Midwives’ experience of promoting the golden hour after a normal vaginal delivery

Abstract

The Golden Hour (GH) is the first hour following the birth of a baby, and it is a crucial time for the wellbeing of both the mother and her baby. This study aimed to understand midwives’ experiences of promoting the GH after a normal vaginal delivery (NVD). Its objectives were threefold, which included; exploring what facilitates the GH, exploring any barriers that might hinder the GH and understanding midwives' perceptions of the benefits of the GH. A qualitative approach was used to explore the experiences of a purposive sample of eight midwives who worked at the central delivery suite (CDS) of a local general hospital in Malta. The study had a 100% response rate as all midwives that were recruited to participate took part in the interview with the student researcher. The data was collected through a one-time, face-to-face interview, using a self-designed, semi-structured interview schedule. All ethical considerations were adhered to. Data were transcribed verbatim and analysed using Braun and Clarke’s thematic analysis (2006). The results of this study revealed that local midwives were able to accurately define the term ‘GH’ and were aware of the numerous benefits that this practice offers to both the mother and her infant. Furthermore, participants expressed how the GH is also beneficial for the midwife and the father, as it provides the midwife with a sense of satisfaction and it also enhances the father-infant bond. It was clear from this study that all of the participating midwives recognised the value of the practice of the GH and stated that they were doing their best to practice it. On the other hand, midwives indicated the need for more training and feedback, to increase their knowledge of the GH and, as a result, improve their practice. Findings concluded that parents' willingness to practice the GH, as well as the midwife herself, both contribute to the promotion of the GH. However, according to the interviewed midwives, working in an obstetric-led environment, the ongoing COVID-19 pandemic, emergencies, parents' unwillingness to practice the GH, having a busy workload with a shortage of staff and an insufficient number of beds are all barriers to the practice of the GH. The results exhibited several recommendations for practice, management, education and further research. These include the need for revising and improving intrapartum guidelines, re-organizing the setup of labour and delivery rooms, introducing midwifery-led care and continuity of care and carrying out monthly reflective meetings. Additionally, it was recommended to introduce compulsory continuous professional development programs, ensuring that all student midwives are competent in practising the GH and improving local antenatal education programs. Lastly, future research with a larger sample size, a mixed-method approach and with varying healthcare professionals (HCPs) experiences is also recommended.