Abstract
Background
Some childbearing women/birthing people prioritize out of maternity care organizational
guidelines’ approaches to childbirth as a way of optimizing their chances of a normal
physiological birth. Currently, there is little known about the experiences of midwives
who support their choices.
Aim
To explore the experiences of UK midwives employed by the NHS, who self-defined as
supportive of women’s alternative physiological birthing choices.
Methods
A narrative inquiry was used to collect and analyse professional stories of practice
via self-written narratives and interviews. Forty-five midwives from across the UK
were recruited.
Findings
Three overarching storylines were developed with nine sub-themes. ‘Stories of distress’
highlights challenging experiences due to poor supportive working environments, ranging
from small persistent challenges to extreme situations. Conversely, ‘Stories of fulfilment’
offers a positive counter-narrative where midwives worked in supportive working environments
enabling woman-centred care unencumbered by organisational constraints. ‘Stories of
transition’ abridge these two polarized themes.
Conclusion
The midwives’ experiences were mediated by their socio-cultural working contexts.
Negative experiences were characterised by a misalignment between the midwives’ philosophy
and organisational cultures, with significant consequences for the midwives. Conversely,
examples of good organisational culture and practice reveal that it is possible for
organisations to fulfil their obligations for safe and positive maternity care for
both childbearing women who make alternative birthing choices, and for attending staff.
This highlights what is feasible and achievable within maternity organisations and
offers transferable insights for organisational support of out-of-guideline care that
can be adapted across the UK and beyond.
Keywords
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Article info
Publication history
Published online: November 30, 2021
Accepted:
November 21,
2021
Received in revised form:
November 20,
2021
Received:
October 19,
2021
Identification
Copyright
© 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
