Introduction:
Interventions are a common part of clinical practice for women and newborns before, during and after birth. In principal interventions are evidence-based and contribute to positive outcomes of childbirth for both the mother and the baby. Still, there is a worldwide debate if in reality interventions are always used in the right way, at the right time, for the right person¹. Midwifery looks critically at intervening in the natural process of birth, as having a physiological birth has short- and long-term benefits for mother and baby. However, midwives also intervene, e.g. encouraging women to walk around during labour to stimulate the physiological process of childbirth is sometimes called a midwifery intervention. The concept of ‘midwifery intervention’ or ‘midwife intervention’ regularly comes up in the literature. But what does it actually mean, what makes it appropriate to add the label midwifery to an intervention? A clear definition and description of this concept seems to be missing. In our systematic review of the literature, we aimed to gain a deeper understanding of the concept midwifery intervention as it is used in research and non-research literature. More clarity will be beneficial for research and education, but also for implementing innovations and policies in care.

Material and Methods:
We performed a concept analysis according to Morse et al. (1996)² to clarify the concept of ‘midwifery intervention’ and delineate a definition. We searched scientific literature for texts where ‘intervention’ and ‘midwifery’ are linked as one joint concept (e.g. midwifery intervention, midwife-led intervention or midwifery counseling intervention) and that offer some explanation of what is meant with this concept. We used the databases Embase, Cinahl, PubMed, PsychINFO and SocialINDEX to identify relevant papers, which we extracted and analysed to generate defining attributes, boundaries, antecedents and consequences. Subsequently, we analysed our findings to gain deeper understanding of the concept, relating it to the ICM Philosophy of Midwifery Care, and we propose a definition. We followed the PRISMA (Preferred Recording Items for Systematic reviews and Meta-analysis) statement for conducting and recording the in- and exclusion process.

Results:
From our search, yielding 500 unique hits, we selected 71 full papers, which gave further information about the concept. The actual term ‘midwifery intervention’ was used in 20 papers. Many papers used this term or related terms, such as midwifery-led intervention, to specify that the intervention was performed by a midwife without further indications of what this implied or aimed for, and/or without describing that midwives were involved in the development of the intervention. However, a number of papers gave the concept a broader consideration. They described how the benefits of this type of intervention were the midwifery approach towards care and related this closely to several or all aspects of the ICM Philosophy of Midwifery Care³. They mainly aimed at strengthening health (with a salutogenic approach), empowering women and promoting physiology of childbirth.

Conclusions:
The term ‘midwifery intervention’ should be used for interventions where midwives (and women) are involved in designing the actual intervention and that focus on an approach and aim that links closely to a philosophy of midwifery care in which women’s involvement, health and physiological childbirth are promoted. Clarity and establishing this concept will be useful for both research and education.