The research that inspired me: Mary Steen

By Mary Steen on 23 November 2018 Student midwives Research Midwives Magazine

I remember seeing Professor James Walker presenting a lecture in the late 1980s and asking an important question: ‘Why were pregnant women being admitted to the antenatal ward when they could just as easily be seen and treated in an antenatal day unit (ANDU) setting?’

Then these women would have the choice to go home after receiving care and treatment in the ANDU and come back the next day or the following day if required. This lecture inspired me to take an interest in research relating to ANDU care and how this was then being interpreted and implemented into clinical practice (Walker, 1993). In 1989, I began working as a midwife (job share position) in the newly set up ANDU at St James’s Hospital in Leeds.

During my clinical experience within the ANDU, I worked alongside three obstetricians, Dr Simon Tyrrell, Dr Peter Buchan and Professor Richard Lilford and also two research midwives Muiread Cave and Susan Cameron, who were undertaking research in the ANDU and antenatal clinic (Lilford et al, 1992; Tyrrell et al, 1990). They collectively inspired me to learn how to understand and undertake research.

I was then asked to be part of a research team led by another obstetrician Dr Derek Tuffnell who undertook a randomised controlled trial (RCT) investigating day care for hypertension in pregnancy (Tuffnell et al, 1992). In addition, I was studying part-time for an undergraduate degree in health sciences, which gave me the opportunity to learn and gain some knowledge and understanding of research study designs and methodologies. Just like Sue MacDonald, who has previously mentioned Sleep et al’s (1984) research relating to perineal care, this had an influence and led me to take a particular interest in RCTs.

I would also work some night shifts when required and one night while on a postnatal ward, a young mother who had had a forceps birth the previous day was standing and leaning on the bed table for support with tears rolling down her face. She looked at me despairingly and I could see she was very distressed and in pain. She explained, as many new mothers often do, that the stitches were worse than having the baby. I had a flashback and could see myself as a young mother with a similar experience following a Keilland’s forceps birth.

This incident and also research undertaken by Kitzinger and Walters (1993) exploring women’s experiences of episiotomy instigated me to look specifically at perineal trauma and its consequences for women. With the support of my HoM Jean Cooper, senior midwifery manager Anne Geddes and obstetricians Dr Martin Griffiths-Jones and Professor James Walker, I went on to develop a maternity cooling pad (femépad) to alleviate perineal pain and undertake RCTs (Navviba et al, 2009; Steen and Marchant, 2007; Steen et al, 2000). 

Mary Steen is a professor of midwifery at the School of Nursing and Midwifery, University of South Australia. She is also the professional editor of Midwives