Maternity Nurses and Midwives in a British Columbia Rural Community: Evolving Relationships

The purpose of this study was to examine the dynamics and evolution of inter-professional relationships between registered midwives and nurses in a rural community where midwifery has become well established over twelve years. Interviews explored the responses of maternity nurses, a nurse manager, and a public health nurse to the integration of midwives in a rural hospital in south east British Columbia. Factors which helped to bring resolution to early concerns were discussed, along with evolving understandings of roles and responsibilities. Participants reflected on the impact of midwifery on job satisfaction and on the character of the maternity unit. Initial concerns following integration included competence and liability, the history of unregistered midwifery in the community, and the loss of job satisfaction for nurses who had a diminished role in the care of labouring women. Nursing shortages and workload issues created some appreciation of the extra help provided by midwives, but also caused some inter-professional tensions. Although close and functional professional relationships developed, significant grey areas remain in the definition of shared roles and responsibilities with midwives.