Mary Carolan-Olah
Victoria University, Melbourne
Mary Carolan-Olah is a midwife with more than 30 year’s experience. She is also an established researcher in Midwifery and Women’s Health, with a strong history of leading interdisciplinary and individual research projects. Mary’s key research foci are in the region of gestational diabetes, ethnicity and ‘at risk’ pregnancy. Mary is well published nationally and internationally with 70 publications to date and 30 international conference presentations
Background Normal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean... [ view full abstract ]
Background
Normal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean section births for unclear reasons. Midwives are interested in ameliorating this trend and aim to facilitate women to have meaningful birth experiences and to achieve the best possible birth. The purpose of this project was to explore midwives’ experiences and views of the factors that facilitate or impede normal birth.
Method
A qualitative study using an Interpretative Phenomenological approach, was undertaken in a maternity setting in Melbourne, Australia. 22 midwives, all with recent birthing experience, participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Analysis was guided by Smith and Osborn’s (2008) approach.
Results
Midwives identified a number of factors that complicated their task of facilitating normal birth. Barriers included: (1) time pressures; (2) a risk adverse culture, and; (3) women’s expectations. Factors facilitating normal birth included: (1) a supporting environment, and (2) midwifery attributes, such as confidence, experience and desire to promote normal birth.
Discussion
In Australia, most births take place in obstetric models of care, in which the majority of midwives are employed. The birth environment, in these units, is often risk-adverse with high rates of intervention and caesarean section. Midwives, wishing to promote normal birth in obstetric led units, face a number of challenges and often feel unsupported by senior colleagues.
Conclusion
The current situation causes conflict and gives rise to stress and unmet support needs for midwives. Such issues need to be addressed, in order to facilitate higher rates of normal birth.
Studies of and contributions to practice and/or service organisation
