Women's perceptions of a midwife's role: An initial investigation: An initial investigation

The role of the midwife has evolved over the years, influenced by a number of social, political and educational factors (Department of Health and Social Security (DHSS ), 1970; Her Majesty's Stationery Office (HMSO), 1984; Tew, 1986; Donnison, 1988, Department of Health (DH), 1993; Kitzinger, 2005; DH, 2007; National Institute for Health and Clinical Excellence (NICE ), 2008). However, little is known about how the contemporary role of the midwife is perceived (Lavender and Chapple, 2002). Some changes were not based on any evidence or health economics (DHSS , 1970; HMSO, 1984). Health costs have predominantly been based on the cost of service provision, rather than costs of unnecessary intervention being considered. The Birthplace study did take into account health economics including intervention costs (Shroeder et al, 2012); therefore, if service changes are made to reflect the benefit of health economics with the new maternity pathway payments (DH, 2012), this may impact on how the role of the midwife is perceived in the future. This qualitative study was conducted to gain understanding of women's perceptions of the role of the midwife. Four focus groups were conducted (n=9) to identify perceptions of the midwife's role from women experiencing care from different care providers; women in different periods of their childbearing experience; women who had previous experience of childbearing; and those who had no previous experience of childbearing. Thematic analysis of the transcripts identified four themes: empowerment influence of midwives; influences of media, friends and family; role of monitoring and technology; and influence of doctors. The conclusion was that the model of care and care provider influenced women's perceptions of the role of the midwife. Women experiencing a consultant-led model of care viewed the role differently to those experiencing amidwifery-led model.