Midwives and women in partnership: the ideal and the real

This qualitative study sought to identify the strategies used by hospital based midwives in assisting women to manage pain in labour, as well as the support they offer in all aspects of the birth process. Data were collected via participant observation of five birthing mothers and their midwives, and pre and post birth interviews. Analysis was by means of the software package QSR NUD.IST (Non numerical, Unstructured, Data, Indexing, Search and Theorizing) Version 3. Analysis of observation of labour and pre and post birth interviews revealed that all women wanted a birth with minimal intervention, however safety was an overriding consideration. During labour women relied on the midwife to oversee and direct care, and trust in care by a midwife was established as a result of prior experience, or during antenatal care. Factors inhibiting full partnership between women and midwives, and also the use of alternative pain strategies, included staffing levels, lack of emphasis on evidence based care and environmental constraints such as the room set up.