"In the shape that she needs me": The 'with woman' relationship in three different practice contexts

Abstract

Background: Being ‘with woman’ is central to midwifery philosophy, cited in statements by professional midwifery organisations around the world. Despite its asserted importance, very little research has been undertaken to describe or understand the phenomenon of being ‘with woman’.

Aim: The aim of this study was to explore Western Australian midwives’ experiences of being ‘with woman’ during labour and birth in a variety of contexts.

Method: Descriptive phenomenology was chosen as the methodology for this study as it useful for revealing constituents of the same phenomena as it is experienced by different individuals. A total of 31 midwives participated in in-depth interviews. Midwives worked in one of three different models where labour and birth care was provided by known midwives, unknown midwives; or unknown midwives and known obstetricians.

Findings: Midwives described experiences of being ‘with woman’ in the context of three models which were unique and distinct in each. Relationship with the woman was inherent to being ‘with woman’ but expressed and experienced differently in each model. Midwives in continuity models emphasised how their trusting relationship built over time enhanced being ‘with woman’ and sustained their passion for midwifery practice in this context. Building a connection, for midwives who were not known to the woman in a public hospital model required highly developed skills to build a rapid rapport with a woman they had not met before. A unique triad relationship between woman, obstetrician and midwife occurred in the private obstetric model which both enabled and challenged being ‘with woman’.

Implications: The innovative findings provide insight into how the phenomenon of being ‘with woman’ is experienced within the context of the different models. Insights gained are useful to facilitate the teaching and learning of ‘with woman’ and to appreciate the unique features and role of the woman-midwife relationships built in each setting.