Mary Carolan-Olah1, Gina Kruger2, Annette Garvey-Graham3. 1. School of Nursing and Midwifery, St Alban׳s Campus, Victoria University, PO Box 14228, Melbourne 8001, Australia. Electronic address: Mary.carolan@vu.edu.au. 2. School of Nursing and Midwifery, St Alban׳s Campus, Victoria University, PO Box 14228, Melbourne 8001, Australia. Electronic address: gina.kruger@vu.edu.au. 3. Sunshine Hospital, Western Health, Women׳s & Children׳s Division, 176 Furlong Rd, St Albans, VIC 3021, Australia. Electronic address: annette.garveygraham@wh.org.au.
Abstract
BACKGROUND: normal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean section births for unclear reasons. Midwives are interested in ameliorating this trend and aim to facilitate women to have meaningful birth experiences and to achieve the best possible birth. OBJECTIVES: this project aimed to explore midwives' experiences and views of the factors that facilitate or impede normal birth. SETTING: one maternity setting in Melbourne, Australia. PARTICIPANTS: a purposive sample of 22 midwives, all with recent birthing experience, participated in in-depth interviews. METHODS: a qualitative study using an Interpretative Phenomenological approach. Interviews were audio-recorded and transcribed verbatim. Analysis was guided by Smith and Osborn's (2008) approach. FINDINGS: midwives identified a number of factors that complicated their task of facilitating normal birth. Barriers included: (1) time pressures; (2) a risk adverse culture, and; (3) women's expectations. Factors facilitating normal birth included: (1) a supporting environment, and (2) midwifery attributes and a desire to promote normal birth. KEY CONCLUSIONS: in Australia, most births take place in obstetric models of care, in which the majority of midwives are employed. The birth environment, in these units, is often risk-adverse with high rates of intervention and caesarean section. Midwives, wishing to promote normal birth in obstetric led units, face a number of challenges and often feel unsupported by senior colleagues. This situation causes conflict and gives rise to stress and unmet support needs.
BACKGROUND: normal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean section births for unclear reasons. Midwives are interested in ameliorating this trend and aim to facilitate women to have meaningful birth experiences and to achieve the best possible birth. OBJECTIVES: this project aimed to explore midwives' experiences and views of the factors that facilitate or impede normal birth. SETTING: one maternity setting in Melbourne, Australia. PARTICIPANTS: a purposive sample of 22 midwives, all with recent birthing experience, participated in in-depth interviews. METHODS: a qualitative study using an Interpretative Phenomenological approach. Interviews were audio-recorded and transcribed verbatim. Analysis was guided by Smith and Osborn's (2008) approach. FINDINGS: midwives identified a number of factors that complicated their task of facilitating normal birth. Barriers included: (1) time pressures; (2) a risk adverse culture, and; (3) women's expectations. Factors facilitating normal birth included: (1) a supporting environment, and (2) midwifery attributes and a desire to promote normal birth. KEY CONCLUSIONS: in Australia, most births take place in obstetric models of care, in which the majority of midwives are employed. The birth environment, in these units, is often risk-adverse with high rates of intervention and caesarean section. Midwives, wishing to promote normal birth in obstetric led units, face a number of challenges and often feel unsupported by senior colleagues. This situation causes conflict and gives rise to stress and unmet support needs.
Authors: Anna E Seijmonsbergen-Schermers; Thomas van den Akker; Eva Rydahl; Katrien Beeckman; Annick Bogaerts; Lorena Binfa; Lucy Frith; Mechthild M Gross; Björn Misselwitz; Berglind Hálfdánsdóttir; Deirdre Daly; Paul Corcoran; Jean Calleja-Agius; Neville Calleja; Miriam Gatt; Anne Britt Vika Nilsen; Eugene Declercq; Mika Gissler; Anna Heino; Helena Lindgren; Ank de Jonge Journal: PLoS Med Date: 2020-05-22 Impact factor: 11.069