Exploring the use of a maternity telephone helpline and the health seeking behaviour of callers’
: a case study

Student thesis: Doctoral ThesisDoctor of Healthcare


Background Telephone helplines have been implemented across the NHS in a drive to enhance service productivity and efficiency. They are a relatively new initiative in maternity care and to date few maternity units have introduced a dedicated helpline for women run by midwives alongside routine service provision. Currently there is a dearth of evidence regarding why women call helplines, whether advice and information offered as a consequence avoids the use of additional health resources or if helplines are viewed positively by healthcare providers. Aims and objectives This study aimed to explore the use and impact of a maternity telephone helpline service established in one large London maternity unit from the perspective of women who called the helpline and healthcare staff based in three clinical areas which traditionally received high call volumes. The study also aimed to explore and understand the health or advice seeking behaviour of women who called the helpline. Study objectives were to identify the reasons for calls, describe the content, impact and outcome of advice on self care offered by the midwife, explore why pregnant and postnatal women sought advice, and explore views of healthcare staff regarding the role of the helpline with respect to impact on their area of care provision. Research design and methodology Feminist epistemology influenced the study design framed within the health belief model. A case study design supported use of multiple methods of data collection in line with the epistemological and theoretical framework with three study phases. Phase one was a service evaluation that involved collating routine data using a prospective cohort of 422 women, 50 community midwives and four partners who called the helpline during a one month period.
Phase two comprised telephone interviews with a purposive sample of 34 women offeredadvice on self management of reported concerns and a purposive sample of women who called the helpline on more than one occasion. Face to face interviews were conducted during phase three with a purposive sample of 11 healthcare workers to explore their views of the helpline. Analyses included univariate approaches of quantitative data and thematic analyses of qualitative data. Key findings Women called the helpline for concerns ranging from individual pregnancy and non-pregnancy related health problems, to requests for information on aspects of routine maternity service provision. Reasons for calls supported constructs of the health belief model. The advice offered appeared to avoid the need for additional health contacts, reassured women and enhanced confidence and self efficacy. The need to revise information systems was highlighted by the extent to which the helpline supported the organisation, when routine systems were not adhered to by staff. The helpline was perceived by health professionals and clerical staff as potentially reducing unscheduled admissions and ’freeing’ up time to focus on other aspects of clinical care and work practices. Conclusion Findings contribute evidence on how a maternity helpline offers support and reassurance for women, building confidence, self-efficacy and potentially reducing need for additional health contacts. Healthcare staff viewed the helpline positively, with the need for services to ensure that strategies for communication and information provision are revised appropriately. Further larger studies are now required to consider outcomes of maternity helplines.
Date of Award1 Sept 2012
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorDebra Bick (Supervisor) & Joanne Fitzpatrick (Supervisor)

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