Digital Health in Midwifery Practice: A Qualitative Review of Midwives’ Experiences and Perceptions

AIM: To synthesize qualitative evidence on midwives' experiences and perceptions regarding the use of digital health technologies in clinical maternity care. BACKGROUND: Although digital health technologies are rapidly transforming maternity care, there is limited understanding of how midwives experience both the benefits and challenges of these tools in real-world maternity care. METHODS: Eight major databases were systematically searched for qualitative studies published between January 2015 and May 2025. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Mixed Methods Appraisal Tool. Findings were synthesized through a structured three-phase aggregation process. RESULTS: This review synthesized evidence from 20 primary studies reflecting midwives' experiences. Three major themes emerged: (1) Agentic Adaptation in Digital Practice, (2) Structural Underenablement in Implementation, and (3) Reflective Becoming of an e-Midwife. These themes were further divided into eight subthemes. DISCUSSION: This review suggests that digital health is reshaping midwifery practice in complex and uneven ways. Although it may enhance service delivery, it also reconfigures professional roles and relational work, generating new tensions in maternity care. CONCLUSION: Digital transformation in midwifery is not solely a matter of technological adoption but of how digital systems are aligned with the professional, organizational, and relational foundations of maternity care. IMPLICATIONS FOR NURSING: Midwives require structured, practice-oriented digital health education that extends beyond basic technical skills to include ethical awareness, data interpretation, and digitally mediated communication. IMPLICATIONS FOR NURSING POLICY: Policy frameworks should clearly define accountability, governance, and quality standards for digital maternity care while ensuring meaningful midwifery involvement in system design and evaluation. Investment in infrastructure, digital leadership, and privacy safeguards is essential for equitable and sustainable integration.