OBJECTIVE: The aim of the study was to explore hospital-based midwives' experiences of providing publicly-funded homebirth services in Australia. DESIGN: A qualitative descriptive study using a constructivist grounded theory methodology was undertaken. SETTING: Five different states or territories of Australia where publicly-funded homebirth services were operating. PARTICIPANTS: Interviews were conducted with 21 midwives and midwifery managers from eight different public hospitals who had recent experience of working in, or with, publicly-funded homebirth models. FINDINGS: Witnessing undisturbed birth in the home setting transformed midwives' attitudes towards birth. Following exposure to homebirth, many midwives felt they were seeing undisturbed birth for the first time. This led them to question their current understanding of physiological birth and develop a new awareness of the powerful influence that the environment has on labouring women. This new understanding resulted in changes to their practice. KEY CONCLUSIONS: For midwives accustomed to working in hospital settings, exposure to homebirth deepened their understanding of physiological birth, resulting in a perspective transformation and subsequent shift in practice. IMPLICATIONS FOR PRACTICE: Exposure to homebirth may motivate midwives to alter their practice in both home and hospital settings in order to shift the power dynamic between women and caregivers and protect women from unnecessary disturbance during labour.
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