Supporting midwife-led care through action research: A tale of mess, muddle and birth balls

Aim. To explore the processes and outcomes of an action research project undertaken to support midwife-led care in a
maternity unit in the north of England.
Objectives. To identify changes in care given by midwives, to offer developmental opportunities to midwives to support the
continuation of a midwife-led ethos and to examine the process of cultural shift created by relocation to shared facilities.
Method. Action research, with its emphasis on collaboration and participation, was considered an appropriate approach,
because it facilitates understanding of, and is able to adapt to, changing situations within clinical practice. A variety of
data-gathering methods, including telephone interviews, personal construct analysis and observation, were used to explore
and consolidate midwife-led care in one setting during a time of transition.
Findings/results. Key weaknesses were identified within a midwife-led unit (MLU) and actions agreed and taken to address
these, with a resulting strengthening of midwife-led care. The reflective process, an integral part of action research, fostered
a shared concept of midwife-led care and an expanded skill-base for the facilitation of physiological childbirth.
Implications. Action research can stimulate change and development within a midwifery context providing common values
are identified and participation is realised. Although the methodology can be complex, it has the potential to clarify and
solve problems within a specific clinical context.