Results
Data Analysis
After data collection, interviews were transcribed and examined using a phenomenological process of writing and re-writing; stories were built from the raw data and analyzed for meaning. The interpretive analysis of the raw data, encompassing all accounts and individual details, involved cycles of thinking-writing-reading until a credible theme emerged. Identified themes allowed new insight into the topic, commonalities and resonant qualities to be determined which become the result of the study. This method appeared to be appropriate considering they were taking interviews that lasted one or two hours and finding meaningful information that repeated itself in each interview. Crafted stories from the raw transcriptions were returned to the participants for their critique, this process is otherwise known as member checking and is “the most crucial technique for establishing credibility” (Baillie, 2015, p. 40).
Findings
Five different themes emerged from the data analysis: showcasing optimal relationships, feeling isolated, living with discord, intra-professional discord, and discord and feelings of being unsafe. The optimal relationship is one with trust and support where the healthcare members work together and are committed to making childbirth a positive experience. The feeling of isolation was present for both the patient and the healthcare worker. An example to describe feelings of isolation were when a patient is transferred away from home to an urban hospital with no nearby support; it can lead to feelings of isolation. Additionally, one of the midwives described feeling isolated although she was working in a large hospital; these feelings arose due to the lack of personal or close relationships with other providers. Relationships revealed themselves to be essential to sustaining support. Professional isolation can be unsafe in practice as well as emotional wellbeing. Midwives reported living with discord due to the lack of support from general practitioners. Different values have led to practitioners not utilizing each other in a situation where the patient would have benefited from the extra care. “Relationships matter in rural regions yet there are tensions at play within these relationships” (p. 7). Functioning relationships within the community of practitioners as well as those at the interface of secondary services are what makes things work. When relationships break down, the consequence of poor communication is discord. Conflict is also felt between midwives who practice in the same area because of the difference in values leading to distrust of the decisions of other midwives. The lack of trust and animosity leads midwives to work alone, rather than in a partnership ultimately affecting everyone involved. Reports of discord and lack of trust between midwives and general practitioners were also discussed leading to unsafe situations for mothers and babies when a decision cannot be made or supported in an emergency.. When relationships are strong and reciprocal, the maternity experience is more enjoyable and safer for all parties involved.
The results of the study are straightforward and easy to understand. As a reader, it’s expected to have a wide array of responses as each person involved with maternity care has their personal view on it, each role the person holds reflects an independent perspective. It was interesting to read that both the mother and the midwife reported feelings of isolation but for different reasons. However, the results are not exciting or unique to the study’s population, showing transferability; it is common knowledge that being alone or having no support can make one feel isolated and that unwanted isolation is unhealthy.
Theoretical integration
Relationships with patients and health care providers are often viewed as a professional relationship.Some would argue that relations between patients and providers should remain professional and should not include personal relationships; however, this is often not the case in rural communities. The study results reveal that patients seeking maternity care have increased trust and satisfaction in the care they receive if they have established relationships with their providers.Through collaboration and open communication, both can appreciate having professional and personal differences.
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