Henshall, Brooke I., Grimes, Heather A., Davis, Jennifer, and East, Christine E. (2025) The PRIMROSE project: What is ‘physiological birth’? Exploring the perceptions of care providers and birthing persons in Australia: A qualitative descriptive study. Midwifery, 150. 104617.

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Abstract

Background: ‘Physiological birth’ as a term, lacks consistency, and the current definition from the World Health Organization in 1997 does not consider the viewpoint of women/birthing persons. Differences in individual interpretations of physiological birth may complicate care provision and the advocation of physiological birth. Aim: To explore the contemporary understanding of physiological birth from the perspective of women/birthing persons, midwives, obstetric doctors, and doulas in the Australian setting, and identify important elements to include in a consensus statement of ‘physiological birth’. Methods: A qualitative descriptive study was undertaken using focus groups and interview. Data was audio-recorded, transcribed verbatim, and was thematically analysed using NVivo software. Results: Ten participants took part in this study. Three aggregate themes were identified: (1) Connection to the natural process of birth, (2) Elements of decision, and (3) Challenges in the birthing setting. Participants agreed that ‘spontaneous onset’ and ‘vaginal birth’ were important terms to include in a consensus statement of physiological birth. Women/birthing persons, midwives and doulas believed physiological birth was a natural process, uninterrupted by intervention; however, the use of the term ‘intervention’ was amorphous. Antenatal education about physiological birth was identified as lacking, and physiological birth was considered not to be a ‘woman's term’. Participants acknowledged a fear-based narrative around childbirth, and that ‘red tape’ within the hospital setting could challenge maternal choice. Conclusion: Trusting in instinctive labour and birth is an important element of physiological birth. Multiple understandings of the term ‘physiological birth’ extend into the terms used to define it.

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