Edinburgh Napier University

  Objective: The objective of the study was to explore the dilemma’s, the conflicting values, and their underlying factors that Dutch
midwives experience when they find it difficult to conform to, or to accommodate women’s care needs.

Methods: Qualitative data were collected from 11 community-based midwives using narrative inquiry.

Findings: Three themes emerged: (1) Loyalty - the conflict between wanting to be loyal to the woman’s wishes and expectations AND to guidelines, scientific evidence and to the collaborative relationships with other professionals – the value of women’s childbirth experiences versus the value of good health outcomes (influenced by the midwife’s risk perception, the healthcare system and organization of care). (2) Responsibility - the conflict between respecting the woman AND doing her justice as a person and the social norm in maternity services - women’s autonomy and individuality versus the midwife’s accountability and responsibility (influenced by fear and wanting to “do good”). (3) Selfhood - the conflict between the woman’s self-assertive behavior in pursuing her needs AND the midwife’s professional behavior - the woman as self-expert versus the midwife’s professional identity (influenced by control, experience, knowledge, and contextual issues).

Conclusion: Midwives encounter women and colleagues whose wishes and norms lead to dilemmas and conflicts they need
to manage in everyday practice. Education and supervision should involve the discussion and questioning of values.