An integrative literature review on midwives' perceptions on the facilitators and barriers of physiological birth.

Aim: To present a synthesis and summary of midwives' perceptions on the facilitators and barriers of physiological birth.

Background: Medicalisation of birth has transformed and dictated how birthing should take place since the 20 century. Midwives' perceptions on their role within this medicalised environment have not been well documented.

Design: An integrative literature review.

Data Sources And Review Methods: Primary research articles published in English from the period of 2004 to 2015 were included in this review. The Joanna Briggs Institute's critical appraisal forms were used to appraise the quality of the articles. Data were identified from CINAHL, PubMed, PsycINFO, ScienceDirect, and Scopus.

Results: Eighteen articles were reviewed. Lack of knowledge due to inadequate training, existing obstetrician-led practices, and midwives' negative perceptions of physiological birth were identified as barriers in the literature. Facilitators like shared decision-making, women's preferences, teamwork, institutional support, and midwives' positive perceptions of physiological birth promoted physiological birth. Most of the studies were conducted in Western countries.

Conclusion: Midwives face barriers and facilitators when promoting physiological birth during their clinical practise. Future studies exploring midwives' perceptions of physiological birth are needed, especially in Asia where cultural and organizational factors may differ from Western countries.