Women’s experiences with long journeys to the nearest birthing facility and midwife accompaniment service: A qualitative study

Abstract

Objective

To explore how pregnant women living 90 min or more from the nearest birthing facility experience the journey and accompaniment by a midwife to the facility.

Methods

A qualitative study using semi-structured interviews with nine first-time mothers living in various regions of Norway, conducted in November 2023. Systematic text condensation was used to analyse the data.

Results

The main findings indicated that having local midwifery expertise was a crucial factor for the women’s sense of security. They received care from a midwife from the first signs of the onset of labour at home until they arrived at the hospital. This was important to them as they expressed concerns about unforeseen situations and uncertainty about when to call an ambulance. The midwife’s birthing expertise and presence in the ambulance were described as vital and reassuring by the women. Although the ambulance journey was intense and uncomfortable, the women felt fortunate and satisfied to have access to it. The midwife accompaniment service was considered valuable but unreliable, as there was no guarantee that the midwife would be available, and the ambulance journey might therefore be unaccompanied.

Conclusion

The availability, presence and expertise of midwives were vital factors for these women. Nevertheless, the uncertain nature of the midwife accompaniment service indicates a need for improvement and further research to enhance the reliability and accessibility of midwife accompaniment to a birthing facility in remote areas.