gms | German Medical Science

Background: Routine work in German labour-wards asks midwives to do a lot of different things at the same time – often there are several women giving birth simultaneously, requesting attention and care. In order to keep up with those appeals midwives unconsciously use their tacit knowledge, which is said to be helpful in daily routines and internalized actions [1]. Furthermore, the objects in a room have a distinct inherent meaning which influences the behaviour of persons acting/working in the room [2].

The randomised controlled study “Be-Up: Geburt aktiv” being conducted in different German cities between 2018–2020 studies the influence of a newly designed alternative birthing room on birth mode and the wellbeing of labouring women [3].

Aim/Research Question: This qualitative study leading to the first author’s doctoral degree explores the midwives’ diverse orientation patterns when attending births in the different birthing rooms: the usual and the alternatively designed one. The research question is the following: Which orientation patterns do midwives demonstrate while attending a birth in the alternatively designed birthing room compared to their orientation patterns in a usual birthing room in hospitals taking part in the study “Be-Up: Geburt aktiv”?

Methods: While not being directly retrievable for cognition, the investigation of tacit knowledge asks for special scientific methods, in this case the “Documentary Method” [4]. The midwives’ tacit knowledge will be examined by means of problem-orientated interviews which will be digitally recorded and transcribed. Analysis will help to identify contrasts between the midwives’ orientation patterns in the alternative and usual birthing room.

Theoretical saturation can only be achieved by circular procedure with repeated data collection, analysis and integration of data; therefore, the number of interviews in different hospitals cannot be defined in advance [5]. Circular procedures will allow interpretation of orientation patterns and identification of different types by formulating and reflecting interpretation.

Results: It is assumed that an alternative hospital environment for labour and birth will result in new ways of acting when attending a birth. In the alternatively designed birthing room midwifery care most likely cannot be carried out as a matter of routine. The present study seeks to describe and contrast the orientation patterns of midwives in the respective birthing environment (alternative versus usual birthingroom).

Relevance: This doctoral study will make an essential contribution to a reflective thinking about midwives’ orientation patterns as well as gaining a deeper understanding of midwives’ acting in different birthing environments in the clinical setting.

Recommendations/Conclusion: Midwives do have enormous influence and power while attending births. This influence most likely will be different in different environments. The present study may be followed by further exploration of orientation patterns which might contribute to strengthening physiological birth in Germany as declared in the nationwide health target.

Ethics and conflicts of interest: The ethics vote is currently under review. The research was financed by own resources. There are no conflicts of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].