Student midwives' exposure to physiological birth practices: A cross-sectional study of 3055 births during 2020-23 in...

Among a range of care episodes and proficiencies UK midwifery students must complete to qualify, they need to personally facilitate 40 births. Students' experiences of midwifery-led birth practices are dependent on their exposure within the clinical environment; however, such variation has not yet been explored.

The aim of this study was to analyse, describe and compare the characteristics of the 40 births personally facilitated by one cohort of 77 students within one English inner-city university.

Routinely collected data were extracted from 77 undergraduate student midwifery documents relating to births from 2020 to 2023. 3055 births were included. Data were analysed using descriptive and inferential statistics.

Most births occurred in Obstetric Unit (OU) settings (71 %). Most care was provided to birthing women/people who were multiparous at term gestation, who used at least one form of pharmacological analgesia. Most births were facilitated in either semi recumbent (45.6 %) or lithotomy birth positions (24 %) with the OU setting accounting for 91 % of these. Some birthing pool use for labour and/or birth were documented where the majority occurred in Alongside Midwifery Unit (AMU) settings. Comparisons between each student demonstrated wide variations of exposure to midwifery-led care practices.

Our findings highlighted that the students had extensive experience within OUs and with medicalised care practices but less consistent exposure to midwifery-led practices. Without exposure to midwifery-led birth practices across all settings, students qualify without the necessary experience to build their competency to optimise physiological birth processes, raising concerns for their preceptor period and beyond.