Midwives and Normalcy in Childbirth: A Phenomenologic Concept Development Study

Introduction: The purpose of this study was to explore midwives' understanding of the concept of normalcy as experienced during the care of women during labor and birth. Methods: A two-tier, elite sampling strategy was used to identify and enroll participants who showed a strong commitment to normalcy in childbirth care. Thirteen participants completed all study procedures, including individual interviews. Iterative rounds of qualitative analyses were conducted to describe the concept, resulting in the defining aspects of the concept, contextual dynamics that influence its manifestation, and empiric referents. Results: Midwives experience normalcy in childbirth care as 1) a wide, individualized continuum of variations; 2) interactive with the woman's unique nature, composed of her physiologic capacities and her specific life circumstances; and 3) sensitive and responsive to the contextual environment. Discussion: Midwives' experience of normalcy in childbirth admits a broad continuum of healthy variations, differing from the narrow parameters held in the predominant maternity care culture. Midwives consider the woman's nature and the context of childbirth to be interactive and significant in explaining variations in the woman's childbirth experience. The contextual environment is considered to be the most influential dynamic affecting the normalcy of childbirth. J Midwifery Womens Health 2010; 55: 206-215 (c) 2010 by the American College of Nurse-Midwives.