This study aimed to explore multilingual communication in maternity, when the midwife does not speak the same language as the childbearing person. A study motivated by my 19 years’ experience as an NHS midwife and having to balance my clinical practice while caring for non-English speakers. When working with Thai-speaking women, I used my native languages, Lao and Thai, to ensure clear communication. A practice highlighted as a gap between theory (NHS guidelines discourage untrained staff from interpreting) and reality (providing interpretation without proper training). Poor multilingual communication can lead to negative maternal and neonatal outcomes prompting a literature review and resulting in my three research questions; RQ1) What current practices are being implemented by midwives to meet multilingual communication needs of women in maternity? RQ2) How are midwives and women’s communicative goals affected during multilingual communication in terms of their relationship? RQ3) What conceptual understanding can be derived from midwifery multilingual communication and how might this inform practice and policy?

I was mindful of my positionality as an insider researcher, an Asian woman, and Lao-speaking professional. This insight significantly shaped my approach to the research questions and my choice of qualitative theoretical framework. Constructivist Grounded Theory (CGT) was the lens used to capture the voices of both service providers and users. The study participants were midwives (n = 29) from University Hospitals Sussex (UHSx) and childbearing women (n = 15) who experienced language-discordant midwifery care at UHSx during 2018-2021. Data was collected through semi-structured interviews, and I was engaged in data analysis and reflexivity throughout the study (evidenced in my regular memo writing). Participants were informed about my professional and research background, the purpose of the study, and the broader goal of understanding multilingual communication in perinatal care. An accredited interpreter was employed in 12 of the 15 interviews to provide unhindered and full expression in participant’s native language (Arabic, Bengali, Polish, and Turkish). The other three interviews (one Lao and two Thai participants) were conducted with myself speaking either in Lao or Thai.

The study findings showed UHSx midwives may adopt several multilingual communication practices (MCPs) or strategies to provide language support for service users along the perinatal journey. Key issues were discovered such as problems with interpersonal communication, namely in terms of trust, kindness and rapport building. Non-verbal communication (NVC) strategies were noted. Then, a mid-range theory called “Crucial MCP at crucial moments” was devised, and the potential implications on future practice recognised. Through my interdisciplinary research between Midwifery and Interpreting Studies (IS), three areas of recommendations were made (1) Practical implications for service providers managing multilingual communication according to the service user's language preferences, (2) Training implications for healthcare professionals and those interpreters involved in language support and (3) Organisational implications for the NHS, a systemwide review of NHS language support resources for maternity. Future interdisciplinary research avenues arose from this study, from fine grain interactional studies to a health economics study of language support for maternity.