Coming to realisation

Grounded theory research methodology has been used to explore the midwife's understanding and beliefs of the woman's pain of labour. A group of seven midwives working in a rural hospital participated in this study. The participants had all practiced midwifery in the rural setting for more than two years. When working in this rural hospital midwives are also required to work as general nurses providing care for the sick and aged. As the birthing population of the rural setting is falling so is the opportunity for midwives to practise their craft. Thus they are practising predominately as registered nurses. However there exists an anomaly for them in managing pain relief. Contemporary midwifery allows the well woman to experience some or all her pain of labour while the sick patient has his pain relieved as soon as possible. Data from the participants' interviews was analysed using constant comparative analysis. The core variable coming to realisation and five concepts hearing, seeing, knowing, birthing and midwife believing and their associated sub-concepts were identified. With time and confidence the midwives in their practice environment have applied they apply these aspects of learning to other labouring women thus complimenting complementing their formal education. This research study identified areas of experiential learning that occur and develop the practice of the midwives. It was also discovered there exists for each midwife a paradox of realisation. This occurs when the expected outcome is not anticipated. This element has the ability to undermine the confidence of the midwife in her experiential knowledge.