The lived experiences of autonomous Angolan midwives working in midwifery-led maternity units

Objective: to describe the lived experiences of autonomous midwives working in Angolan midwifery-led maternity units. Design: a qualitative approach using semi-structured, audiotaped interviews, in Portugese. Data were analysed in a six-step process. Setting: three midwifery-led maternity units in the most densely populated suburbs in the capital of Angola, Luanda. The average number of deliveries per unit was 2500 per year. Participants: II midwives from the three maternity units. Findings: four main areas emerged: society/culture, significant others, personal self and professional self. Sub-areas, concepts and supporting statements were defined in each area. Key conclusions: the midwives served within a population living in rough circumstances but which maintained strong traditional roots. The midwives did not support homebirths, but did assist when needed,The midwives described their professional role as a 'calling: which was very independent, Cure, was considered more important than care, and strong emotions were expressed when discussing cases of failure,The partograph was viewed as an important instrument and continuous learning as crucial in their role as autonomous midwives. Implications for practice: the model of a midwifery-led delivery unit described in this study may be used in other countries facing the same problems as Angola, Difficulties concerning transfer should be seriously considered as well as adequate education for the midwives. A pre-requisite in order for peripheral maternity units to have any impact on maternal morbidity and mortality, is a well-organised first-referral level. (C) 2001 Harcourt Publishers Ltd.