Through the looking glass; midwifery students' experience of ethical issues: A feminist explanatory case study

Abstract

Background: The ethical component in midwifery education is governed by international professional values, codes, and ethical principles. The aim of midwifery education is to encourage students to develop a lifelong commitment to ethical practice within their midwifery role and scope. However, little evidence is available on the experiences of midwifery students and how they navigate ethical issues in maternity systems.

Aim: To present a case study from a midwifery students' perspective that demonstrates observed ethical issues and to provide analysis of the ethical issues identified.

Design: A Single explanatory case study design with a feminist lens applied. Explanatory case studies present the 'how and why' of a phenomenon and contributes to understanding phenomena in a holistic and real-life context.

Setting: This project was set at a West Australian university from which pre-registration midwifery courses are delivered.

Participants: A solitary case study is presented from a midwifery students' clinical placement.

Methods: Ethics were approved 2023-04805. Edith Cowan University HREC. The source of data for this case study was direct observation by the primary author (Priya, 2021) and the Joanna Briggs Methods for Case study reporting guide followed. Thematic analysis with a feminist lens was applied to the data.

Results: Three themes were generated 'Through the looking glass; observing ethical issues'; 'Whose body Is It? The Erosion of Maternal Consent' and 'Relational care versus defensive practice'. These themes explain the antecedents and consequences of the ethical issues identified by the midwifery student, the findings are supported by ethical theory and midwifery philosophy to highlight some of the underlying causes that contribute to ethical issues.

Conclusion: Midwifery students experience ethical distress when they observe ethical issues and are powerless to support birth people in a way that aligns with midwifery philosophy of relational, woman-centred care. Further research is required to better understand how midwifery students may be better supported to foster ethical care.

Keywords: Ethics; Feminist research; Midwifery; Midwifery education; Relational ethics.