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
Betül Uncu, Feyza Aktaş Reyhan, Elif SelimoğluIntroduction
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.