Contextual factors that mediate midwives’ behaviour towards pregnant women's use of complementary and alternative medicine.

Abstract: Introduction: Research indicates that many midwives support the use of complementary and alternative medicine to manage the normal challenges of pregnancy and birth. However, midwives’ responses involve highly complex processes and assuming that their positive views will translate into advocacy of the therapies in practice fails to appreciate the impact of contextual conditions. Methodology: Grounded theory was employed to explore the personal, social and structural factors that influence midwives’ behaviour and attitudes towards the use of complementary and alternative medicine. Twenty-five midwives who were employed in metropolitan hospitals situated in Victoria, Australia, participated in the study. Data was collected from semi structured interviews and non participant observation of a subgroup, over an 18-month period in 2010–2011. Results: Contextual conditions exert a powerful influence on midwives’ behaviour towards complementary and alternative medicine. The most significant factors identified in our study include the context of professional work, the midwife''s beliefs and knowledge, and the woman''s expectations and health. Conclusions: Midwives’ professional behaviour regarding complementary and alternative medicine is the result of the complex interface of opposing factors. While many assert that the use of complementary therapies is congruent with their professional philosophy and there is a strong demand from women, integration into clinical practice remains limited in the Australian maternity setting. [Copyright &y& Elsevier]