Birth centres in the East Midlands: views and experiences of midwives

Abstract

In order to investigate midwives' views and experiences of working at birth centres a qualitative interview study was performed at three birth centres in the UK. Nine midwives were recruited for personal interviews via snowball sampling. Qualitative content analysis was undertaken with the identification of categories and themes. Autonomy of practice emerged as the main category with five subcategories: midwifery aspects, professional development, flexibility and work demand, independence and interprofessional relationships. The main outcome of this study was the autonomy the midwives felt by practising and promoting normal midwifery care. Many midwives also expressed a feeling of increased confidence and professional development by working in a birth centre. Experiences of flexibility and work–life balance were generally positive. Continuity of care was much appreciated. Negative aspects were mainly associated with high work pressure, staff shortages and at times a demanding work environment. The different localizations of the birth centres had both advantages and disadvantages.

Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting

“…This result has also been described by others (18) and can be understood based on the different contexts of AMU/FMU and obstetric units; the latter is the main work setting for most midwives in Norway. Obstetric-led units are heavily medically influenced by both doctors and midwives (10).…”

“…These settings require midwives to be trained in the skills of normal birth (12)(13)(14). Care in midwifery units is associated with promoting the midwife-mother relationship, facilitating a sense of higher satisfaction and autonomy for both mothers and midwives (13,(15)(16)(17)(18)(19). An American study noted that midwives' experiences of the birth centre atmosphere are described as relaxing, quiet, and less restricted with respect to time and guidelines (20).…”

An integrative literature review on midwives' perceptions on the facilitators and barriers of physiological birth

“…Although Thorgen and Crang-Svalenius' (2009) study had a relatively smaller sample size, there was heterogeneity, and the findings were congruent with other studies. All participants in the studies had several years of clinical experience and were females, except for 1 study that also interviewed a male midwife (Carolan-Olah et al, 2015).…”

“…Marquis and Huston () explained that the more involved an individual is with his/her work, the higher their job satisfaction. Thorgen and Crang‐Svalenius () examined midwives' views and experiences of working in birth centres and found that despite the demanding workload, the midwives experienced a sense of accomplishment and fulfilment when they were able to exercise autonomy and utilize their midwifery skills. Similarly, midwives strongly felt that they play pivotal roles in determining a fulfilling birth experience for their patients.…”

“…Occasionally, the woman's inability to cope with the situation can challenge this process, which can be emotionally draining for the midwife/ nurse (Aune et al, 2014). Using interviews, such negative aspects also emerged from midwives working in free-standing birth centres (Thorgen & Crang-Svalenius, 2009) and obstetric-led environments (Carolan-Olah et al, 2015;Earl & Hunter, 2006), proposing that supporting physiological birth is time-consuming and emotionally draining, regardless of the level of autonomy possessed by the midwives/nurses.…”