Perspectives of experienced midwives working in the communities on detecting child maltreatment and its risk during visits

Abstract

Purpose

This study aimed to clarify the perspectives of experienced midwives working in the community regarding the detection of situations where child abuse and abuse risks are high in situations of postpartum mothers and child support, such as childcare consultation.

Methods

The participants were midwives with 10 or more years of experience in their professions, and who had experience in providing support to parents and children in cases of child abuse or high risk of child abuse. Semi-structured interviews were conducted using an interview guide. The data obtained were transcribed verbatim, and the content was qualitatively analyzed with reference to Krippendorff's content analysis method.

Results

The data collected in the interviews were summarized into 90 codes, 37 subcategories, and 8 categories. The eight categories are as follows: “what is reflected in the home environment,” “suffering manifested in the mother's mental and physical condition,” “lack of ability to seek help,” “difficulty in developing attachment to the child,” “mismatch between the child's condition and parenting method,” “behavior toward the child,” “condition of the child in crisis,” and “dissonance in family relationships.”

Conclusion

Experienced midwives working in the community had multifaceted perspectives of the home environment, state of the mother and child, and attitude of the family. These perspectives could only be formed by building a supportive relationship from a holistic perspective as viewed by the mother. For preventing child abuse and providing care, skilled midwives working in the community believed in offering continuing support that is based on the support relationship from the standpoint of maternal protection.