title: The lived experiences of autonomous Angolan midwives working in midwifery-led, maternity units.
abstract: OBJECTIVE
  to describe the lived experiences of autonomous midwives working in Angolan midwifery-led maternity units.
  
  
  METHODS
  a qualitative approach using semi-structured, audiotaped interviews, in Portugese. Data were analysed in a six-step process.
  
  
  METHODS
  three midwifery-led maternity units in the most densely populated suburbs in the capital of Angola, Luanda. The average number of deliveries per unit was 2500 per year.
  
  
  METHODS
  11 midwives from the three maternity units.
  
  
  RESULTS
  four main areas emerged: society/culture, significant others, personal self and professional self. Sub-areas, concepts and supporting statements were defined in each area.
  
  
  CONCLUSIONS
  the midwives served within a population living in rough circumstances but which maintained strong traditional roots. The midwives did not support homebirths, but did assist when needed. The midwives described their professional role as a 'calling', which was very independent. Cure, was considered more important than care, and strong emotions were expressed when discussing cases of failure. The partograph was viewed as an important instrument and continuous learning as crucial in their role as autonomous midwives.
  
  
  CONCLUSIONS
  the model of a midwifery-led delivery unit described in this study may be used in other countries facing the same problems as Angola. Difficulties concerning transfer should be seriously considered as well as adequate education for the midwives. A pre-requisite in order for peripheral maternity units to have any impact on maternal morbidity and mortality, is a well-organised first-referral level.
authors.affiliation: Department of Health Sciences, Halmstad University, Halmstad, S 301 18, Sweden. Karen.Odberg.Pettersson@hos.hh.se
authors.forename: K O
authors.initials: KO
authors.lastname: Pettersson
authors.forename: M L
authors.initials: ML
authors.lastname: Svensson
authors.forename: K
authors.initials: K
authors.lastname: Christensson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000810:Angola; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003696:Delivery Rooms / Q000458:organization & administration; D005260:Female; D006700:Home Childbirth / Q000523:psychology; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D016294:Models, Nursing; D009721:Nurse Midwives / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D011203:Poverty / Q000523:psychology; D017009:Professional Autonomy; D011361:Professional Competence / Q000592:standards; D012649:Self Concept; D011795:Surveys and Questionnaires