South African midwife specialists practice: Medico-legal experts’ experiences

Background: Medical litigations are rising and becoming a global challenge. The multilayered demands of midwifery-related conditions and the multiple responsibilities of the midwifery team contribute to possible litigations. Midwife specialists in South Africa are trained to provide specialised midwifery care to improve outcomes for patients with midwifery-related complications. While midwife specialists are equipped with specialised knowledge and skills, no specific practice regulations exist to protect them against possible medical litigations. Aim: The study aimed to explore and describe medico-legal experts’ experiences of midwife specialists optimally utilising their knowledge and skills. Setting: The context of the study is the public and private sectors of South Africa. Methods: A qualitative, descriptive and contextual research design was employed. Six medico-legal experts identified through a snowball sampling technique participated in virtual, semi-structured interviews. Data were analysed using Collaizi’s descriptive method. Results: Three themes with subthemes emerged. Results confirmed that medico-legal experts recognised the midwife specialists’ expanded knowledge and skill set. The medico-legal experts experienced a disconnect between training regulations and the current practice regulations. Midwife specialists’ practice was experienced as being guided by a moral obligation rather than prescribed regulations. Conclusion: Midwife specialists are yet to receive full legal recognition in South Africa, challenging midwife specialists’ assumption of autonomous and independent roles. Contribution: Midwife specialists face potential risk of involvement in medical litigations under the current legislative framework. The findings of this study may guide the formulation of a scope of practice (SOP) that legally guides midwife specialists’ practice in South Africa.