Midwives' Experiences of Working with Highly Anxious Childbearing Women

Anxiety is a normal human phenomenon. It is fundamental to our survival as a species, allowing us to adjust and plan for the future and prompts us to seek help and security from others. High levels of anxiety during childbearing are associated with poor fetal development, behavioural/emotional problems in children and adolescents, prolonged labours, increased obstetric intervention, impaired lactogenesis and bonding problems.

Working with highly anxious childbearing women can be a challenging experience for independent lead maternity care midwives. This qualitative investigation guided by the principles of feminist research examined four independent midwives experiences of working with highly anxious childbearing women. Data were collected by interview, and thematic analysis found three themes that encapsulated the experience. The resultant themes were of: 1) challenging partnerships, 2) making a difference and 3) realising own limitations.

The midwives, while very committed to their highly anxious clients, experienced considerable stress while endeavouring to provide effective care. This stress is of concern to midwives and midwifery as it makes midwives vulnerable to burnout. Given the damage that high levels of unchecked anxiety have on childbearing women and their families, midwifery has to look for safe and effective ways to work with these women.

Recommendations for practice are based around negotiating boundaries to the midwife-client relationship, increased help and support for midwives, especially clinical supervision, better midwifery education, and continuous professional development in relation to maternal mental health, and properly resourced and funded maternal mental health services.