Work

Exploring Australian midwives’ approaches to labour pain and workplace realities: Philosophies in practice

Year: 2025

Type: article

Abstract: • Explores Australian midwives’ approaches and philosophies of support for women with pain in labour. • Identifies level of support from workplaces according to model of care. • Midwives feel well supported when working in women-centered and midwifery-led models of care. • The workplace context and structural positioning were critical factors for support of midwives to practice according to their philosophy. This study explored midwives’ views and experiences of supporting women to manage labour pain. This paper specifically examines midwives’ philosophical underpinnings and the organisational factors that influence their ability to enact these approaches in practice. A national cross-sectional survey of Australian midwives was undertaken, incorporating both open- and closed-ended questions. Closed-ended questions were analysed using descriptive analysis, while open-ended responses were examined through thematic analysis. Of the 557 respondents, the majority reported a ‘working with pain’ philosophy in their approach to supporting women during labour. Perceived workplace support for practicing, in alignment with this philosophy, was more likely when working in a continuity of care model. Workplace context and structural positioning were critical to feeling supported. Many midwives described healthcare settings as constraining, often requiring them to relinquish their philosophical approach due to systemic factors – an experience that was frequently associated with distress. Midwives commonly prefer to support women to work with pain during labour, aligning with a philosophy that honours the physiological process of birth. However, system factors, particularly fragmented models of care, high intervention rates, and a culture that prioritises pain relief, pose significant barriers to practising in this way. Enhancing access to tools to facilitate birth physiology, as well as addressing unhelpful cultural beliefs surrounding labour pain, may not only improve women’s birth experiences but also contribute to greater midwifery job satisfaction and retention.

Source: Sexual & Reproductive Healthcare

DOI: 10.1016/j.srhc.2025.101163

Authors: Kate Dawson, Elizabeth Newnham, Lester Jones, Christine East, Laura Whitburn

Institutions: Australian Catholic University, Flinders University, Singapore Institute of Technology, La Trobe University

Language: English

Topic: Maternal and Perinatal Health Interventions

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Decent work and economic growth, Gender equality

Open Access status: gold

Estimated APC paid: $1,850