The relationship is everything: Women׳s reasons for choosing a privately practising midwife in Western Australia

•Women choosing private midwifery value working in partnership with their midwife.•Women choose a private midwife having researched all other options.•Women reject mainstream maternity care due to its restrictive, impersonal and risk-focused nature.

Objectivethe purpose of this study was to describe women׳s reasons for choosing to birth with a privately practising midwife.Designa modified grounded theory methodology was used.Participants and settingthe sample comprised 14 Western Australian women who had received maternity care from a privately practising midwife within the previous five years.Findingsdata analysis revealed three categories: the first was conceptualised as ‘I knew what I wanted from my caregiver’, which included sub-categories of: I wanted continuity of care; I wanted a relationship with my care provider; and I wanted a care provider with the same childbirth philosophy as me. The second encapsulated ‘I knew what I wanted from my pregnancy and birth experience,’ with two sub-categories, I wanted a natural, active, intervention free pregnancy and birth and I wanted my partner and family to be included. The final category was labelled ‘I was willing to get the research to get what I wanted’ and incorporated two sub-categories, I researched my care options and I researched my care provider options and the evidence around pregnancy and birth to be actively involved.Key conclusionsfindings offer insight around women׳s reasons for choosing this model of midwifery care and highlight that women know exactly what they want from their caregiver. Women valued working with their midwife towards a shared goal of an intervention-free, normal birth, researched their options and found mainstream services restrictive and focused on medical risk status rather than on the individual woman.Implications for practicefindings will be of interest to maternity care practitioners and policy makers, as they highlight why some women prefer a social model of midwifery care that reflects a family centred, individualised and holistic approach. This insight can inform the development of maternity health care practices to recognise and accommodate the needs and values of all childbearing women.