The 5 components of an effective relationship

It’s clear that effective relationships are a foundation for maternity care – not just because we want everyone to feel good, but so that the women and babies who are at the centre of care receive the best health outcomes.

Thinking back to the Fable of Porcupines, we acknowledge that sometimes we need to make compromises – but there are some key components that need to be present to make relationships work effectively.

Sharing the balance of power

Relationships need to be equitable, rather than conditional or hierarchical. If one person or group holds the balance of power, it undermines the ability for others in the relationship to be heard, trusted and respected – or even to have a voice at all. Relationships cannot be truly effective where there is an inequality: where somebody holds and exerts the balance of power. This is particularly important when we think about planning maternity care.

There is a real risk that where an imbalance of power exists, people will not be heard or respected; their contribution will be devalued and their requests and choices ignored. Ultimately people will disengage as they lose trust in the person holding the power. Unfortunately, we see this imbalance in power played out in many aspects of life and it often has far-reaching consequences, some of which determine the conditions under which people live their lives.

Core components of strong relationships

The goal in maternity care is to promote optimal outcomes for mothers and babies. Creating effective relationships based on trust and shared power, where all players are heard and respected, is a key strategy needed to achieve that goal.

But in order for relationships to work effectively at every level of care, from midwife-to-woman, to collegial relationships that promote and enable collaborative care, there are certain baseline components that need to be in place. These are:

• appropriate, skilled communication
• mutual respect
• trust
• acceptance
• shared values and goals.

Have a look at the graphic for more detail on what each component involves.

© Griffith University

These five components need to be evident and present within every relationship in maternity care.

Additional components for interprofessional relationships

Collaborative relationships between health professionals require additional specific components to establish the trust required to work together as a team:

• Competence: understanding and accepting that each person in the relationship offers skills and experience in areas in which they excel.
  • We saw in Week 1 that this is a core component of the Lancet Series framework for optimal maternal and newborn care.
• Reliability: the confidence that everyone involved will do what they are meant to do.
• Integrity: being responsible and acting according to stated values or ethics.

These additional components of collegial relationships also rest on that same foundation of shared power balance – the understanding, acknowledgement and appreciation that everyone brings expertise to the table, and no one holds or exerts power over another.

It’s important to overtly acknowledge the power dynamics that may play out in the various relationships inherent in maternity care.

Relationships matter

It’s clear that relationships matter – in life, and in maternity care specifically. No matter who is involved or what they bring to the table, the core components of strong relationships must be in place.