Resources and challenges for midwives supporting women in the latent phase of labor: A qualitative study from Germany

The latent phase of labor is a critical stage of childbirth, yet access to continuous, needs-based care during this phase remains limited in Germany. Structural challenges in the healthcare system, including a reduced number of obstetric facilities and insufficient financial support for outpatient services, further restrict options for women and midwives.

This study aimed to explore the resources available to midwives and the barriers they encounter when providing care and counseling during the latent phase of labor. A qualitative research design was employed. Thirteen semi-structured interviews with midwives were conducted between June 2024 and March 2025. Data were analyzed using qualitative content analysis.

Four main categories emerged: 1) the physiology of the latent phase, 2) decision-making criteria for the location of care, 3) structural conditions in the hospital, and 4) aspects of care improvement. Midwives reported a lack of outpatient options, uncertainties in defining the latent phase, and tensions between guideline recommendations and women's subjective needs. Structural barriers, such as staff shortages, limited space, and financial disincentives, were highlighted. At the same time, midwives expressed an openness to innovative concepts, including midwife-led outpatient care, designated rooms within clinics, and improved prenatal education.

Midwives in Germany perceive current support for childbearing women during the latent phase as insufficient. To ensure needs-based care, structural and financial reforms are required, alongside expanded counseling and educational opportunities. Strengthening midwife-led concepts, improving antenatal education, and adapting reimbursement structures, could reduce unnecessary interventions and enhance woman-centered care.