Midwives׳ experiences of the factors that facilitate normal birth among low risk women at a public hospital in Australia

normal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean section births for unclear reasons. Midwives are interested in ameliorating this trend and aim to facilitate women to have meaningful birth experiences and to achieve the best possible birth. this project aimed to explore midwives׳ experiences and views of the factors that facilitate or impede normal birth. one maternity setting in Melbourne, Australia. a purposive sample of 22 midwives, all with recent birthing experience, participated in in-depth interviews. a qualitative study using an Interpretative Phenomenological approach. Interviews were audio-recorded and transcribed verbatim. Analysis was guided by Smith and Osborn׳s (2008) approach. midwives identified a number of factors that complicated their task of facilitating normal birth. Barriers included: (1) time pressures; (2) a risk adverse culture, and; (3) women׳s expectations. Factors facilitating normal birth included: (1) a supporting environment, and (2) midwifery attributes and a desire to promote normal birth. in Australia, most births take place in obstetric models of care, in which the majority of midwives are employed. The birth environment, in these units, is often risk-adverse with high rates of intervention and caesarean section. Midwives, wishing to promote normal birth in obstetric led units, face a number of challenges and often feel unsupported by senior colleagues. This situation causes conflict and gives rise to stress and unmet support needs. •In Australia, most births occur in obstetric models of care, with risk adverse management policies.•Midwives working in these units face a number of challenges to promoting normal birth.•Conflict between these different philosophies results in stress and dissatisfaction for midwives.