RESEARCH DESIGN

The second phase of the study is led by my chosen theoretical perspective, Haraway (1988, 1991, 1997). This perspective has associated implications to the methodology of this study, which I have visited in section 4.6. The design for the second phase incoporates different methods to enhance the mix of methods contributing to the credibility of this study.

The findings from the first phase informed the second phase of the study. In the second phase I decided to concentrate on the women receiving consultant- led care only, therefore exploring the views of a midwife’s role within a consultant unit. This exploration is unique, as a study has not been performed previously on the views of consultant led women in relation to the role of the midwife.

4.8.1 Sample

Purposive samples were also used in this phase. Following the findings from the first phase and based on the lack of current literature available in relation to consultant led care in contemporary midwifery practice, my supervisory team and I agreed that investigating the view of women receiving consultant led care would provide a unique perspective of their views in relation to the role of the

midwife. Women experiencing consultant led care would be at an increased likelihood of experiencing technology and interventions, as they would have been assessed with some complication or an anticipated complication in the antenatal, intrapartum or postnatal period. Therefore this sample will be appropriate for using Haraway’s (1991, 1997) notions, especially of the cyborg to investigate the views of women experiencing this model of care in relation to technology and the role of the midwife.

The sample of women in this second phase of the study, were recruited from a different area in the West Midlands region. They were recruited from a Hospital Trust, which provides two birth environments. These are the woman’s home and the consultant led labour ward. The Trust has two hospitals providing the same environments. Women and midwives from both hospitals were included in the study. The sample of women, were all receiving consultant led care and all intended to deliver their baby in the consultant led labour ward setting. The sample of midwives for the second phase were all working within the consultant led setting at the time of the woman’s birth experience.

4.8.2 Recruitment

The purposive samples in the second phase were primigravida women receiving consultant led care. They had been identified in antenatal clinic at their initial consultant appointment and approached by myself to request recruitment. A written information sheet was provided and the study explained verbally by myself. When they left the clinic I asked if they would be interested in taking part, if they agreed they gave me their contact details. I agreed to contact them after twenty-four hours to ensure they still wanted to take part. If they did, I arranged to see them at their home to gain verbal and written consent for the study. I also provided another information sheet and ensured they understood it, prior to completion of written consent. Ten women were recruited and were part of this phase. I used a small number to ensure I was able to investigate their perceptions over their pregnancy, birth and postpartum experiences. This enabled me to observe for any changes in perceptions across this continuum and explore these perceptions in a much deeper sense. At each interview I was consciously using Haraway’s notions to investigate their perceptions, through questioning with these in mind. The midwives who were in

attendance at the birth were approached regarding the study and asked if they would participate. I approached them all in person, explaining the study, its implications for them and provided them with an information sheet. I contacted them again twenty-four hours following this initial contact. All of the ten midwives agreed to participate.

4.8.3 Methods

A mixture of data collection methods were utilised.

A diary was given to the women at mid-trimester of their pregnancy to record their thoughts about the midwife’s role throughout their journey up to 6 weeks in the post-natal period, so they could record an entry each time they were seen by the community midwife or at the hospital. Diaries can provide researchers with an in-depth personal perspective from a particular time point and also have the capacity to show how feelings or events may alter over a time period (Walsh and Baker 2004). This qualitative research method offers the opportunity of capturing perspectives of the midwife’s role from a different angle, which also supplements other methods to provide a mixture of research methods. Using this approach offers the opportunity to explore perceptions using Haraway’s notions across different approaches of data collection, to provide further validity of the findings.

Each woman received an in-depth interview during the mid-trimester (20-24 weeks gestation) when a diary was distributed to her. She then had a further three interviews at 36-38 weeks of pregnancy, following the birth and at six weeks in the postnatal period. The midwives who were with the woman at the birth of their babies were also interviewed to establish how they felt they were perceived. The interviews of both the women and the midwives were semi- structured to enable exploration of the themes discovered in the first phase. Semi- structured interviews allow for a dynamic operation between researcher and the participant, as they both shape the focus of the enquiry (Walsh and Baker 2004). Interviews will vary on an individual basis with each participant as responses to initial questions are explored, with the direction and flow being led by both the researcher and the participant.

The research method in phase one combines with the two from this second phase, to provide a multiple exploration from three different angles to investigate perceptions of the midwife’s role. This investigation goes a step further by allowing for reflection of the women’s perceptions with those of the midwife’s, which provides a unique aspect to this study, to portfolio a comprehensive collection of data.

4.8.4 Aims and Objectives

The overall aim for both phases of this study is to explore the views of midwives and women, relating to the role of the midwife. The themes identified in the first phase have been used as a basis to explore further the midwife’s role in a consultant led setting. This is achieved using a postmodern epistemological approach, concerning feminist technoscience, focusing on the work of Haraway (1991,1997).

The objectives are to:

• Explore how women receiving consultant led care view the role of the midwife through their pregnancy, birth and the post-natal period.

• Explore the themes identified in the first phase further in the second phase.

• Compare and contrast the women’s and midwive’s perceptions in the second phase.

4.8.5 Moderation

The semi-structured interview plan was formed with the assistance of my supervisory team. I consulted with them throughout the four stages of the women’s interviews and following the midwives interviews. We discussed the data and I consulted with them throughout the analysis stage.

4.8.6 Member Checking

I posted the transcripts of the midwive’s and the women’s interviews to them (the four together) and provided my contact details for them to contact me if they felt it was not a true reflection of their interviews. I decided to do this, not that it was led by Haraway’s (1991. 1997) writings, but because I felt that I was

being open and honest with the participants and this provided credibility to my study.33