The role of the midwife in facilitating continuous support during childbirth: a qualitative study

Abstract

Background: Continuous support during childbirth is an example where best practices are known but not consistently implemented. The midwife is the ideal person to provide continuous support, but if impossible, the midwife should facilitate continuous support. This study investigated the role of the midwife, in facilitating continuous support during childbirth, as part of a larger project aiming to promote continuous support during childbirth. Objective: The objective of this study was to explore and describe the role of the midwife, providing antenatal and intrapartum care, in facilitating continuous support during childbirth according to the perspectives of midwives working in a selected public hospital and Community Health Centre (CHC) in the North West Province of South Africa. Design: The study followed an explorative, descriptive and contextual design using a qualitative descriptive research approach to reach the objective of the study. Method: An all-inclusive sample of the midwives working in one selected public hospital and one CHC in North West Province was used. Face-to-face semi-structured interviews were conducted with 14 midwives, seven from the selected hospital and seven from the selected CHC. Data were analysed qualitatively and presented in a thematic chart. Findings: Two main categories were identified, each with a number of themes and sub-themes. Facilitating continuous support during childbirth was the first category. The midwife's role in facilitating continuous support during childbirth while providing antenatal and intrapartum care were the underlying themes. The second category identified roles in facilitating continuous during childbirth with facilitating and impeding/hindering factors related to continuous support during childbirth as themes. Conclusion: Two main categories with a total of four themes and 20 sub-themes were identified, illustrating the complexity of the issue. A unique finding was the recommendation by participants of mobile phone communication via 'mom-connect' as a way of facilitating continuous support during childbirth. The participants were not familiar with the use of doulas. Recommendations were made for research, education, practice and policy based on the role of the midwife in facilitating continuous support during childbirth.