Midwives' experiences of working with women in labour: interpreting the meaning of pain
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A key midwifery activity is the support of a woman in labour. Pain in labour has been extensively researched from the woman's perspective, but less has been explored in relation to the midwife and her approach to pain. The way in which the midwife works with a woman and her pain in labour is the focus of this qualitative study, using Heideggerian hermeneutic phenomenology. This philosophical approach seeks to uncover or illuminate aspects of the midwife's practice which are frequently taken for granted in their everydayness. Seven midwives, including both independent practitioners and hospital-employed, were interviewed. Their narratives were analysed to uncover the meaning of the way in which midwives work with women and their pain in labour. The findings of this thesis suggest that midwives work by interpreting the woman's pain. Before the pain begins, they 'leap ahead' to help them anticipate the pain and how they will confront it. During labour, midwives give pain meaning by translating its purpose in that context. They 'leap in' when required, sometimes using 'self as an intervention. Midwives interpret women's pain through their understanding of lived time. They know how the perception of time passing changes depending on the setting for labour or the amount of anxiety and pain the woman is experiencing. Midwives use time in their work. They break it down to help a woman focus on a single contraction rather than looking too far ahead toward the unknown. Time can be a midwife's friend when the arrival of the baby replaces the urgent need for pain relief. It can also be her enemy if her interpretation of a woman's pain differs from the woman's perception. The memory of pain may persist for the woman, after labour has finished, with a backlash for the midwife. Some midwives believe in the process of birth and the woman's ability to labour with such conviction that they gain a woman's complete trust. At her most vulnerable time, they encourage the woman to call upon inner reserves and be truly empowered by her experience.