title: Keeping birth normal: research findings on midwifery care during childbirth.
abstract: OBJECTIVE
  This study describes processes and outcomes of midwifery care through narratives told by exemplary midwives.
  
  
  METHODS
  Narrative analysis.
  
  
  METHODS
  Midwifery practices in hospital, birth center, and home settings.
  
  
  METHODS
  Purposive sample of 14 midwives drawn from a large national Delphi panel on exemplary midwifery practice.
  
  
  METHODS
  Systematic analysis of interview data was conducted until interpretive consensus was achieved across all text and codes. Results were compared with two prior qualitative studies conducted by the first author on midwifery practice for congruence and emergence of new findings.
  
  
  RESULTS
  The support of normalcy was identified as a significant process of midwifery care during labor and birth.
  
  
  CONCLUSIONS
  The midwives believed that birth is normal, and many of their actions were specifically aimed toward the support of it as a physiologic, rather than pathologic, process. Through their words, we see subtle care processes focused on meeting a woman's individual needs and tapping into her personal strength. Implications for practice and further research to link their approach to caring for women with perinatal outcomes are reviewed.
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
mesh_terms: D000328:Adult; D000739:Anecdotes as Topic; D003697:Delphi Technique; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D008880:Midwifery / Q000379:methods; D009035:Mothers / Q000193:education; D009321:Natural Childbirth / Q000451:nursing*; D009721:Nurse Midwives / Q000592:standards; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D011247:Pregnancy; D012107:Research Design; D011795:Surveys and Questionnaires; D014481:United States