Organising presence: how continuity of care shapes midwives' temporal and embodied agency at the birth-room threshold.

PROBLEM: Midwife-led continuity models improve outcomes and experiences, yet less is known about how organisational design shapes the relational work of midwives at critical clinical moments.

BACKGROUND

The moment of entering a birth room is a threshold where assessment, coordination and 'being with woman' must be established quickly, often under pressure.

AIM: To explore how midwives experience entering the birth room in a caseload continuity model compared with a shift-based standard model of intrapartum care.

METHODS

A Heideggerian hermeneutic phenomenological study using semi-structured interviews with seven Danish midwives who had experience of both models. Analysis was iterative and interpretive, attending to temporality, embodiment and organisational conditions.

FINDINGS: Four themes described how entry was organised: (1) entering through information versus relationship; (2) experiencing 'thin' versus 'thick' time; (3) embodied attunement and tacit coordination; and (4) organising presence as professional agency. Caseload continuity enabled anticipatory knowing and a more stable entry rhythm, whereas shift-based entry was characterised by catch-up work, interruptions and risk-oriented task focus.

DISCUSSION: Organising presence captures how temporal arrangements, relational continuity and work organisation configure what midwives can perceive, do and sustain at the threshold of birth-room entry.

CONCLUSION

Protecting early, uninterrupted entry and relational continuity may be a practical service-design lever for strengthening midwifery presence and woman-centred care during labour.