Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting

•Midwives who start working in a midwifery unit could experience strong emotions.•Midwives may experience that their midwifery philosophy and practice are revitalised in a midwifery unit setting.•Midwives, particularly those working in FMUs, experience that the labouring process demands especially careful assessment.•Midwives in midwifery units may experience more autonomy (than they did in obstetric units).•Midwives practicing in midwifery units may describe their work as “the art of midwifery”.

ObjectiveIn some economically developed countries, women's choice of birth care and birth place is encouraged. The aim of this study was to explore and describe the experiences of midwives who started working in alongside/free-standing midwifery units (AMU/FMU) and their experiences with labour care in this setting.MethodsA qualitative explorative design using a phenomenographic approach was used. Semi-structured interviews were conducted with ten strategically sampled midwives working in midwifery units.ResultsThe analysis revealed the following five categories of experiences noted by the midwives: mixed emotions and de-learning obstetric unit habits, revitalising midwifery philosophy, alertness and preparedness, presence and patience, and coping with time.ConclusionsStarting to work in an AMU/FMU can be a distressing period for a midwife. First, it may require de-learning the medical approach to birth, and, second, it may entail a revitalisation (and re-learning) of birth care that promotes physiological birth. Midwifery, particularly in FMUs, requires an especially careful assessment of the labouring process, the ability to be foresighted, and capability in emergencies. The autonomy of midwives may be constrained also in AMUs/FMUs. However, working in these settings is also viewed as experiencing “the art of midwifery” and enables revitalisation of the midwifery philosophy.