The Competency of Midwives in Independent Practice: Their Supporting Mothers' Autonomy in Childrearing

The objective of the present study is to clarify the competency of private midwives through examination of how midwives help mothers gain autonomy in childrearing. An empowerment approach was used as a conceptual framework. This research was conducted with midwives working at three facilities. Data were obtained by observing each encounter between mothers and midwives; that was realized from the 30^th week of mothers’ pregnancy to 3 months after their delivery. In addition, the midwives and the mothers were interviewed. Data were analyzed by qualitative and inductive analysis. Recorded data were coded and categorized, and a total of 7 categories and 39 subcategories were extracted. The results showed that midwives build relationships of mutual trust with mothers, empowering mothers through psychological and educational support and helping them to be independent. The competency of midwives in independent practice could be classified into the following five types: 1) based on mutual trust, the midwife builds a relationship with each client to facilitate friendly interactions as a healthcare professional; 2) the midwife evaluates situations and assesses the skill set of each client; 3) the midwife becomes close to each client and provides individual assistance; 4) the midwife provides reliable techniques in various situations; and 5) the midwife offers information beforehand to prepare each pregnant woman to become a mother and then supports the new family after birth.