• Expert nurse;
  • Intuitive nursing care;
  • Labor and birth outcomes;
  • Nurse-managed labor;
  • Nursing autonomy;
  • Patient advocacy

Objective: To examine how expert perinatal nurses in a nurse-managed labor model view their role in caring for mothers during labor and birth.

Design: Focus group methodology. Data were analyzed using inductive coding methods to gain understanding from the perspective of those providing the care.

Setting: Labor and birth units in four large Midwestern medical centers.

Participants: Fifty-four expert labor nurses. Inclusion criteria: 5 years experience in nursing care during labor and birth in institutions where nurse-managed labor was the predominant practice model.

Results: Four common themes related to nursing roles were identified. These included knowing the labor process and the intuitive nature of nursing care provided by expert labor nurses based on years of experience, knowing the woman and letting her body guide labor, advocacy for laboring woman, and the autonomous nature of the nurse-managed labor model.

Conclusions: Expert labor nurses developed a keen sense of intuitive knowledge based on their years of experience. They reported using hands-on high-touch supportive care techniques with the potential to affect labor and birth outcomes. Autonomy is perceived as a key component of practice within the nurse-managed labor model.