title: Midwives experiences of removal of a newborn baby in New South Wales, Australia: Being in the 'head' and 'heart' space.
abstract: BACKGROUND
  A newborn baby is removed from his/her mother into formal care when he/she is considered at risk of serious harm and it is not in the best interests to go home with their parent(s) or carer(s). In New South Wales (NSW), this removal is known as an "assumption of care". This process is challenging for all involved especially when it occurs soon after birth. There is very limited research to inform midwives in this area of practice.
  
  
  OBJECTIVE
  To explore the experiences of midwives who had been involved in the assumption of care of a baby soon after birth or in the early postnatal period.
  
  
  METHODS
  A qualitative descriptive approach was used. Ten midwives involved with the assumption of care of a baby were interviewed. A thematic analysis was undertaken.
  
  
  RESULTS
  There were two overarching themes. "Being in the head space" represented the activities, tasks and/or processes midwives engaged in when involved in an assumption of care. "Being in the heart space" described the emotional impact on midwives, as well as their perceptions on how women were affected.
  
  
  CONCLUSIONS
  Midwives described feeling unprepared and unsupported, in both the processes and the impact of assumption of care. They were confronted by this profound emotional work and described experiencing professional grief, similar to that felt when caring for a woman experiencing a stillbirth. In the future, midwives need to be provided with support to ensure that they can effectively care for these women and also manage the emotional impact themselves.
authors: Clinical Midwifery Consultant, St George Hospital, South East Sydney Local Health District, Kogarah, NSW, Australia. Electronic address: Louise.Everitt@sesiahs.health.nsw.gov.au.
authors: Louise
authors: L
authors: Everitt
authors: Professor of Midwifery and Clinical Chair, Gold Coast University Hospital & Griffith University, Logan Campus, University Drive, Logan, Queensland, Australia.
authors: Jennifer
authors: J
authors: Fenwick
authors: Professor of Midwifery, Associate Dean: International and Development, Associate Head, WHO Collaborating Centre for Nursing, Midwifery and Health Development, Faculty of Health, PO Box 222, Jones St, Ultimo 2007, Australia.
authors: Caroline S E
authors: CS
authors: Homer
mesh_terms: D001315:Australia; D000068216:Child Protective Services; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D008880:Midwifery; D009035:Mothers / Q000523:psychology*; D009517:New South Wales; D009721:Nurse Midwives / Q000523:psychology*; D024802:Nurse's Role; D049590:Postpartum Period; D011247:Pregnancy; D036301:Qualitative Research
keywords: Assumption of care; Child protection; Emotional work; Professional grief; Removal of newborns