Background
The way women give birth is important. Childbirth is a significant life event and one of the most profound experiences in a woman’s life (1). Whilst most women desire to birth vaginally (2, 3), concerning data worldwide highlights reduced rates of normal physiological birth (NPB), with a corresponding rise in caesarean section and instrumental vaginal birth rates (4, 5). Previous research has focussed on clinical outcomes, highlighting practices linked to improving NPB rates (6-8). However, research exploring factors influencing the intentions of midwives to facilitate NPB is lacking. The focus of this research is aligned with midwifery philosophy to promote normal birth.
Objectives
To explore factors influencing intentions to facilitate normal physiological birth (NPB) from the perspective of midwives. Specifically, the study explored salient beliefs relating to NPB, knowledge and information influencing midwives’ decision making, social influences, as well as factors that are perceived to support or inhibit ability to facilitate NPB.
Methods
A qualitative approach utilising the Theory of Planned Behaviour to guide semi-structured interviews gathered perceptions, thoughts, knowledge and experience of NPB from participants.
Results
Factors shown to inhibit and support facilitation of NPB from the midwives’ perspective will be presented and explored, highlighting key influences such as midwifery education and information sharing, workplace culture and collegial factors, system structures and models of care, as well as global surveillance and micro-management.
Conclusions
Care provider practice can drastically impact birth experiences and outcomes for women. This study highlights key factors that influence midwives’ intentions to facilitate NPB. While some are supportive factors including attitudes and beliefs aligned with midwifery philosophy, many are inhibitive however are modifiable within the context of maternity care services and can be translated into clinical practice.
Key message
Understanding factors influencing midwives’ intentions to facilitate normal physiological birth can inform future improvements to health systems and practices.