Obstetricians’ perceptions of midwife specialists’ roles in South Africa

Background: The midwife specialists (MS) are trained midwifery professionals with advanced knowledge and skills to perform interventions to respond to complicated maternal and neonatal conditions. A midwife specialist is expected to function independently and interdependently with other healthcare professionals such as obstetricians and paediatricians. However, studies have shown that the circumstances within public hospitals could be more favourable to the midwife specialist's independent and autonomous practice. Aim: This study aims to explore and describe obstetricians' perceptions of midwife specialists' roles in public hospitals in South Africa. Setting: The study was conducted in the selected public hospitals in South Africa. Methods: Authors followed a qualitative, descriptive, explorative research design. Data collection took place between March 2022 and June 2022. Purposive sampling was utilised to sample nine obstetricians to participate in online individual semi-structured interviews. Data were analysed using Colaizzi's seven-step method. Results: Three themes emerged. In theme 1, midwife specialists are skilled professionals practicing with limitations. In theme 2, there is an absence of the specific scope of practice (SOP) for midwife specialists'. In theme 3, they are defensive practitioners with over-reliance on physicians and clinical records. Conclusion: The SOP should be revised to grant midwife specialists full professional and legal authority to practice independently. Removing these limitations would enable them to collaborate effectively with physicians, ensuring safe and comprehensive maternal and neonatal care. Contribution: This study highlights the state of midwife specialists practice in the public hospitals of South Africa. Obstetricians elucidate various barriers to midwife specialists autonomous and collaborative midwifery care.