Tailoring midwifery care to women's needs in early labour: The cultivation of relational care in free-standing birth centres

• Published in: Midwifery 2025-01, Vol.140, p.104202, Article 104202
• Main Authors: Stone, Nancy I., Thomson, Gill, Tegethoff, Dorothea
• Format: Article
• Language: English
• Subjects: Adult; Birthing Centers - standards; Childbirth; Female; Free-standing birth centers; Hermeneutic phenomenology; Hermeneutics; Humans; Interviews as Topic - methods; Labor, Obstetric - psychology; Midwifery; Midwifery - methods; Nurse Midwives - psychology; Nurse-Patient Relations; Pregnancy; Qualitative Research; Relational care
• ISSN: 0266-6138; 1532-3099; 1532-3099
• DOI: 10.1016/j.midw.2024.104202

To understand and interpret the lived experience of newly qualified midwives in their first year in a free standing birth centre caring for women in early labour. Women who present in hospital labour wards in early labour are encouraged by hospital staff to go home. This leaves women to navigate early labour without professional care, leaving them on their own to manage the transition from early to active labour. However, some women request care for this transition. This is a Heideggerian hermeneutic phenomenology study. Three unstructured interviews were conducted with 15 newly qualified midwives in their first year working in a free-standing birth centre. This paper focuses on the research participants’ lived experience offering care to women in early labour. The study was conducted from 2021-2024. Three themes were revealed in analysis: “Paving the way into labour”: Tailoring care to women's needs in early labour; “Perhaps it was intuition.”: Experiencing deeper knowing as a newly qualified midwife; and “She locked the door and wouldn't let me in.”: Navigating uncomfortable situations in early labour. The lived experience of newly qualified midwives offering care in early labour shows potential for midwives to build trusting relationships with women in this phase. Prioritizing relational care over interventions in early labor can enhance trust and confidence between midwives and birthing women, particularly in settings where policies discourage early admissions. Women presenting in hospital labour wards in early labour who are sent home are often discouraged, feeling that their concerns and embodied experiences have not been heard. When labouring women are admitted to hospitals in early labour, they are prone to receive a cascade of interventions. When newly qualified midwives began working in free-standing birth centres, they acquired skills and knowledge to accompany women in early labour who requested care. Relational care in early labour builds women's trust in their ability to give birth and does not rely on interventions to augment labour.