Midwifery Students' Definitions of Normal Labor and Birth: A Study From Five Countries

INTRODUCTION: Internationally, many women and birthing people are receiving maternity care interventions as a routine with no medical indication for their use. This medicalized environment influences midwives' practice and, by extension, midwifery students' clinical learning experiences, gaining knowledge and confidence in facilitating normal labor and birth. To educate midwifery students in the provision of high-quality maternal and newborn care, it is important to explore their understanding of normal labor and birth, as this underpins their philosophy of care and will inform their future practice. METHODS: An online survey was developed from a review of current evidence. Following ethical approval, the survey was disseminated at midwifery education programs across five countries-Australia, England, Northern Ireland, Poland, and the United States-between February 2019 and December 2023. RESULTS: In total, 664 midwifery students responded to the open-ended question: "What do you consider the phrase 'normal labour and birth' to mean?" Reflexive thematic analyses resulted in seven themes, representing the key components of the midwifery students' definitions of normal labor and birth. These included: "Vaginal birth with no or minimal intervention in labour; Spontaneous onset of labour; Respectful women-centered care; The concept of normal is disputed; The midwife's role; Birth outcomes define normality; and Environment and freedom to move." CONCLUSIONS: Despite some differences in maternity care and midwifery education across the five countries, midwifery students develop a comparable understanding of normal labor and birth gained through their education and clinical experiences, which has implications for the future of midwifery practice and identity.