“I’m just a number, I’m not a person, I’m just a servant to the system”: introducing a new conceptual framework to understand bullying in NHS midwifery

Workplace bullying in NHS midwifery has persisted for decades, despite research and interventions designed to eliminate it. This thesis explores the persistence of the bullying, by reconceptualising the phenomenon and the traditional approaches taken to addressing it. I question the merit of utilising the dominant modes of understanding bullying whereby it is considered primarily interpersonal or is labelled as an outcome of workplace stress. In seeking to understand the impact of employment structures and embedded workplace practices, I advocate for the Depersonalised Bullying conceptual framework. This approach can unveil the hidden mechanisms that inform how the midwifery profession is positioned with regard to workplace bullying. These ideas formed the basis of the forty-seven semi-structured interviews conducted with NHS midwives. Reflexive Thematic Analysis was used to explore midwife subjectivities and the sense of being bullied within the particular paradigm of NHS midwifery. In these conversations, the expected topics of woman-centredness and wishing to avoid causing harm emerged strongly, while I discovered the strength of feeling the interviewees had for their midwife identity. By reconceptualising bullying as depersonalised, I am able to reveal the sense of insecurity and confusion experienced by midwives who work within the current framework of maternity services. Recommendations are for research which will lead to a better critical understanding of the midwifery profession within the context of the structures of employment.