Mycket behöver förändras! Barnmorskors uppfattning om postpartumvård när barnet behöver neonatalvård
Quality of health carePostpartum careIntegrated careMother infant separationVårdkvalitetPostpartumvårdSamvårdSeparation av mor och barn
Aim: To examine how midwives describe good and safe postpartum care of mothers with infants in neonatal care, and which prerequisites and obstacles they see to giving good and safe care while minimizing time of separation. Method: Semi structured qualitative interviews with ten midwives at two maternity wards in Uppsala. The interviews were recorded, transcribed verbatim and processed by manifest analysis. Results: Three categories were identified, Good and safe care, Organization as an obstacle and The midwife role. Good and safe postpartum care of mothers with infants in neonatal care required knowledge, appropriate equipment, good guidelines, possibility to see the mother, contact between mother and infant and good collaboration between the maternity and neonatal wards. This collaboration was insufficient. Organizational obstacles were shortage of staff, lack of guidelines and the distance between the wards. The midwives thought that integrated care of mother and child would be optimal, or at least a midwife responsible for the mother at the neonatal ward and a pediatric nurse on the maternity ward. The midwife saw herself as the woman's advocate who perceives the family as a whole. Being responsible for the mother´s care, their dilemma was how to prioritize between medical safety and encouraging her to stay with her infant. Conclusions: This is a topic that midwives are committed to. It causes frustration and feelings of insufficiency, but also of being important and capable of making a difference. Many thoughts about how the nursing care functions and should be provided were found. Many improvements are needed, organizational improvements as well as an increased collaboration between the departments are desired.