A midwifery model of woman-centred childbirth care - In Swedish and Icelandic settings

Background: Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. Aim: The aim of this study was to define and develop an evidence-based midwifery model of woman-centred care in Sweden and Iceland. Method: Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women's and/or midwives' experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. Findings: The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. Conclusion: The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability. (C) 2012 Elsevier B.V. All rights reserved.