Is a midwife's continuous presence during childbirth a matter of course? Midwives' experiences and thoughts about factors that may influence their continuous support of women during labour.
OBJECTIVE
to gain an understanding about midwives' experiences of providing a continuous supportive presence in the delivery room during childbirth, and to learn about factors that may affect this continuous support.


DESIGN/SETTING
qualitative study at a maternity unit in Norway, where about 4000 births take place each year. In-depth interviews were conducted with ten midwives working in two different maternity wards. The qualitative data were analysed using systematic text condensation.


FINDINGS
the analysis generated three main themes: relational competence, the midwife's ideology, the culture and philosophy of the maternity unit. The midwives identified being mentally present and actively developing mutual trust with the woman in labour as two very important factors for building a relationship with her. They suggested that the midwife's first encounter with the woman is a key opportunity for establishing rapport during labour. Successfully providing a continuous presence during labour fostered the midwives' perception of themselves as a 'good midwife'; this was considered a feature of holistic care and health promotion. The workload in the unit sometimes made it difficult for them to provide a continuous presence in the delivery room. The midwives experienced feelings of inadequacy when they felt that they had too little time available for the woman in labour.


KEY CONCLUSIONS
midwives' skill in building a relationship with the woman in labour combined with their values and understanding of the midwifery profession are important factors influencing their decision to provide a continuous presence during childbirth. If it is policy that maternity units should provide continuous support to women in labour, managers should ensure that it is actually provided.
['Aune|Ingvild|I|', 'Amundsen|Hanne Hvaal|HH|', 'Skaget Aas|Lene Christina|LC|']
D000328:Adult D003266:Continuity of Patient Care D036861:Delivery, Obstetric D005260:Female D006801:Humans D007407:Interviews as Topic D008875:Middle Aged D008880:Midwifery D009664:Norway D057184:Practice Patterns, Nurses' D011247:Pregnancy
Continuous presence Health promotion Continuity of care Midwifery ideology