Background Preterm birth (PTB), defined as birth before 37 weeks, is estimated to affect >10% of pregnancies worldwide. In Denmark, women with a short cervix (<15 mm) are often recommended to restrict physical activity to prevent preterm birth. It is uncertain how women and their partners balance rest and activity in daily life during a high-risk pregnancy in this situation.Aim To explore how women at risk of PTB and their partners navigate decisions regarding activity and rest.Methods Qualitative, semi-structured interviews with 13 women hospitalised for cervical shortening and risk of PTB and 9 partners. Data was analysed using reflexive thematic analysis.Results Three main themes were developed. 1) Following the prescribed boundaries of “safe” activity describes how couples relied on healthcare professionals (HCPs) to define acceptable activity, thereby distributing responsibility for potential adverse outcomes. 2) “She was pregnant, but the baby was ours” describes how some partners left the decision-making to the pregnant women, either trusting her embodied judgment or downplaying their own concerns. Others intervened when they perceived her behaviour as “risky”. 3) Doing what felt right to me, illustrates how women adjusted activity in response to bodily sensations and negotiated between minimizing risk and maintaining self-care. However, for some, bodily sensations were difficult to interpret.Conclusion: When in risk of PTB, HCPs play a decisive role in women’s decision-making regarding activity levels. However, professional advice is actively managed and negotiated in the context of the woman’s relationship with her partner and her bodily sensations.
Background Women seeking sanctuary as refugees and asylum seekers face significant barriers accessing maternity services in the UK. Whilst existing research largely focuses on women’s experiences, this study explores the lived experiences of specialist midwives navigating their relationships with women seeking sanctuary within complex institutional and socio-political contexts. Aim To explore the lived experiences of specialist midwives developing relationships with women seeking sanctuary. Methods A hermeneutic phenomenological approach was used to explore the experiences of six specialist midwives working with women seeking sanctuary in England. In-depth interviews were analysed interpretively, drawing on Foucault’s theories of disciplinary power and governmentality, alongside the concept of positive deviance. Findings Five themes were identified: (1) bridging between services, (2) specialist knowledge, (3) adapting care, (4) building trust, and (5) navigating hostility. Midwives described relational practices that often defied institutional norms, positioning themselves as advocates and change makers. Conclusion Specialist midwives' were able to work within institutional constraints to achieve positive relationships with women. The ability to develop meaningful relationships with women seeking sanctuary was facilitated by protected roles which afforded time, autonomy, continuity and flexibility. These findings highlight the value of positively deviant practices in sustaining compassionate, relational maternity care. The study calls for investment in specialist midwifery roles to better support women seeking sanctuary and advance equitable maternity care.
