. This has impacts for the sustainability of this provision regardless of its value. However, midwives reported significant benefits from involvement. Thus, there is a need for services to provide additional guidance and investment.