title: The landscape of caring for women: a narrative study of midwifery practice.
abstract: Our purpose was to expand knowledge on the process and outcomes of midwifery care. Narrative analysis was used to interpret stories provided by midwives to illustrate their practice and recipients of midwifery care about their experience. A purposive sample of 14 midwives and four recipients of midwifery care was recruited as a subsample from a prior Delphi study on midwifery practice. Three broad themes were identified: 1) the midwife in relationship with the woman, 2) orchestration of an environment of care, and 3) the outcomes of care, called "life journeys" for the woman and the midwife. The findings are discussed from the perspectives of therapeutic landscapes described in cultural geography and prior research on midwifery practice. The challenge is to confirm the associations between the processes of care identified in these narratives with both short- and long-term outcomes in the health of women and their families. These appear to go well beyond the usual perinatal measures currently used in health care research and hold implications for how care is delivered, measured, and evaluated.
authors.affiliation: Department of Family Health Care Nursing, University of California, San Francisco 94143, USA. holly.kennedy@nursing.ucsf.edu
authors.forename: Holly Powell
authors.initials: HP
authors.lastname: Kennedy
authors.forename: Maureen T
authors.initials: MT
authors.lastname: Shannon
authors.forename: Usa
authors.initials: U
authors.lastname: Chuahorm
authors.forename: M Kathryn
authors.initials: MK
authors.lastname: Kravetz
mesh_terms: D000739:Anecdotes as Topic; D005260:Female; D006302:Health Services Research; D006801:Humans; D008880:Midwifery / Q000458:organization & administration / Q000592:standards*; D009721:Nurse Midwives / Q000523:psychology / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011787:Quality of Health Care; D014481:United States