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Joys and challenges of relationships in Scotland and New Zealand rural midwifery: a multicentre study.

Crowther, Susan; Deery, Ruth; Daellenbach, Rea; Davies, Lorna; Gilkison, Andrea; Kensington, Mary; Rankin, Jean


Susan Crowther

Ruth Deery

Rea Daellenbach

Lorna Davies

Andrea Gilkison

Mary Kensington

Jean Rankin


Background: Globally there are challenges meeting the recruitment and retention needs for rural midwifery. Rural practice is not usually recognised as important and feelings of marginalisation amongst this workforce are apparent. Relationships are interwoven throughout midwifery and are particularly evident in rural settings. However, how these relationships are developed and sustained in rural areas is unclear. Aim: To study the significance of relationships in rural midwifery and provide insights to inform midwifery education. Methods/design: Multi-centre study using online surveys and discussion groups across New Zealand and Scotland. Descriptive and template analysis were used to organise, examine and analyse the qualitative data. Findings: Rural midwives highlighted how relationships with health organisations, each other and women and their families were both a joy and a challenge. Social capital was a principal theme. Subthemes were (a) working relationships, (b) respectful communication, (c) partnerships, (d) interface tensions, (e) gift of time facilitates relationships. Conclusions: To meet the challenges of rural practice the importance of relationship needs acknowledging. Relationships are created, built and sustained at a distance with others who have little appreciation of the rural context. Social capital for rural midwives is thus characterised by social trust, community solidarity, shared values and working together for mutual benefit. Rural communities generally exhibit high levels of social capital and this is key to sustainable rural midwifery practice. Implications:Midwives, educationalists and researchers need to address the skills required for building social capital in rural midwifery practice. These skills are important in midwifery pre- and post-registration curricula.

Journal Article Type Article
Publication Date Feb 28, 2019
Journal Women and birth
Print ISSN 1871-5192
Electronic ISSN 1878-1799
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 32
Issue 1
Pages 39-49
Institution Citation CROWTHER, S., DEERY, R., DAELLENBACH, R., DAVIES, L., GILKISON, A., KENSINGTON, M. and RANKIN, J. 2019. Joys and challenges of relationships in Scotland and New Zealand rural midwifery: a multicentre study. Women and birth [online], 32(1), pages 39-49. Available from:
Keywords Rural; Midwifery; Relationships; Social capital; Sustainability; New Zealand; Scotland


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