Midwives'Â experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone

•Fear of Ebola affected the midwives' professional and personal lives.•Motivation and support were important to cope with challenging midwifery practice.•Competency, courage and creativity were used to improve clinical guidelines.•Sufficient training and equipment were essential for safe midwifery practice.•Midwives requested competence sharing and support by colleagues and peers.

Objectiveto explore and describe midwives' experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone.Designa qualitative interview study with an exploratory and descriptive approach.Settingindividual semi-structured interviews with midwives who provided care for pregnant woman in eight different Ebola centres in Sierra Leone during the Ebola outbreak in 2014-16.Participants11 midwives, Sierra Leoneans and expatriates, who worked for three different humanitarian organisations in Sierra Leone during the Ebola outbreak in 2014-2016.Findingsthree themes emerged as a result of the analysis. The first theme described how personal and public fears of Ebola infection affected the midwives' professional and personal lives. Secondly, motivation and support influenced the midwives' ability to cope with challenging midwifery care and finally competency, creativity and courage was described as essential for improving clinical guidelines and learn for the future.Key conclusions and implications for practicemidwives who worked in Ebola centres in Sierra Leone have a wide range of experiences in caring for pregnant women affected by Ebola. Their views should therefore be sought and considered when new guidelines are being developed on how best to provide care for pregnant women during an outbreak of Ebola virus disease, or any comparable infectious disease. Balanced information, sufficient training, adequate equipment and access to support by colleagues and peers would assist the midwives in coping with the challenges they face.