Midwives' perception about their practice in a midwifery-led care model in Karachi, Pakistan

Objective: To explore the experiences and perceptions of midwives practising the midwifery-led care model at two private facilities of women and children hospital in Karachi, Pakistan. Methods: The descriptive qualitative data was collected through semistructured questionnaires with 10 midwives. Results: The findings of the study revealed one theme and four related categories. The theme of the study emerged as 'struggling to be a professional midwife' and the related four categories were: (i) asking to perform within the full scope of practice, (ii) obstetricians' reliance and trust in midwives' expertise, (iii) raising concerns about expensive midwifery services, and (iv) encountering barriers to practise midwifery as independent practitioners. Conclusion: Midwives face some challenges practising the midwifery-led care model such as lack of visibility in society, low salaries and increased workload due to the shortage of staff. Lack of higher education was also highlighted by the midwives as they have no opportunities for career growth. This study will increase midwives' autonomous role and decisionmaking in the clinical setting.