Midwives practices and mothers' experiences during intrapartum midwifery care: a qualitative study.

BACKGROUND: Limited research addresses the intersection of women's intrapartum care experiences and midwives' daily practices within the same facilities, resulting in insufficient documentation of discrepancies between expectations and care routines. For women with low-risk pregnancies, midwife-led care is optimal. Quality intrapartum care measures are essential for reducing avoidable maternal-newborn morbidity and mortality. One factor contributing to the high rate of maternal and neonatal morbidity is sub-standard care. Thus, this study aimed to understand midwives’ practices and mothers’ experiences during intrapartum care. METHODS: This exploratory qualitative descriptive study was conducted in three health facilities in South Western Uganda between April 2025 and May 2025. Eleven (11) mothers admitted in early labour, expecting a normal physiological birth, and receiving midwifery care were purposively selected. Through nonparticipant direct observation ten (10) midwives were observed while caring for mothers in labour and in-depth interviews were conducted with the mothers after receiving care. Latent content analysis was applied for direct observations data, thematic analysis was applied for in-depth interviews data finally both data sets were triangulated. RESULTS: Three main themes emerged: “Disrespectful and Abusive intrapartum care” This emerged from three sub themes: Mistreatment, lack of emotional support and empathy, and abandonment of care. “Violation of Clinical Guidelines and Protocols”, Four important subthemes gave rise to the main theme: Retrospective filling of the labour care guide, disregard for women's rights during childbirth, improper immediate transfers of postpartum mothers by non-healthcare personnel, and lack of informed consent. “Mixed Perception of care” emerged from experiences with positive care, normalization of poor care and showing gratitude despite challenges. CONCLUSION: To enhance midwives' care practices and satisfy women's needs and preferences, it is crucial that they get ongoing support supervision and training, with an emphasis on guidelines and woman-centered care. We advise including respect, empathy, accountability, and good communication into every aspect of intrapartum care. This will improve maternal-newborn outcomes, create a positive childbirth experience, and restore women's trust in facility-based birth services.