The phenomenon of intrapartum transfer from a western Australian birth centre to a tertiary maternity hospital: The overall experiences of partners

Abstract

Aim: the aim of this Western Australian study was to describe the overall labour and birth experience of partners within the context of an intrapartum transfer occurring from a low risk midwifery-led, woman-centred unit to an obstetric unit. Design: a descriptive phenomenological design was used. 15 male partners were interviewed in the first 8 weeks post partum between July and October, 2013 to explore their experience of the intrapartum transfer. Setting: a midwifery-led birth centre set on the grounds of a tertiary maternity referral hospital. Participants: partners of women who were transferred from the birth centre to the onsite tertiary hospital due to complications during the first and second stages of labour. Findings: five main themes emerged: (1) ‘emotional roller coaster’; (2) ‘partner׳s role in changing circumstances’ with subthemes: ‘acknowledgement for his inside knowledge of her’ and ‘challenges of being a witness’; (3) ‘adapting to a changing model of care’ with subthemes: ‘moving from an inclusive nurturing and continuity model’ and ‘transferring to a medicalised model’; (4) ‘adapting to environmental changes’ with subthemes: ‘feeling comfortable in the familiar birth centre’, ‘going to the place where things go wrong’ and ‘Back to comfortable familiarity afterwards’ and (5) ‘coming to terms with altered expectations around the labour and birth experience’.Key conclusions: partners acknowledged the benefits of midwifery continuity of care, however, noted that as partners they also provided essential continuity as they felt they knew their woman better than any care provider. Partners found it difficult to witness their woman׳s difficult labour journey. They found the change of environment from birth centre to labour ward challenging but appreciated that experienced medical assistance was at hand when necessary. Being able to return to the birth centre environment was acknowledged as beneficial for the couple. Following the transfer experience partners asked for the opportunity to debrief to clarify and better understand the process. Implications for practice: findings may be used to inform partners in childbirth education classes about what to expect when transfer takes place and offer the opportunity for them to debrief after the birth. Finally, themes can provide insight to maternity care professionals around the emotions experienced by partners during intrapartum transfer to enhance informed choice, involvement in care and empathetic support.