Abstract
Background
The purpose of regulation of health professionals is public protection. Concerns regarding
professional conduct or midwifery care can lead to clinical investigation. Midwifery
literature reveals midwives feel ill-equipped and unprepared for clinical investigation
and experience stress and abreaction.
Aim
To explore the lived experience of clinical investigation and identify the personal
and professional impact on Australian midwives.
Method
Semi-structured interviews of a purposive sample of Australian midwives. Data analysis
was informed by a phenomenological conceptual framework derived from Husserl, Heidegger
and Merleau-Ponty.
Findings
Twelve midwives were interviewed, with seven under current investigation. Discussion
involved personal and professional experiences of three or more investigations each,
over a period of three to five years. Most investigations were instigated by hospitals
with two complaints from women. Seven participants were alleged negligent following
adverse neonatal outcomes and five had misconduct allegations. Midwives were employed
or in private practice and half provided homebirth services. Themes included being
safe, being connected, time and being, perception and well-being.
Discussion
The investigative process involves different health services, state and national bodies
using varying powers and processes over protracted time periods. Participants discussed
aspects such as disrespect, inequity, powerlessness, silence and ostracization. Midwives
who successfully navigated clinical investigation developed resilience through reflection
on clinical practice in a culture of safety.
Conclusion
The process of regulating midwives, designed to protect the Australian public, may
be harming investigated midwives. Understanding the personal and professional impact
of clinical investigation needs to underpin midwifery education, clinical practice,
inform policy and regulatory reform.
Keywords
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Article info
Publication history
Published online: September 15, 2020
Accepted:
September 2,
2020
Received in revised form:
August 11,
2020
Received:
August 25,
2019
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Ltd on behalf of Australian College of Midwives. All rights reserved.
