title: Is a midwife's continuous presence during childbirth a matter of course? Midwives' experiences and thoughts about factors that may influence their continuous support of women during labour.
abstract: OBJECTIVE
  to gain an understanding about midwives' experiences of providing a continuous supportive presence in the delivery room during childbirth, and to learn about factors that may affect this continuous support.
  
  
  METHODS
  qualitative study at a maternity unit in Norway, where about 4000 births take place each year. In-depth interviews were conducted with ten midwives working in two different maternity wards. The qualitative data were analysed using systematic text condensation.
  
  
  RESULTS
  the analysis generated three main themes: relational competence, the midwife's ideology, the culture and philosophy of the maternity unit. The midwives identified being mentally present and actively developing mutual trust with the woman in labour as two very important factors for building a relationship with her. They suggested that the midwife's first encounter with the woman is a key opportunity for establishing rapport during labour. Successfully providing a continuous presence during labour fostered the midwives' perception of themselves as a 'good midwife'; this was considered a feature of holistic care and health promotion. The workload in the unit sometimes made it difficult for them to provide a continuous presence in the delivery room. The midwives experienced feelings of inadequacy when they felt that they had too little time available for the woman in labour.
  
  
  CONCLUSIONS
  midwives' skill in building a relationship with the woman in labour combined with their values and understanding of the midwifery profession are important factors influencing their decision to provide a continuous presence during childbirth. If it is policy that maternity units should provide continuous support to women in labour, managers should ensure that it is actually provided.
authors.affiliation: Department of Postgraduate Nursing Programmes, Midwifery Education, Sør-Trøndelag University College, Mauritz Hansens gt. 2, 7004 Trondheim, Norway. Electronic address: Ingvild.aune@hist.no.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Aune
authors.forename: Hanne Hvaal
authors.initials: HH
authors.lastname: Amundsen
authors.forename: Lene Christina
authors.initials: LC
authors.lastname: Skaget Aas
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D036861:Delivery, Obstetric / Q000451:nursing*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008880:Midwifery; D009664:Norway; D057184:Practice Patterns, Nurses'; D011247:Pregnancy
keywords: Continuity of care; Continuous presence; Health promotion; Midwifery ideology