Urgency to build a connection: Midwives' experiences of being 'with woman' in a model where midwives are unknown

Objective: The objective of this study was to explore midwives' experiences of being with woman' in the intrapartum period within the context of an unknown midwife model. Design: A descriptive phenomenological design was used with individual in-depth interviews. Transcribed interviews were analysed using thematic analysis that incorporated the data analysis framework offered by Amadeus Giorgi. Setting: Hospitals within Western Australia providing intrapartum care to women where the midwife is not usually known to them. Participants: Ten midwives were interviewed and recruitment ceased when data saturation was reached. Findings: Findings confirm the importance of building a connection to enable partnership with the woman and provide woman-centred care that is inclusive of her partner. Factors influencing midwives' ability to be with woman' included the 'systems' approach to childbearing as well as common birth interventions prevalent within the public hospital system. Midwives experienced both rewards and challenges associated with being with woman' in the unknown midwife model, adaptability and self-awareness were features that enhanced the ability to be with woman' within this model. Key conclusions: Findings present new knowledge about being with woman', a phenomenon so central to the profession of midwifery, yet previously unexplored in the empirical domain. Insights gained reveal the intersection between the phenomenon and the unknown midwife model and highlight characteristics of the midwives that facilitate being with woman' such as adaptive expertise. Implications for practice: Understanding the concept of being with woman' through the lived experience of midwives provides unique insight into the applied practices of the phenomenon. Characteristics of being 'with woman' as well as attributes and strengths demonstrated by the midwives provides important data for education and development of the profession. Explicating the challenges faced by midwives seeking to be 'with woman' in the unknown midwife model is useful for health leaders of service delivery and policy development to consider innovative ways to enhance this important practice advised by professional philosophy. (C) 2018 Elsevier Ltd. All rights reserved.