“What You Leave…Will Leave You”: A Qualitative Study of Perceptions of Midwifery’s Intangible Heritage and Professional Identity Among Midwives and Student Midwives in Cyprus
Abstract
1. Introduction
2. Materials and Methods
2.1. Sampling
2.2. Topic Guide
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Themes
3.1.1. The Elements That Constitute MIH and Their Transfer Through Generations
“… perpetuation of the species is a stable event in human life, and midwives are always needed” … “Society is changing but the MIH, such as being close to the woman, caressing her and talking to her does not change and no one can take it from the Midwife”.(M1)
Unless you see the old ones apply them and learn, you cannot have the adequate experience.(M6)
Oldest midwives should embrace the young ones. To be mentors.(M7)
[they] follow physicians’ orders and practice because they DON’T have experienced midwives to follow.(M4)
A midwife is a person of trust … to be trusted by women who asked for her during labour. I could not understand exactly how to create this trust, until I started my practice and then I felt that indeed during the time of delivery a woman is together with a midwife.(SM 4)
I believe that the most important thing is our independence. In other words, I learned from the old midwives how to be independent and empower myself. And when we, the youngest ones, also try… Yes, we want to take it further… And we will take it….(M 6)
3.1.2. The Sense of Common Professional Identity
We are thinking about the good of the mother and child and we put everything … aside … woman and child are coming always first.(SM 1)
What unites us all midwives like this, is that if you travel and go anywhere and find midwives, what unites us immediately… is the question if they have a lot of caesareans? What unites us is the concept that we all midwives believe in normal birth, and we are disturbed by the consequences of medicalization and deviations from normal birth and we fight to bring and keep birth in its normal state, as the old ones did… They wanted to give to the woman the choice to give birth naturally and we must keep it in this way. It characterizes midwives… it’s characteristic…(M1)
Midwives are different from other health professionals because they have to think, decide and act quickly. They can’t be late. You evaluate and decide immediately.(M2)
All midwives felt pride in saving a woman from an unnecessary caesarean section or an intervention.(M7)
There was a lady with her 20 years old son…she saw me and run towards me and hugged me…‘You delivered my son….i can never forget you’. Her son kneeled and kissed my hands. He said…‘these hands are the ones that touched me first…I honor them’…(Μ2)
She said to me…I will never forget your eyes, the way you stared at me and said… you will make it. And I believed you, and I made it. I will never forget that.(Μ2)
In the past, as students, we were left alone to do so many things, and experienced midwives were there if we needed them. By this way, we felt so strong. This strengthened us. We felt part of the team, the power of the maternity ward.(Μ14)
3.1.3. Perceived Risks That the Midwifery Profession Is Facing
I can remember that in older times a midwife was autonomous, strong, and independent and…alone. I was practicing alone at my village, and other midwives too… now, our issue is medicalization.(M3)
Reduction in normal births leads to a reduction of skills. So, this thing creates insecurities, creates a reduction in training for new midwives, a reduction in skills, a reduction in everything that is a vicious circle that will not stop.(M9)
The young midwives took from the old knowledge and experience. The increase in knowledge at the university level has reduced the practical part that will be useful to you in times of need. What you leave…will leave you.(M9)
During a night shift i was talking to a female patient, she was a teacher, about our role as midwives, that we do normal births …she was surprised…she thought we are just doctors’ assistants. And this is the majority’s opinion.(M9)
Because they know that they will be employed and paid by an obstetrician, and if they express a different opinion they will be fired.(M5)
They need to understand…first of all the administration of the hospital…If they cannot understand us…how do we expect to be understood by others.(M3)
First of all, we are understaffed and we can’t do our job. When there are two people working, how am I going to be next to a birthing woman and support her? I don’ t think that they understand what we are doing … we feel left out, we are alone. I’m not sure what’s going on in the end, but we’ve been side-lined.(M5)
3.1.4. Midwives’ Expectations About Their Profession
We need to reintroduce ourselves to society as midwives.(M10)
We have to show off our profession and what we are able to do.(SM4)
With antenatal classes we saw women change their perceptions. They started out telling me I will come [to the classes] but I am going to have a C/S, and after hearing about normal birth from us and from other women who had given birth, they became passionate about it. And that was the miracle of education.(M10)
[we need to] empower women through antenatal education so that they can demand their rights for normal birth.(M7)
We must go to schools and inform children about normal birth and breastfeeding, us midwives with experience in normal birth…what an investment for the future.(M1)
We have to investment in post-partum care. It is an area of maternity care where the midwife’s role has not been fully integrated or emphasized in the current system.(M13)
We have to go out to the community to regain our role and our autonomy back.(M10)
The experienced midwife should improve herself to pass on knowledge to and empower the new midwife. Be an example to follow.(M8)
An experienced midwife with evidenced based knowledge and skills is fundamental for student midwives.(SM1)
Full implementation of the Legislation is what we need.(SM3)
Midwives working in the private sector need empowerment, reinforcement and support to get ahead.(M2)
…empower women to assert their rights about normal birth and ask for a midwife to help them.(M1)
4. Discussion
4.1. Ethics
4.2. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CS | Caesarean section |
MIH | Midwifery Intangible Heritage |
M | Midwife |
SM | Student midwife |
UNESCO | United Nations Educational, Scientific and Cultural Organization |
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List of Possible Questions (High Importance Questions, Questions that Provoke the Discussion) | |
---|---|
Experiences | 1. Talk to us about your experience as a midwife/student midwife about the way that MIH is transferred |
2. What was the element that helped you the most during the procedure of understanding midwifery practice and science? | |
3. Beyond university, what are your experiences in the clinical field and your contact with more “older” experienced midwives? a. If you wish, you can share with us specific incidents, events, experiences, anything that impressed you, etc. b. Do you believe that there is MIH that is passed through generations of midwives? | |
Perceptions | 1. What gives midwives a “sense of professional identity”? Can you describe what it is that connects midwives–that creates a sense of common professional identity? |
2. What do you believe is the Cypriot Society’s view of the midwifery profession? 3. What do you understand by the concept of MIH? Do you think this is linked to the midwife′s sense of professional identity? 4. What are the elements that prepare a midwifery student/new midwife to practice the profession? | |
Expectations | 1. Can you tell us in what ways the midwifery profession in Cyprus could be protected and developed (risks)? |
2. What could be the recommendations for improvement changes so that the profession of midwifery emerges again as an integral, elemental foundation of better perinatal care and a prosperous society? | |
3. Anything else you would like to add, which we did not cover above? Or that you have the chance to say? |
Steps | Actions |
---|---|
1 | Development of an introductory section for understanding the theme |
2 | Recording and transcribing |
3 | Dada coding |
4 | Making links with the literature |
5 | Grouping of similar codes and supporting interview extracts into categories |
6 | Codes and categories analysis: revision of codes, comparing differences and similarities, exchanging ideas and interpretations |
7 | Synthesis of categories into themes |
8 | Final agreement on the themes in relation to the literature and the available evidence |
9 | Selection of quotes illustrating the data analysis and the synthesis of the themes |
Age | Status | Years of Experience |
---|---|---|
20–30 | 7 Nurses/student midwives | 1 year of experience in practicing midwifery as SM |
30–40 | 5 Midwives | 6–10 |
40–50 | 3 Midwives | 10–15 |
50–60 | 3 Midwives | 15–20 |
Over 60 | 4 Midwives | Over 30 |
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Share and Cite
Panagiotou, M.; Hadjigeorgiou, E.; Vryonides, S.; Karanikola, M.; Merkouris, A.; Middleton, N. “What You Leave…Will Leave You”: A Qualitative Study of Perceptions of Midwifery’s Intangible Heritage and Professional Identity Among Midwives and Student Midwives in Cyprus. Healthcare 2025, 13, 1936. https://doi.org/10.3390/healthcare13151936
Panagiotou M, Hadjigeorgiou E, Vryonides S, Karanikola M, Merkouris A, Middleton N. “What You Leave…Will Leave You”: A Qualitative Study of Perceptions of Midwifery’s Intangible Heritage and Professional Identity Among Midwives and Student Midwives in Cyprus. Healthcare. 2025; 13(15):1936. https://doi.org/10.3390/healthcare13151936
Chicago/Turabian StylePanagiotou, Maria, Eleni Hadjigeorgiou, Stavros Vryonides, Maria Karanikola, Anastasios Merkouris, and Nicos Middleton. 2025. "“What You Leave…Will Leave You”: A Qualitative Study of Perceptions of Midwifery’s Intangible Heritage and Professional Identity Among Midwives and Student Midwives in Cyprus" Healthcare 13, no. 15: 1936. https://doi.org/10.3390/healthcare13151936
APA StylePanagiotou, M., Hadjigeorgiou, E., Vryonides, S., Karanikola, M., Merkouris, A., & Middleton, N. (2025). “What You Leave…Will Leave You”: A Qualitative Study of Perceptions of Midwifery’s Intangible Heritage and Professional Identity Among Midwives and Student Midwives in Cyprus. Healthcare, 13(15), 1936. https://doi.org/10.3390/healthcare13151936