Confidence: Fundamental to midwives providing labour care in freestanding midwifery-led units

Abstract

The aim of this study was to reveal what enables, safeguards and sustains midwives to provide labour care in freestanding midwifery-led units. DesignA hermeneutic phenomenological study was undertaken in the Auckland region of New Zealand. In-depth interviews were conducted with 14 participants: 11 midwives who provide care in freestanding midwifery-led units and three obstetricians who provide antenatal consultations on site in midwifery-led units. Main findingsConfidence is necessary to provide intrapartum care in freestanding midwifery units. This confidence is cultivated by working in the community or freestanding unit and believing this unit is an appropriate space for healthy women to labour and birth. Normal labour and birth are commonplace in this space which in turn reinforces midwives’ confidence. Maintaining confidence for midwives to work in these units requires trusting relationships in the midwifery team. Further, there needs to be mutually respectful relationships with obstetric colleagues. Midwives who have lesser experience, or experience in obstetric unit only, may need support to step into the role of providing labour care in freestanding midwifery units. When the midwife feels supported, when s/he witnesses women and families experiencing their normal birth, one's resolve to practising in this manner is strengthened. The midwife holds confidence. Key conclusions and implications for practiceConfidence required to provide labour care in a midwifery-led unit is cultivated through immersion in these units.