Women's Experiences of Community-Based Midwifery Care Provided by Independent Midwives in Turkey: A Qualitative Study Based on the World Health Organization Positive Childbirth Experience Framework


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UNCU B., AKTAŞ REYHAN F., Selimoğlu E.

Journal of Midwifery and Women's Health, 2026 (SCI-Expanded, SSCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1111/jmwh.70152
  • Dergi Adı: Journal of Midwifery and Women's Health
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, Gender Studies Database, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: midwife-led birth, respectful maternity care, WHO positive birth experience framework, women’s experiences
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction: Midwife-led birth models are gaining increasing acceptance because of their potential to promote respectful, woman-centered, and positive birth experiences. However, evidence regarding women's lived experiences of midwife-led births in Turkey is limited. This study aimed to investigate women's experiences, perceptions, and thoughts regarding midwife-led births in Turkey within the World Health Organization (WHO) Positive Birth Experience Framework. Methods: A qualitative descriptive design was employed. Semistructured interviews were conducted with 9 women from different regions of Turkey who experienced childbirth under the care of independent midwives. Purposive sampling ensured variation in age, parity, and birth setting. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis informed by the WHO Positive Birth Experience Framework. Results: Three main themes emerged from the analysis: (1) continuous and autonomous one-on-one midwife support from pregnancy through the postpartum period (4 subthemes); (2) a woman-centered, noninterventionist, and empowering birth experience (3 subthemes); and (3) advocating for an independent midwife model with a critical perspective on the health care system (3 subthemes). Women described midwife-led care as empowering, respectful, and emotionally supportive, emphasizing continuous presence, effective communication, trust, and shared-decision-making. Positive experiences were facilitated by individualized care and calm birth environments. However, participants also reported systemic barriers, limited institutional support, and unequal access to independent midwife-led services. Discussion: In general, women's experiences of midwife-led births were strongly aligned with the WHO Positive Birth Experience Framework, particularly in terms of emotional security, participation in the decision-making process, and perceived safety. However, structural constraints within the health care system may hinder the wider implementation and sustainability of midwife-led models. Strengthening continuity of care and institutional recognition of independent midwifery practice are essential.