Joy, guilt and disappointment: An interpretative phenomenological analysis of the experiences of women transferred from midwifery led to consultant led care.

Background: Irish maternity services are predominantly medicalised and consultant led, therefore women who choose midwifery led care (MLC) do so in the context of limited birth choices. Transfers to consultant led unit (CLU) for consultant led care (CLC) can be unpredictable and can affect women's birth experiences. This study provides an in-depth exploration of women's experiences of transfer fromMLC to CLC during late pregnancy or labour.

Methods: Transfer experiences are explored through qualitative explorative in-depth interviews using interpretative phenomenological analysis (IPA).

Sample: Mothers who had experienced transfer from MLC to CLC during late pregnancy or labour were invited to participate. A purposive sample of eleven women following birth (five to 16 months post partum) provided their views.

Findings: Women described choosing MLC as a means of avoiding interventions and hoping for a fulfilling natural birth experience. However, participants describe feelings of ambivalence about their experiences, leading to conflicting emotions of joy with their new baby offset with disappointment about needing to transfer to CLC.

Conclusions: Choosing MLC in a risk averse culture can affect how women experience the transfer process. The impact of the transfer can involve a multilayered psychological and emotional adjustment to a different birth experience for women. The findings provide important insights into issues of policy, preparation, and communication prior to and after transfer to CLC, which should be useful for policy makers, health care professionals and educators.