title: Exploring Dutch midwives' attitudes to promoting physiological childbirth: A qualitative study.
abstract: OBJECTIVE
  to describe Dutch midwives' attitudes toward, and motivations for, the promotion of physiological childbirth and to identify factors associated with those attitudes and motivations.
  
  
  METHODS
  exploratory, qualitative design using focus groups.
  
  
  METHODS
  The Netherlands.
  
  
  METHODS
  hospital- and community-based midwives.
  
  
  RESULTS
  four themes emerged: physiological birth as a continuum, navigating the settings, woman-centeredness and competence and confidence. Midwives view the safeguarding and promotion of physiological childbirth as central to their role. They define physiological childbirth along a continuum that is related to the context of their practice. Hospital culture is seen as an inhibitor of practices that promote physiological birth. Midwives believe that woman-centred ways of working and challenging practices that are not evidence-based will promote physiological childbirth.
  
  
  CONCLUSIONS
  in order to become competent and confident practitioners of physiological childbirth midwives need to be aware of the factors that inhibit and encourage practices that support this way of giving birth.
  
  
  CONCLUSIONS
  midwives should consciously employ strategies that promote physiological birth in both home and hospital settings. Midwifery education and midwifery science research should focus on developing strategies that support midwives in this endeavor.
authors: Research Centre for Midwifery Science, Maastricht, Zuyd University, PO Box 1256, 6201 BG Maastricht, The Netherlands; CAPHRI, School of Public Health and Primary Care Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: s.thompson@av-m.nl.
authors: Suzanne M
authors: SM
authors: Thompson
authors: Research Centre for Midwifery Science, Maastricht, Zuyd University, PO Box 1256, 6201 BG Maastricht, The Netherlands.
authors: Marianne J
authors: MJ
authors: Nieuwenhuijze
authors: School of Nursing and Department of Women's Studies, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109-5482, USA.
authors: Lisa Kane
authors: LK
authors: Low
authors: Research Centre for Midwifery Science, Maastricht, Zuyd University, PO Box 1256, 6201 BG Maastricht, The Netherlands; CAPHRI, School of Public Health and Primary Care Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors: Raymond
authors: R
authors: de Vries
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D017144:Focus Groups; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008880:Midwifery / Q000193:education / Q000379:methods*; D009321:Natural Childbirth / Q000379:methods*; D009426:Netherlands; D011247:Pregnancy; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: Competence; Confidence; Home; Hospital; Physiological childbirth; Women-centeredness