Student midwives’ views on maternity care just before their graduation

van kelst l., spitz b., sermeus w. & thomson a.m. (2013) Student midwives’ views on maternity care just before their graduation. Journal of Advanced Nursing69(3), 600–609. doi: 10.1111/j.1365-2648.2012.06042.x

Abstract

Aim.  To report a hermeneutic study of student midwives’ views on maternity care just before their graduation.

Background.  Woman-centred care, which is the hallmark of midwifery, is taught to midwifery students around the globe. Woman-centred care is advantageous for women at low obstetric risk. However, adopting this ideology might be a problem for student midwives whose clinical placements are mainly in a medicalized obstetric-led hospital setting.

Design.  A hermeneutic phenomenological study was conducted.

Methods.  In 2010, three focus groups were held where 19 student midwives participated. Data were transcribed verbatim and analysed using van Manen’s approach.

Findings.  The choice for midwifery was a ‘positive’ choice and not the result of an elimination process. Students’ description of a midwife as a coach was in line with the international definition of a midwife. With regard to maternity care, midwifery students identified two types of care, factory-style care and tailored care, both of which were ascribed to caregivers and hospital culture. Furthermore, student midwives made the distinction between hierarchy and teamwork, referring to the professional relations in maternity care. Hierarchy was driven by tradition, it implied that decisions were made top-down, and it resulted in impersonal relations. Midwifery students felt it was unjust that midwives were not allowed to perform deliveries while having the legal autonomy to do so.

Conclusion.  In spite of the medicalized context, midwifery education succeeded in educating midwives who hold a woman-centred ideology. Midwifery students linked style of care to a person rather than to a profession.