title: Critical realism: an important theoretical perspective for midwifery research.
abstract: BACKGROUND
  there is a dearth of papers in midwifery journals exploring the philosophical underpinnings of various research methods. However, explaining and justifying particular ontological and epistemological positions gives coherence and credibility to chosen research methods.
  
  
  OBJECTIVE
  to explore and explain the philosophical underpinning of critical realism and argue for it to be more widely adopted by midwifery researchers, using the exemplar of dystocia research.
  
  
  CONCLUSIONS
  critical realism as originally espoused by Bhaskar sees reality as layered (realist ontology) and seeks to explore causative mechanisms for what is experienced and observed. In this way it illuminates the complexity of health care, though recognising that knowledge of this complexity is filtered through an interpretive lens (constructionist epistemology). Critical realism encourages a holistic exploration of phenomena, premised on multiple research questions that utilise multiple research methods.
  
  
  CONCLUSIONS
  critical realism as a philosophical underpinning is therefore particularly apposite for researching midwifery issues and concerns.
authors.affiliation: Academic Division of Midwifery, University of Nottingham, A Floor, Medical School, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Electronic address: denis.walsh@nottingham.ac.uk.
authors.forename: Denis
authors.initials: D
authors.lastname: Walsh
authors.forename: Kerry
authors.initials: K
authors.lastname: Evans
mesh_terms: D005260:Female; D006801:Humans; D008880:Midwifery; D015399:Nursing Research; D010687:Philosophy, Nursing; D011247:Pregnancy; D012107:Research Design
keywords: Critical realism; Epistemology; Ontology; Research