Objective: to explore the nature of intrapartum midwifery expertise using a phenomenological approach, in order to illuminate the essential characteristics and skills that facilitate optimal birth outcomes for women.
Methods: included group and individual interviews, underpinned by an interpretive hermeneutic phenomenological perspective.
Results: Findings of this study suggest that there are three domains of expert midwifery practice; ‘physiological expertise’, ‘technical expertise’ and ‘integrated expertise’. Integrated expertise appears to be the strongest of the three, being characterised by the expert’s ability to work across boundaries of normality and through differing models of care in order to promote optimal birth outcomes for women.
Conclusions: The findings appear to resonate with those of the wider literature surrounding nursing and medical expertise in high-resource settings, and with both phenomenological and cognitive psychological interpretations of expertise. In lower resource contexts different skills or types of expertise may be more significant in averting maternal and neonatal morbidity and mortality rates . Further cross-cultural research would be required to explore this.
L Simpson, K Trafford.
Infrastructure/East Lancashire Hospitals NHS Trust research funds.
Paper submitted to Journal of Midwifery and Womens Health.