First antenatal visit : meeting now for the future : a grounded theory study of the meeting between the independent midwife and the pregnant woman : a thesis submitted in partial fulfillment of the requirements for the degree of Masters of Arts in Midwifery

Abstract

This is a study of what happens between independent midwives and women at the first antenatal visit. Six experienced midwives and six pregnant women participated in the research. Data were gathered through the observation of six first antenatal visits, individual interviews with the women and midwives and a review of the literature. Grounded theory was used to conduct the study, and a descriptive model of the first antenatal visit emerged. Up until the change to the Nurses Act in 1990 midwives predominately practiced within the hospital system. Since 1990 and the legalising of independent midwifery practice in New Zealand, midwives have taken up the challenge to practice independently. A few guidelines have been set to assist independent midwives in practice; some of the guidelines being used have been taken from the hospital system into independent practice. The first antenatal visit is the beginning point of the relationship between the pregnant woman and the midwife. It is a key element for determining the quality and effectiveness of a mother's subsequent maternity care (Methven, 1990). The midwife and the woman each have an important part to play in the first antenatal visit which sets the stage for future care. The data from the study revealed a number of paradoxes that exist when independent midwives deliver midwifery-only care. The basic social process to emerge from the study was "meeting now for the future" but the study identified that the midwife and the woman are meeting for different reasons.