Exploring experiences of midwives practicing midwifery led care in the Aga Khan Hospital women and children (Garden and Kharadar)

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Introduction Globally, through Midwifery Led Care (MLC) model, midwives play an autonomous and independent role by providing continuity of maternity care to women during their childbirth processes in any setting (facility, home or community based).However, in many hospitals in Pakistan, midwives have not provided full scope of their services because of the influence of Medical Model of Care. Therefore, the Aga Khan Hospital for Women and Children (AKI-IWC) took initiative to strengthen the role of midwives by implemented the MLC model of their two sites (Garden and Kharadar). Thus, it is highly important, to study the perspective of the midwives providing care to women in MLC model during their antenatal, intranatal and postnatal period at these sites. Purpose The aim of this study was to explore the experiences and perceptions of midwives (MWs) practicing the MLC model at AKHWC (Garden and Kharadar). Data Collection Method The descriptive qualitative data was collected through semi-structured questionnaire to interview from 10 midwives. Finding The finding of the study revealed one theme and five related categories emerged from the data. The theme of the study emerged as 'struggling to be a professional midwife' and the related five categories were (i) asking to perform within the full scope of practice (ii) pleading to provide full intrapartum care (iii) Persuading to trust in midwives expertise (iv) raising concern for expensive midwives' services and (v) encountering barriers to practice midwifery as independent practitioners. Conclusion The study highlights that Midwives are struggling for their professional identity while practicing MLC model because their professional roles undermined due to the dominancy of the medical led care. It is also observes that while practicing MLC model, midwives face some challenges such as the lack of visibility in society, low salaries and increase workload due to the shortage of staff. Moreover, lack of higher education was also highlighted by the midwives as the midwives have no opportunities for career growth. Implication This study has implication for midwifery practices that is, it increase midwives autonomous role and decision making, raise their salaries, eliminate the shortage of staff and increase the business model of care. Additionally, the study brings attention of the policy makers about the urgent need for the availability of midwifery education which can increases midwives professional identity.

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