Midwives are about to get a dedicated online training package to help them care for LGBTQ+ birthing people, co-designed by the people who will use it and those who need it. This matters because LGBTQ+ people often face discrimination and negative attitudes in maternity care, leading to fear, anxiety, and poor health outcomes. Currently, no specific LGBTQ+ awareness and diversity training exists for midwives. The project will first analyse survey data on LGBTQ+ people’s maternity experiences, review existing literature, survey midwives on their training needs, and map current NHS service provision for LGBTQ+ families. Using a design-thinking approach, LGBTQ+ parents and midwives will then co-create the training package, which will be tested for usability with a small group of midwives. If successful, this training could directly improve the birthing experiences and health outcomes of LGBTQ+ people across the NHS. It addresses a clear gap in midwifery education, with the potential to reduce fear and discrimination in a setting where care is fundamental but often not delivered equitably. The researcher plans to seek further funding to roll the training out nationally.
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Background Providing good care to marginalised groups including LGBTQ+ birthing people is a fundamental to midwifery practice, but this care is not always delivered (3). LGBTQ+ people often face discrimination and negative attitudes in maternity care causing fear and anxiety about their interactions with midwives (4). The unique maternity care needs of LGBTQ+ birthing people are not being met and negative healthcare experiences and poor maternity care outcomes are present (5). Currently there is no specific LGBTQ+ awareness and diversity training for midwives. Aim To co-design and test an online training package to support midwives in the care of LGBTQ+ maternity service users to improve maternity experiences and outcomes. Methods This two-stage project will achieve the research objectives through 5 work packages (WP), WP 1-4 will be completed within stage one and WP2 within stage 2; Stage 1 WP1 Identification of LGBTQ+ peoples experiences of maternity care through analysis of data from the BESt-UK study Identifying the experiences for LGBTQ+ birthing people will be achieved by analysing responses to the BESt-UK survey results. The BESt-UK Study is an international collaboration led by Dr Claire Feeley, I am part of the trial team exploring childbearing experiences and seeking to discover the prevalence and impact of birth trauma and obstetric violence on women and birthing people [Pre-doctorate until month 3]. WP2: Scoping review of the literature This WP will identify the existing knowledge, skills, attitude and behaviours (KSAB) of midwives in relation to LGBTQ+ birthing people and maternity care, through a scoping review of the literature (including grey literature), to ensure all relevant literature is included. [Months 2-6]. WP3: Survey of midwives needs in caring for LGBTQ+ birthing people Informed by WP2, a UK wide online survey will be designed and conducted to understand the perceived training needs of midwives in caring for LGBTQ+ birthing people [Months 7-13]. WP4: Mapping exercise of maternity service provision for LGBTQ+ people A mapping exercise of UK NHS maternity units services/care provision for LGBTQ+ birthing people, will be undertaken. NHS Trusts will be asked to provide details of specific services/guidelines/protocols/care provisions in place for LGBTQ+ birthing people [Months 10-15]. Stage 2 WP5: Training package co-design The design thinking (DT) approach will underpin WP5. LGBTQ+ parents and midwives will be co-design participants to designing the training package. Findings from WP 1-4 will inform designing the training package. DT provides a framework for researchers to incorporate the needs and feedback of the service users throughout the development process (6). Once complete, a small number of midwives will use the think-aloud method to provide insights into its usability by verbalising their thoughts on the package (7). [Months 16-29]. Impact and dissemination The impact of the project is to improve the birthing experience of LGBTQ+ people through the co-design of an online training package for midwives. Small-scale testing of the package will be undertaken with midwives using the think aloud method (7). Following PhD completion, post-doctoral funding will be sought for evaluation and implementation of the training across the NHS.
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