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. 2025 Jul 29:9.
doi: 10.18332/ejm/205673. eCollection 2025.

Empowering women in decision-making about mobility during labor: Insights from experts

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Empowering women in decision-making about mobility during labor: Insights from experts

Marlene I Lopes et al. Eur J Midwifery. .

Abstract

Introduction: Allowing freedom of movement and positions during labor facilitates safe progression, improves maternal and neonatal outcomes, and contributes to a positive birth experience for women and their partners. Childbirth preparation aims to empower women by equipping them with skills and confidence to manage labor actively and knowledgeably. However, in many hospital settings, women's mobility remains restricted. This study explores expert perspectives on the core components of an intervention designed to promote women's autonomy and active participation during labor, to be implemented by nurse-midwives within Childbirth Preparation Programs in primary healthcare.

Methods: A qualitative study was conducted in February 2024 in Portugal, using a focus group composed of ten nurse-midwives recognized as experts in childbirth preparation. The session was recorded and analyzed through content analysis, guided by the Theory of Emancipated Decision-Making in Women's Healthcare.

Results: Nine women and one man participated, aged 34-64 years, representing primary healthcare, hospitals, and academia. Six key themes emerged from the analysis: the intentionality behind the intervention; understanding the meanings and expectations women hold about their birth experience; empowering women by providing knowledge and skills; raising awareness of social norms that may influence women's decisions and actions; encouraging women to reflect on their options; and fostering woman-centered care.

Conclusions: The experts emphasized the importance of promoting mobility during labor to enhance perinatal outcomes and the childbirth experience. Empowering women through experiential learning, fostering reflection, supporting informed choices, and ensuring continuity of care through collaborative professional practices were identified as essential strategies for effective intervention.

Keywords: active birth; childbearing women; decision-making; nurse-midwives; prenatal education; upright positions.

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Conflict of interest statement

The authors have each completed and submitted an ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. They report receiving support for the present manuscript from the Portuguese Foundation for Science and Technology I.P., within the scope of the project Refª. UID/DTP/00742/2013.

Figures

Figure 1
Figure 1
Main themes identified by expert nurse-midwives to inform an intervention supporting women’s decision-making on movement and positioning during the first stage of labor

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