The importance of reciprocity in relationships between community-based midwives and mothers

SummaryObjectiveto explore the emotion work experiences of community-based midwives, focusing on their relationships with clients.Designa qualitative study using an ethnographic approach. Data were collected via observation, interview and focus groups.Settinga National Health Service (NHS) Trust in South Wales, UK.Participantsa purposive sample of 19 NHS community-based midwives, working in different teams and with differing lengths of clinical experience.Findingsrelationships between midwives and women varied considerably, and could be the source of emotion work for midwives. A model of midwife–woman relationships is proposed, based on the concept of reciprocity. Four key situations are identified: balanced exchanges, rejected exchanges, reversed exchanges and unsustainable exchanges. Balanced exchanges occur when there is ‘give and take’ on both sides; these are emotionally rewarding for the midwife. The other exchanges are out of balance, and require emotion work by the midwife.Key conclusionsthe concept of reciprocity is a useful analytical tool that enhances understanding of midwife–woman relationships and the emotion work that these may generate. Increased understanding of these issues is important, given the current national and international policy recommendations for health-care professionals to work in partnership with clients.Implications for practicethe midwife–woman relationship and the factors that affect it need to be explicitly addressed within educational settings, in order to further develop interpersonal and communication skills. In turn, this should enhance the emotional well-being of midwives and the quality of care that women receive. Additional research is needed to further develop and refine the model.