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Midwives’ care on a labour ward prior to the introduction of a midwifery model of care: a field of tension

Journal article
Authors Christina Nilsson
Olof Asta Olafsdottir
Ingela Lundgren
Marie Berg
Liselott (Lisen) Dellenborg
Published in International Journal of Qualitative Studies on Health and Well-being
Volume 14
Issue 1
ISSN 1748-2623
Publication year 2019
Published at Institute of Health and Care Sciences
Language en
Keywords Midwifery; women; models of care; experiences; childbirth; ethnography; culture; woman-centred; work place
Subject categories Reproductive health, Nursing, Other Medical Sciences


Purpose: There is a need to deepen knowledge about midwives’ care in obstetric-led labour wards in which midwives are responsible for normal births. This ethnographic study explores the content and meaning of midwives’ care of women in a hospital-based labour ward in Sweden prior to the introduction of a theoretical midwifery model of care. Methods: Data were gathered through participant observation, analysed through interpretation grounded in reflexivity discussions and are presented in the form of ethnographic descriptions. Results: The midwives’ care was provided in a field of tension in which they had to balance contrasting models of care, described in the themes: The birthing rooms and the office—Different rooms of care, Women giving birth or being delivered—Midwives’ expectations and relationships with women, Old and new caring roles of the midwife—Women giving birth in a “new age”, Being and doing—Different approaches to caring, and Holistic and reductionist care— Guided by contrasting models and guidelines. The midwives’ freedom to act as autonomous professionals was hindered by medical and institutional models of care and this led to uncertainty regarding their roles as midwives. Conclusions: Midwives having to balance their activities in a field of tension require midwifery models that can guide their practice.

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