RH: How did you find out about the Better Births research project, and why did you get involved?
LS: I was at my local playgroup with my son where I met a member of the Better Births team who was recruiting local parents to work on the project with the aim of improving local maternity services. My son was about to turn one, so his birth, and adjusting to motherhood was very fresh and maternity care was something I felt passionate about.
Although my own birth was fairly straightforward in that nothing disastrous happened, it was still a traumatising experience in many respects. It seemed as though everyone I knew - family, friends, mothers at play groups - had such varied experiences. I therefore hoped that by taking part and carrying out the research we'd be able to improve the birth experience of mothers, ease the transition into parenthood, and even-out the quality and experience of care during pregnancy, birth and postnatally.
RH: Can you tell me about the participatory research method that you used?
LS: There were 15 mums recruited to carry out the research. We had an intensive three days of training in the research method, Participatory Appraisal, which was new to all of us. Instead of having a static questionnaire and survey that yields limited information, we were trained how to use maps, spider diagrams, comic strips and even washing lines as a way to facilitate discussions with participants, hear their stories and gather their views. It’s a much more fun and interactive way of engaging with people and allows space for open questions and in-depth conversations. We learned how to use this approach by practicing the methods on each other which was an amazing experience in itself. It was fantastic to work so closely with women from all walks of life, and to hear their incredible journeys into motherhood.
RH: What did the fieldwork entail?
LS: What is so great about the participatory approach is that we [the community researchers] planned, carried out, and summarised the data ourselves rather than being told what to do and how to do it. Although this was really daunting, it meant that we had ownership and investment in the fieldwork stage which was really empowering. We brainstormed different groups of people we wanted to talk to, ideally tapping into seldom heard or marginalised groups like the Orthodox Jewish community, parents of children with disabilities, teenage parents and dads. We then devised research sessions to target places where we would find these groups, which ranged from children’s centres, parks, libraries, community centres and religious buildings.
RH: Can you tell me about any stand out moments in the fieldwork?
LS: Even though I've lived in my area for five years, it was an eye-opening experience hearing life-changing stories from such diverse people practically on my doorstep. Throughout the fieldwork mums and dads were happy and willing to share their views, as many had never been asked about their birth/maternity experiences before. The sensitive and emotive nature of our research topic meant it was a privilege, but also challenging, to hear difficult accounts of traumatic births, or from women on the receiving end of discrimination. Particular stand out moments include hearing how difficult it was for an asylum seeker who didn't speak English to go through her birth on her own and without an interpreter. It was fascinating talking to a group of Orthodox Jewish women about how their community all pull together to support mums immediately after birth through the provision of mother and baby homes. There were also really positive stories of women expressing their thanks to amazing midwives, and their deep gratitude for the free services provided by the NHS.
RH: From your perspective what are the main findings from the research?
LS: For me, one of the main findings of the research is that there doesn't need to be a drastic overhaul of maternity services to transform women's experiences. Lots of women talked about how they felt they were on a conveyor belt, some even described being treated like a ‘machine’ or ‘animal’, and negative-sounding medical terminology like “failure to progress” all contributed to a de-humanising feeling. We kept hearing again and again how much difference it made when midwives made eye contact, smiled, were reassuring and respectful. These small caring gestures, which cost nothing, have the power to make a woman feel like an individual, empowered, and listened to - and this had a big impact on their experience of pregnancy, birth and post-natal recovery.
RH: What impact do you hope the project will have on maternity services?
LS: What was incredible about the project is that the research was commissioned in the first place - there is clearly a desire to hear how service-users currently experience maternity care and to make changes. It was amazing to collect the data, and then feed it back in real time to senior midwives and commissioners. The data and stories we gathered have such potential for impact that I hope the project is widely publicised and acted on. Whilst no concrete changes have been made yet, there are plans to build a training package for NHS staff to highlight the importance of social and communication skills.
I hope that the work we have done is built upon, and that the small changes we suggest are made because they have the potential to have a big impact on women’s experiences of maternity care.
Bio: Laura Speers has a background in teaching and research in Higher Education. She’s now training to be a counsellor while working as a freelance writer and researcher.
Bio: Rowena Hay is the Research Director at Shortwork, a research agency providing participatory research, evaluation and training services to public sector organisations and non-profits. Shortwork were commissioned to co-ordinate the peer research element of the Better Births project.
Better Births: The Better Births North Central London participatory research project was commissioned by UCL Partners for NHS trusts delivering maternity services in North Central London. The project was managed by Emily Ahmed, the participation lead at UCL Partners, with research and training provided by Rowena Hay from Shortwork and Roger Newton from 3ps.
AUTHOR: Rowena Hay, Research Director, Shortwork. [email protected]