Exploring midwives views of midwifery in a hospital environment

A systematic review and metasynthesis

Midwives are required to be accountable for their practice, support normal birth and provide women centred care. However where childbirth is concentrated in large hospitals there are concerns about the number of birth interventions used in the routine care of labouring women and the impact this has on childbirth. The objective of this metasynthesis is to explore midwives’ perceptions of hospital midwifery with particular focus on labour ward practice. Twelve studies were selected for the metasynthesis. Three overarching themes were identifies; ‘power and control’, ‘compliance with cultural norms’ and ‘attempting to normalise birth ’. Midwives strive to provide woman centred care, but working in busy obstetric units means they are required to manage a heavy workload and provide equitable care to all women. This is achieved by complying with the norms for the individual maternity unit and accommodating women’s choice where this does not deviate too far from these norms. Some midwives engage in discursive or subversive practices, and occasional overt resistance to technocratic norms, in an attempt to provide ‘real midwifery’ for individual women.


PhD study and infrastructure

Further Information

Review complete: Paper subject to amendments for Health.