Midwives' support needs as childbirth changes.

This paper reports on midwives' support needs as they were described by midwives in a large study of the supervision of midwives in England. The data are derived from six sites: five, very different, National Health Service (NHS) sites, and one composed of midwives outside the NHS. In-depth, ethnographic interviews were conducted with 168 midwives and a grounded theory approach was used for the analysis. The findings identified midwives' many and varied support needs. Midwives also clearly described the culture of midwifery in the NHS. This culture inhibited midwives from arranging to have their support needs met and acted as an obstacle to progress in developing midwifery practice. The dilemmas and tensions inherent in this situation are explored and suggestions made as to the way forward.