Supportive relationships between maternity nurses/midwives and childbearing women in Saudi Arabia: a mixed-methods study

Background: Childbearing experience could be more satisfactory for women with quality relationships with maternity staff. In many situations, women and maternity staff can face relationship challenges. Aim: To examine perceived enabling practices for building supportive relationships between Arabic-speaking childbearing women and maternity nurses/midwives, and explore facilitators and barriers to these relationships. Design and Method: A mixed-methods study with two phases: Phase One included validation of Arabic Neo-Enabling Practice Scale (Neo-EPS) for women and maternity nurses/midwives; and an online survey using Arabic Neo-EPS with a convenience sample of 213 postnatal women and 114 maternity nurses/midwives from maternity hospitals across Saudi Arabia (KSA) via social-media and snowballing. Phase Two included15 women and 15 maternity nurses/midwives were interviewed to explore the perceived factors impacting the relationships with women. Result: Phase One found the Arabic Neo-EPS has good content validity and test-retest reliability. Women's Arabic Neo-EPS mean scores were significantly lower than maternity nurses/midwives'. Non-Saudi maternity staff had higher perceptions of supportive relationships. Level of education was significant in influencing the difference between women and maternity nurses/midwives' scores. Phase Two: Four themes confirmed the importance of integrating all aspects of support in the relationships with women. Professionalism and compassion were perceived as facilitators. Unsupportive behaviours were perceived as barriers. Cultural diversity might impact the practice of building relationships. Discussion: Woman-centred care positively affected women's experience. Staff workload impacted on supportive relationships. Women’s culture should be considered. Non-Saudi maternity nurses/midwives had higher levels of perceptions on supportive relationships they built with women compared to Saudi staff. Conclusion: To the best of our knowledge, this is the first study in KSA. Healthcare leaders need to support the development of nurses/midwives' coping strategies and self-reflection for high-quality maternity care. Implementation of continuity care requires KSA policymakers to have an organisational shift from standardization to woman-centred care.