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Australian midwives and clinical investigation: Exploration of the personal and professional impact

  • Catherine Alexander
    Correspondence
    Corresponding author at: Caboolture Maternity Services, Birth Suite Level 2, Caboolture Hospital, 120 McKean Street, Caboolture, 4510, Queensland, Australia.
    Affiliations
    The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia
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  • Fiona Bogossian
    Affiliations
    The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia

    University of the Sunshine Coast, Sippy Downs, Qld 4558, Australia
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  • Karen New
    Affiliations
    The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia
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Published:September 15, 2020DOI:https://doi.org/10.1016/j.wombi.2020.09.002

      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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