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In 2012, I conducted a study exploring how midwives learn, develop and demonstrate communication to embrace elements of empathy, intuition and sensitivity when ‘with woman’ at the point of birth. The purpose of this study was to develop a better understanding of ‘hidden’ skills that midwives perceive they need to draw upon to truly be ‘with woman’. The findings suggest that midwives fulfil the ‘with woman’ concept in different ways and identify several attributes which describe the interplay between woman and her midwife during the time of birth.

The perceived therapeutic relationship between women and midwives is one attribute of this concept which a midwife perceived as building ‘a relationship with them [women] and understanding what they want’. ‘Identifying their needs without them having to ask you.’ ‘Being in tune with their [women's] emotional state’ and ‘being trusted’. ‘Having a good interpersonal relationship.’ ‘If you don't have that empathy you don't build up that rapport with women … pick up cues from the women.’ Another attribute of the ‘with woman’ concept is being able to identify and support women's needs and was seen by midwives as ‘being perceptive to their needs’ and ‘responding to things that she [the woman] says, by nodding to acknowledge you've heard what she said’ and ‘it's about what her [woman's] body is doing and what your body is doing in response’, ‘… and being sensitive to when some parents don't want you with them’.

Another interesting attribute of the ‘with woman’ concept became apparent in this study (Brown 2012). This was demonstrated through compassion, by giving women time to adjust during their pregnancy and in labour played out through watching and waiting. A midwife said, ‘You can show presence, a supportive presence, its watching and waiting, it's not just doing.’ Another midwife said, ‘You just need the women to get used to their surroundings, and to me, they just need to get used to my voice.’ ‘Kindness is so hard to measure, and it is a sixth sense … and I think it's sensitivity – there is something there that you cannot explain but you have a feeling’ and ‘reading the situation’ and ‘knowing when you should shut up and when you shouldn't’, ‘the language you use because you have to adapt to their [the women's] ability to understand the language you are using’ and ‘tone of voice’; ‘recognising when it is good not to say anything’ and ‘recognising silence’.

Findings from this study (Brown 2012) suggest a resulting consequence of the above ‘with woman’ attributes which was a positive birthing experience overall. One participant said, it is ‘not just being there, but exploring everything that will make labour time and delivery bring pleasure to them, something they will always remember’ and ‘make her [the woman] feel empowered’ whilst ‘being an advocate for her’ and ‘just keeping her the focus’. A midwife succinctly explained that, ‘part of it is your own personality … an innate thing … your own belief … a self‐awareness’, whilst another midwife sums up the learning from being ‘with woman’ in terms of, ‘By just being there I am able to instil autonomy and confidence.’ One midwife concludes, ‘A good midwife achieves an awful lot by doing nothing and that is what it's all about.’ ‘Women are great teachers and so always use them as a resource as well, be good listeners and if you listen to women, then very often they're very, very intuitive to their own bodies so they can teach us a lot and we can learn a lot from them.’