“Bringing forth” skills and knowledge of newly qualified midwives in free-standing birth centres: A hermeneutic phenomenological study

Abstract

Aim: to understand and interpret the lived experience of newly qualified midwives as they acquire skills to work in free-standing birth centres, as well as the lived experience of
experienced midwives in free-standing birth centres in Germany who work with newly qualified midwives.
Background: In many high-, middle-, and low-income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home, and free-standing birth centres. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out-of-hospital settings.
Methods: This study was underpinned by hermeneutic phenomenology. Fifteen newly qualified midwives in their orientation period in a free-standing birth centre were interviewed
three times in their first year. In addition to this, focus groups were conducted in 13 freestanding birth centres. Data were collected between 2021-2023.
Findings: Using Heidegger’s theory of technology as the philosophical underpinning, the results illustrate that the newly qualified midwives were facilitated to bring forth competencies to interpret women’s unique variations of physiological labour, comprehending when they could enact intervention-free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary.
Conclusion: Newly qualified midwives learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery
approaches to care.
Implications: This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice
practitioners in FSBCs.
Impact: The findings of this study will have an impact on training and orientation for nurse midwives and direct-entry midwives when they begin to practice in out-of-hospital settings after training and working in hospital labour wards.
Patient or Public Contribution: This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out-of-Hospital Birth, and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organisation. In addition, at each meeting, three midwives from various freestanding birth centres were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment.