Beginning an action research project to investigate the feasibility of a midwife-led normal birthing unit in China

Aim. To explore issues arising during preliminary stages of a research project in order to consider the feasibility of a midwife-led normal birthing unit in mainland China.

Background. Midwife-led normal birthing units, as a route to ensuring normality, have become a feature of western maternity care, but are unknown in China.

Design. Action research, using a qualitative descriptive approach, was performed. Data were collected at meetings, by non-participant observation and by face-to-face semi-structured interviews. Observation was undertaken in the midwife-led normal birthing unit and a standard care setting. Data analysis was by thematic analysis using constant comparison techniques.

Methods. In the labour ward of a large general hospital in a major city, stakeholders included midwifery staff, managers, university staff and researchers. Childbearing women proved keen to use this service, but were unable to participate in the planning. The midwife-led normal birthing unit sought to provide one-to-one care in labour and support by a birth companion. Routine interventions were to be avoided.

Results. The midwives in the midwife-led normal birthing unit created a more suitable environment for supportive care. The midwives demonstrated high-quality communication skills. The woman's choice of position/mobility was limited. Difficulties with staffing were identified.

Conclusions. The preliminary findings suggest that continuation of the project is feasible. The woman's role demonstrates passivity. The perception of staff shortage has serious implications.

Relevance to clinical practice. This action research project suggests that a study of a midwife-led normal birthing unit in China is feasible, with some attention to staffing issues.