OBJECTIVE: to explore and describe Chinese midwives' experience of providing one-to-one continuity of care to labouring women.DESIGN: a qualitative study using a phenomenological approach. Data were collected using open-ended, tape-recorded interviews. The analysis of the transcribed texts included searching for themes sorted into clusters for a final expression of the essential structure of the phenomenon.SETTING: Obstetrics and gynaecology hospital of Fudan University, Shanghai, China.PARTICIPANTS: 12 midwives, providing one-to-one continuity of care to labouring women.FINDINGS: two main categories were identified: (1) midwives' feelings on providing continuity of care, and (2) impact of on-call system on midwives providing continuity of care. Key themes emerged from each main category: (1) 'playing important roles in labour care', 'gaining a sense of self-achievement', 'falling into exhaustion and frustration' and 'coping with caring work'; and (2) 'on-call syndrome', 'affecting personal lives' and 'managing on-call shift'. The midwives experienced mixed feelings of being with women and expressed their adaptation to being on-call, which was the essence of this study. They played important roles in caring for women, gained a sense of self-achievement and developed suitable coping strategies. However, they also indicated the impact of the on-call system upon them in the process of providing continuity of care.CONCLUSION AND IMPLICATIONS FOR PRACTICE: midwives have gained both positive and negative experiences when providing continuity of care to labouring women. The positive aspects may facilitate other professional midwives working in a similar role, whereas the negative aspects may inform them of learning to live with this situation, and may also have implications for managers to develop new approaches to the organisation and provision of continuity of care to support midwives' practice, and to fully utilise 'flexibility' under an on-call system.
Adaptation, Psychological Attitude of Health Personnel