title: An exploration of midwives' views of the current system of maternity care in England.
abstract: OBJECTIVE
  to explore, in-depth, the views of midwives working in maternity services about birth setting, models of care and philosophy of care.
  
  
  METHODS
  an Appreciative Inquiry approach was adopted utilising focus group interviews as the method of data collection.
  
  
  METHODS
  15 focus group interviews were conducted at 14 sites in England.
  
  
  METHODS
  a purposive sample of 120 midwives and six student midwives who were serving women in different birth settings (home, free-standing maternity units, midwife-led units, and traditional obstetric units) participated, in 2001/2002.
  
  
  RESULTS
  the main themes generated by the midwives were: cultural changes; midwifery leadership; appropriate role models; training in normality; appropriate responsibility of care divisions; choice for women; equity of care provision between women considered to be at high or low risk; and staff morale.
  
  
  CONCLUSIONS
  this study highlighted the consistency of views amongst midwives working in different settings. Midwives wanted support to practice autonomously in an environment that facilitated equity of care for women and job satisfaction for midwives. Suggestions were put forward by midwives on how to improve maternity services. A unified approach is required to develop these suggestions into strategies, that will remove the identified barriers and promote normality.
authors.affiliation: Department of Midwifery Studies, University of Central Lancashire, Preston PR1 2HE, UK. tinalav@yahoo.co.uk
authors.forename: Tina
authors.initials: T
authors.lastname: Lavender
authors.forename: Jean
authors.initials: J
authors.lastname: Chapple
mesh_terms: D002983:Clinical Competence; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D007588:Job Satisfaction; D008427:Maternal Health Services / Q000592:standards*; D008880:Midwifery / Q000193:education / Q000458:organization & administration*; D009721:Nurse Midwives / Q000193:education / Q000458:organization & administration*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration; D010687:Philosophy, Nursing; D011795:Surveys and Questionnaires