What do we know about midwife-woman interactions during vaginal childbirth: a scoping review and thematic analysis.

BACKGROUND

Against the backdrop of changes in the medical model, a clearer awareness among women of their rights, and a deeper emphasis on the "woman-centred" approach, it has become increasingly important to focus on the current state and quality of intrapartum interactions. While midwife-woman interactions during vaginal childbirth are recognized as central to shaping maternal health outcomes and birthing experiences, existing studies offer fragmented insights, with a limited synthesis of how these dynamics influence intrapartum care and support, maternal autonomy in decision-making, and the midwife-woman relationship.

OBJECTIVES

To synthesize the existing literature addressing midwife-woman interactions during childbirth and to identify any research gaps.

METHODS

A scoping review was conducted using Arksey and O'Malley's methodology, with results reported following the PRISMA-ScR guidelines. A three-stage search strategy was conducted between December 2023 and August 2024, and 11 databases were searched. Eligible articles were charted and thematically analyzed.

RESULTS

A total of 6,560 articles were retrieved, of which 22 were included in the review. Three themes and six subthemes were identified: "Directive or instructive communication", "Multi-facet support needs and provisions (Emotional support: The indispensable but unseen labour; Information support: how much to share; Professional support: Balancing Care and Protocols; Shared Decision-making: Navigating Autonomy and Challenges)", and "Close or distant intrapartum relationship (Trust and respect: The hidden pillars of intrapartum care; The shocking reality of obstetric violence)".

CONCLUSIONS

The study of midwife-woman intrapartum interaction needs further in-depth exploration. Notable discrepancies exist in the descriptions of intrapartum interactions between midwives and women, which may result in a mismatch between the care provided by the midwife and the actual needs of the woman. As an innovative and valuable approach, it is recommended that micro-analysis methods, such as CA, be employed in future research to gain a deeper understanding of the nuanced dynamics present in midwife-woman interactions during labour and birth.

REGISTRATION

The research protocol was preregistered on the Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/R5WYQ ).