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The power of shared philosophy: A study of midwives' perceptions of alternative birth care in Norway

02 February 2016
Volume 24 · Issue 2



The aim of this study was to explore important factors that promote the best possible health for mother and child during pregnancy, birth and post-birth in an alternative birth clinic (ABC) in Norway.


The authors used in-depth interviews to identify factors important in ABCs according to the holistic treatment model in the philosophy of ABCs.


Transcription and text condensation were achieved by looking for text to find themes and subthemes to explore daily activities and the role of empowerment.


The most important factors were teaching women how to cope, mentally and practically, and being true to the philosophy of ABCs. Factors connected to empowerment of the women were strengthening their ability to make good decisions, their ability to cope practically, and the midwives' ability to step back and let the women gradually take responsibility.


The ABC in this study reflected theoretical principles for ABCs. Midwives shared common opinions of important factors empowering women.

Implementing safe maternal care is a worldwide concern. Optimal care should be provided during the antenatal, intrapartum and postpartum periods, and should include both the mother and infant (World Health Organization (WHO), 1994; 1996; 2014). In Western countries, births usually take place in hospitals with equipment and personnel to deal with unexpected situations relating to health concerns (Kunnskapssenteret, 2006). The Norwegian Directory of Health emphasises continuity of care. Beyond evidence-based practice in midwifery, there is also a need to address underpinning theory (Halldorsdottir and Karlsdottir, 2011). Holistic care involves considering and supporting the interaction between the patient's physical, mental and social health, and state of mind (Haugan and Rannestad, 2014).

An alternative birth clinic (ABC) features strong elements of supporting the empowerment of women, alongside the professional integrity of midwives. ABCs seek to present a less routine-based, more homely atmosphere compared to hospital units, with an environment featuring specially chosen colours, furniture and plants (Homer, 2013). ABCs support normal birth as the gold standard for giving birth. WHO (1996: 4) defines normal birth as

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