Challenges to midwives' scope of practice in providing women's birthing care in an Australian hospital setting: A grounded theory study

Objective: To identify and explore processes midwives use to exercise their scope of practice whilst caring for women during normal birth. Methods: Strauss and Corbin's (1998) grounded theory approach was used. Data were collected from 17 midwife participants using participant observation of women's labour and birth care followed by semi-structured interviews. Results: The core category of promoting normal birthing: aspiring to develop a midwife-led scope of practice conceptualises midwives working to develop their scope of practice to promote and facilitate normal birthing for women. Two interrelated categories, promoting and maintaining healthy birthing and optimising scope of practice further explicate how midwives provide woman-centred care within their scope of practice. Conclusions: The theoretical framework generates conceptual knowledge of how midwives aspire to promote healthy, safe and responsive birthing care for women in their scope of practice in a hospital setting. Findings provide greater insights into the competing perspectives of birthing care challenging midwives' capacity to provide woman-centred care, influencing the degree to which midwives are able to exercise their scope of practice in promoting normal birth.