Organising presence: how continuity of care shapes midwives’ temporal and embodied agency at the birth-room threshold

Problem Midwife-led continuity models improve outcomes and experiences, yet less is known about how organisational design shapes the relational work of midwives at critical clinical moments. Background The moment of entering a birth room is a threshold where assessment, coordination and ‘being with woman’ must be established quickly, often under pressure. Aim To explore how midwives experience entering the birth room in a caseload continuity model compared with a shift-based standard model of intrapartum care. Methods A Heideggerian hermeneutic phenomenological study using semi-structured interviews with seven Danish midwives who had experience of both models. Analysis was iterative and interpretive, attending to temporality, embodiment and organisational conditions. Findings Four themes described how entry was organised: (1) entering through information versus relationship; (2) experiencing ‘thin’ versus ‘thick’ time; (3) embodied attunement and tacit coordination; and (4) organising presence as professional agency. Caseload continuity enabled anticipatory knowing and a more stable entry rhythm, whereas shift-based entry was characterised by catch-up work, interruptions and risk-oriented task focus. Discussion Organising presence captures how temporal arrangements, relational continuity and work organisation configure what midwives can perceive, do and sustain at the threshold of birth-room entry. Conclusion Protecting early, uninterrupted entry and relational continuity may be a practical service-design lever for strengthening midwifery presence and woman-centred care during labour.