Objective: To examine the influence of midwives' approaches on the care given to women for pain relief during labour.
Design: Non-participant observation was used to collect data on midwives' behaviours during interactions with women in labour.
Setting: A large teaching hospital in Northern Ireland.
Participants: Observations focused on interactions that were related to pain relief and involved 11 midwives caring for 15 women throughout the first stage of labour.
Key findings: Midwives' approaches to pain relief differed; at one extreme the midwife acted as 'a cold professional' whilst at the other extreme she was observed to be 'a disorganised carer'. In the middle of these two extremes was the 'warm professional'; her approach had a positive influence on the women's experience of labour pain. IMPLICATION FOR RESEARCH: Further research is needed to develop a profile of the factors that 'make' for a warm professional. The information gained could be used to teach midwives the skills of being 'a warm professional', in particular, the value of effective communication for sensitive care such as pain relief in labour.