Midwives’ perceptions of high-risk pregnancies and their role with vulnerable pregnant women

Context

High-risk pregnancy constitutes a factor of vulnerability for women. The role of midwives in caring for these women is crucial, but little is known about their views concerning these complex pregnancies.

Objective

This study aims to increase insight on midwives’ outlook on high-risk pregnancies, their self-perceived roles, the challenges encountered, and their guidance for best practice.

Methods

This qualitative study took place in a maternity clinic of a University Hospital in France. Ten midwives were interviewed, and a thematic analysis was performed. The design of the research followed the COREQ checklist guidelines for reporting qualitative research.

Results

Five themes emerged from the analysis: (1) “Like a bolt from the blue” for the psychological impact and the essential reassurance midwives bring, (2) “Helping women get help” to detect alarming signs and the difficulty to address mental health issues (3) “Human Swiss army knives” for their specific expertise and the human part of their work, (4) “Women and their environment” for taking the time to understand women as a whole and consider the impact of/on their environments, and (5) “Clinical and human setting” for consistent teamwork, respectful of each woman's individuality.

Discussion

This study highlights the necessity of a woman-centred care in high-risk pregnancies. Midwives reflected on their roles in this particular care as they contribute to a more human and respectful approach of women while helping to maintain clinical stability and enhance women's well-being. Midwives advocated for normalizing mental health issues, for approaching women in a holistic way, for providing continuity of care, and for being consistent in teamwork.