Practical wisdom of expert midwives' intrapartum care ―Care for women showing a strong fear of pain during delivery―

Abstract

Purpose

The purpose of this study was to explore the practical wisdom of expert midwives caring for women who demonstrated a strong fear of pain during delivery.

Subjects and Methods

Semi-structured interviews were conducted with 13 expert midwives recruited using snowball sampling. Subject matter that met the research criteria were extracted as small themes from the cases narrated by the research participants. These concerns were then grouped according to their similarities, and were subsequently abstracted for classification into main and large themes.

Results

According to the research participants, regardless of the delivery period, women showed various expressions of pain during delivery, including crying out, violent behavior, rigidity even in intermission, not reacting, speaking in an aggressive manner, otherwise dangerous behavior. In terms of the practical wisdom of the expert midwives attending to such women, the following were extracted as the large themes: receptive attitude; Promote their own presence to women; preventing her from becoming too caught up in the moment; not encouraging her agitation; making her husband's feelings stay close to her; and inferring her needs from mother-daughter relationships and responding to those needs. Additionally, it was apparent that the expert midwives competently cared for women who expressed high levels of fear during delivery on the basis of the following basic attitudes stemming from practical wisdom: understanding that a woman expresses her feelings like a child in the process of becoming a mother, and that often women who seem to be in a state of panic are actually listening to them calmly.

Conclusion

Expert midwives accept any expression of distress or anger without encouraging agitation as long as they are not jeopardizing the mother or the child. Additionally, they take into account the feelings of the husband seeing his wife acting out of the ordinary, as well as the mental distance between the woman and husband. These midwives are often well-versed in ascertaining what underlies these strong feelings of fear. Mother-daughter relationships sometimes play a significant part in this. Key characteristics of expert midwives are that they do not erase their own presence and take the initiative in interacting with the mother.