To ask for your ideas about what research needs doing in midwifery?

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Sorry, posting for traffic!

I am a third year student midwife about to embark on a research project but I am struggling to decide on a topic.

As many of you are parents, is there anything in your experiences of maternity care that you think could have been done better or that you wondered why something was done or suggested? Anything you would have wanted more research on?

Any suggestions would be much appreciated.

Thanks in advance.

Why some midwives lose the ability to actually care - compassion fatigue.

I agree with @PermanentTemporary I hated the maternity ward as there were people everywhere and noisy as anything. I am noise sensitive so my reaction is probably worse than most but some other women agreed it was hard to sleep.

As a former academic, please, please, please pick a small research question. The aim here is for you to become a midwife. You won't actually find out anything new, and you shouldn't try.

Pick an interesting question, sure, but pick something which lets you showcase what you can do so you get the best mark you can. Pick something for which the information already exists - secondary data like this is much quicker to use than collecting your own through interviews etc. Look at the last five years of the Maternity Survey. Compare what it shows about Black women (who say that they have good experiences of maternity care) with what we know about maternal and infant deaths (more common in Black women). Write something about why that might be, and then suggest some further research.

For the love of god, just pass your degree. You don't need to do original research.

When I was a junior physio 15 years ago we went round every women on postnatal ward and talked to them about pelvic exercises, back care post baby, what activities to encourage and what to avoid, and tgey were given a phone number to call to request an outpatient review with a physio if any continence issues. But this, as with many things, has been cut

In my early student days I saw terrible treatment of a woman in labour with SPD. The midwife in question no longer practices but I admit I need more knowledge in how to help these women, so this is definitely something I will look into. Thank you.

The huge increase in inductions and the impact that has on birth outcomes.

About a third of women are induced now. If. you are induced it is more likely to result in an instrumental delivery, more likely to end in a c-section etc.

The births are more painful because the body isn't ready. Recovery longer due to the likelihood of intervention.

I was a healthy mother, with a healthy pregnancy that went overdue. I was forced to have an induction which took days and ended up in a very traumatic forceps birth (and months long recovery). No other option was presented to me, and in retrospect I think that I was forced into this awful situation when there wasn't really good reason.

Thank you, I appreciate this.

I did a lot of research in my former role and plan to carry over my topic into a Masters and PhD so something with scope is what I am looking for.

Oh I have another one - the lack of infomation on how to care for yourself after a c-section .

I wasn't told anything on how to look after the scar and what to expect in the coming months to do with recovery from an operation

It is sad isn't it. I do put a lot of focus on pelvic floor health and drum it home every contact I have with women. We do have a self referral to a women's physio but passed given women the contact details, I am not sure what happens past that point. I should find out.

This is actually starting to form some ideas in my mind. My pelvic floor is not great after my son and I didn't have much in the way of pelvic floor care in my pregnancy. if I can save some women from pelvic floor issues in the future, that would be a big achievement. Thank you.

This is something I am very hot on but I appreciate not all trusts are the same.

It is such a big thing to have to recover from, whilst caring for a baby, so thank you.

I will put together a list and will share this with my cohort so that more ideas can be used. You are all wonderful, thank you.

Perinatal mental health.

Oh god, don't do a PhD! OK, I'll admit that many HCPs make fabulous PhD students - but think very carefully about what you want to achieve with it. If you're sure that's what you want, use this opportunity to practice your research skills. Use data or conduct interviews. Practice keeping your data in good order. Start building a reference library in e.g. Mendeley (other referencing software is available). Good luck!

Thank you. It is something I have in me that I need to get out. Midwifery is my second degree (I am not young anymore!) and whilst I am very passionate about it and aim to practice for many years, I don't want to be a hospital midwife in my later years and would rather try an leave my mark and help midwifery if I can.

My partner is an academic and a well known researcher so I am in good company should I need some help :)

The impact of induced deliveries without adequate pain management in the likelihood of having further children.

I would agree with more research on Tongue Tie. Both my children had it, not diagnosed until my 1st baby was 4 weeks old - I was suffering and about to give up midwives and HV dismissed it. It was a volunteer breastfeeding supporter that first mentioned it. Doctor who snipped it said it was obvious! 2nd baby I asked several times after birth and during first check ups about it but again I was dismissed, HV finally did a referral to ‘reassure me’ it was fine . It wasn’t and again needed correcting. 2 babies who I nearly stopped breastfeeding due to lack of knowledge and support from professionals. It’s a very simple procedure, effective and cheap and I would like to see every midwife trained and it be part of the newborn check.

I’m not sure midwives would have time to explain pelvic floor exercises in detail at antenatal appointments even if they did have more training. I think maybe a routine appointment with a physio in pregnancy for every women would be more effective (although even the physio appointments for women with problems are in short supply) or maybe better signposting to the information on the nhs website or perhaps a class or video for women in early pregnancy to go through all the health advice more clearly and concisely

This is going beyond the scope of midwifery but it seems that you have an interest in future academic research so I hope you don't mind me sharing. I think it would be beneficial for there to be more research into the impact of surrogacy on the child that is given to the non bio parents to be cared for. Should we expect outcomes similar to birth children or similar to adopted children? It is a big piece of research that would take decades and probably be controversial but basically is the trauma of being removed from the birth parent so insignificant that the practice should be allowed? If you could just look down the back of the couch and find some funding for that, that would be great, thanks!

That’s definitely a Trust issue. My London hospital gave me timed appointments and I was able to choose the time when I rebooked at the end of that day’s appointment. Usually I went for the 5pm Friday appt!

This was in 2022 as well so recent

The use of forceps. The UK is unusual in still using them commonly and it was one of the reasons I went for a c-section in the end as they wanted to induce me.

I wrote about the law and ethics or surrogacy in a recent piece and so can appreciated there is a lot that needs to be considered in these arrangements. It is something I already have on my radar as I have come across it numerous times already in my short 3 years of practicing. Thank you.

HELLP Syndrome

Also, women’s experiences of postnatal wards and the impact it has on their early motherhood experience.

I went in with zero expectations (they were met at the same level) that I would receive any care or help postnatally but I was also quite lucky that I’d had experience of abdo surgery and knew what to expect. I was also an older mum so able to vocally advocate. Lots of NCT friends had really awful post birth care and you hear about it all the time on Mumsnet.

Every time I walked past the nurse station they were furiously filling out paperwork and it made me sad. Audit trails are important but not at the expense of care.

@Porridgeislife glad to hear it! The trust in question used to regularly appear in the "worst NHS trusts" so it doesn't surprise me...

Improved postnatal care specifically pelvic floor issues. I had a 3rd degree tear and now have a prolaspe. No one checked I was doing pelvic floor exercises properly and it is only after paying to see a private pelvic floor physio I have had any help with this.