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A Qualitative Study on Midwives' Perceptions of Physiologic Birth in Singapore

Wong, Cassandra Yuit Wah, BSc (Nurs) (Honours), RN; Shorey, Shefaly, PhD, RN, RM; Liew, Kelly, BSc (Nurs) (Honours), RN, RM; He, Hong-Gu, PhD, MD, RN; Koh, Serena S. L., PhD, RN, RM

The Journal of Perinatal & Neonatal Nursing: October/December 2018 - Volume 32 - Issue 4 - p 315–323
doi: 10.1097/JPN.0000000000000321
Feature Articles

Midwives are advocates for parturients, and their actions and attitudes can influence a woman's experience during childbirth. Hence, it is valuable to examine midwives' perceptions of physiologic birth in an obstetric-led environment. A descriptive, qualitative study design was utilized. Semistructured face-to-face interviews were conducted with 10 registered midwives from the birthing suite of a public hospital in Singapore. Data were analyzed using thematic analysis. Three major themes were (1) perceptions of physiologic birth, (2) perceived facilitators of physiologic birth, and (3) perceived barriers to physiologic birth. Interestingly, senior midwives in this study experienced more negative outcomes with physiologic birth, resulting in apprehension and reduced confidence levels. This study contributed to the understanding of midwives' perceptions regarding facilitators and barriers to physiologic birth. Factors such as supporting birthing team and antepartum education could be useful in supporting physiologic birth. However, advanced age of some of the midwives was found in this study to be a barrier to physiologic birth.

National University Hospital, National University Health System, Singapore (Ms Wong and Ms Liew); and Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Drs Shorey, He, and Koh).

Corresponding Author: Shefaly Shorey, PhD, RN, RM, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Dr, Singapore 117597 (

The authors thank the support from the participating hospital and the parents who shared their invaluable experiences with them. The authors appreciate the Medical Publications Support Unit of the National University Health System, Singapore, for assistance in language editing of the manuscript.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: October 16, 2017; accepted for publication: January 26, 2018.

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