Avoiding disturbance: Midwifery practice in home birth settings in Norway

Objectiveto explore midwifery practice in home birth settings in Norway, especially practice assumed by the midwives to promote normal labour and birth.Designin-depth interviews transcribed verbatim and analysed using a grounded theory method.Settinghome birth settings in Norway.Participants12 midwives who regularly attended home births and who had assisted a minimum of 30 home births between 1990 and 2007.Findingsthe core category ‘avoiding disturbance’ was identified during the analyses, indicating that the midwives prevented the woman from being disturbed and protected her from disturbance if it occurred during labour. The core category must be understood in the light of the midwives’ attitudes towards and beliefs about labour and birth. The labour process could be disturbed by the midwife, the birthing woman, the partner and other supporting persons, and older children. The midwives regarded labour as work to be done by the woman, as a sexual process, and had a basic understanding that labour and birth usually had good outcomes.Key conclusionsfactors regarded as beneficial for the woman and her labour, like a partner, friends and helpers supporting the woman and doing important and necessary work, and a midwife observing the woman, fetus and course of labour, could also be perceived as sources of disturbance.Implications for practicethe effect of a calm, undisturbed environment on the labour course should be explored further.