Midwives ‘with woman’ in the private obstetric model: Where divergent philosophies meet

Abstract

© 2018 Australian College of Midwives Background: The phenomenon of being ‘with woman’ is central to the profession of midwifery. There is currently no available evidence that explicitly explores this phenomenon. In Western Australia, over a third of childbearing women choose to engage the services of a private obstetrician who provides antenatal care and manages the care provided by midwives during labour and birth. Aim: The aim of this study was to explore midwives’ experiences of being ‘with woman’ during labour and birth in the private obstetric model. Methods: Using a descriptive phenomenological approach, 11 midwives working in the private obstetric model in Western Australia were interviewed. Data analysis was conducted using Giorgi's framework. Findings: Two main themes emerged (1) triad of relationships and (2) the intersection between being ‘with woman’ and the private obstetric model; seven subthemes are reported. Discussion: Being ‘with woman’ is an important element of midwifery practice and fundamental to midwifery theory and philosophy. Relationships between the woman, midwife and obstetrician are key to implementing ‘with woman’ practices in the private obstetric model. The interrelatedness of midwifery philosophy and practice is revealed through shared common challenges and enablers to being ‘with woman’ from the perspective of midwives. Conclusion: Findings offer insight into midwives’ experiences of being ‘with woman’ within the context of the private obstetric model. New understandings are revealed of a phenomenon central to midwifery professional philosophy that is embedded within midwifery practices which has implications for service mangers, professional leaders and educators.