Midwife’s Professional Identity in Gadamer’s Hermeneutic Perspective

There is a genuine crisis in midwifery from which attention may be deflected by economic and political world events. Midwifery students are still taught that a midwife has four main professional senses or qualities in her professional work: hearing, sight, smell and most importantly, empathy. Can midwives still really use these senses however? We have international, state and local healthcare facility guidelines and a never-ending workload increase due to almost annual new ‘optimisation actions’ resulting from financial issues. In guidelines and protocols, we do see changes. Since 2014, the criteria for the international guidelines for the professional activity of midwives have also changed significantly: the position of respectful care and the woman's choice as the determining factor in the healthcare process have increased in importance and been put at the centre of perinatal healthcare. There have been many changes in healthcare philosophy in recent decades. The emphasis has shifted not only to thinking about safe healthcare, but also to respectful cooperation with the person cared for and to satisfaction with the healthcare services received. To date, despite these many changes, no research has been done into how Latvian midwives themselves see their professional identity and what basic values, norms and beliefs the concept of midwife’s professional identity includes. The aim of the Thesis is to gain an understanding of a midwife’s perceived professional identity from Gadamer’s hermeneutic perspective. The objectives of the Thesis include exploring the concept of a practicing midwife’s perceived professional identity and describing the core elements the concept of professional identity currently includes for practicing midwives. The question of the Thesis is: how do practicing midwives perceive their professional identity? Overall, in this research four main themes of midwives perceived professional identity with subthemes/intertwining elements were conceptualised: 1. The core elements of a midwife’s professional identity: love for humanity and belief in God / higher power and a woman’s own ability and a midwife’s ability ‘to go with the flow’; variation in the ability ‘to go with the flow’; courage and persistence; professional education and experience; practice of reflection and self-examination; changes in perspective after their own childbirth; ability to draw boundaries and attain professional/private life balance; look back at the Covid period and reflect on that period’s values. As core hindrance, but regrettably constant element of midwife’s professional identity nowadays, midwives noted overwork and struggles with finances. The following three themes were conceptualised as elements which intertwine with the core elements of a practicing midwife’s professional identity: Working alongside changing attitudes towards childbirth; Communication; Legislation and practice. Conclusions. Considering all the narratives gained from these conversations with the midwives, the main message that emerges is the core elements of professional identity perceived by the midwives in connection with love for humanity, faith in God or a higher power and a sense of mission in this profession, which suggests that it is also a possible reason why, despite every hardship, midwives continue to work. It is also possible that some midwives avoid self-reflection to protect themselves from emotional distress and avoid acknowledging how difficult it really is. Thus they work, perceiving their work as a mission and a way of life and do not leave it in spite of the possibility of better pay and working conditions in another profession. This, in turn, does not allow them to insist loudly enough on their demands for midwives’ rights to fully realise their professional potential and receive a decent salary. However, we must also take into account the fact that midwives are constantly overworked and struggle daily to earn a living, so they may no longer have the will or strength to fight for their rights. Recommendations. One could simply start by reflecting on one’s own professional performance and seeing what comes up. What could I start doing to promote the implementation of core elements of midwifery's professional identity in practice? There is need for open and creative attitude. Above all, it requires a willingness to take action and the ability to mutually agree and act proactively to improve the professional situation of midwives, rather than expecting someone else to miraculously resolve all the aforementioned issues.