Never be afraid to question practice: the professional dilemma of a student midwife

As a third-year caseloading student midwife, I experienced a professional dilemma during an intrapartum placement whilst working on a busy obstetric unit: to use vaginal examination to confirm full dilatation (a medical approach) or advocate normality and a woman-centred approach.This article explores the three influential forces that contributed to the dilemma: the culture of obstetric units, the midwife-woman relationship, and the importance of assertive behaviours to achieve autonomy. Through reflection and use of Gibbs’ (1988) reflective cycle, I highlighted the need to develop my assertive skills, which also led me to make amendments to my own practice; this helped me transition from student to a newly qualified midwife.