BACKGROUND:
Midwives/nurse midwives are the professionals most commonly involved in assisting women in labour. The WHO recognises their knowledge/competence to assist in low-risk pregnancies and childbirth. However, autonomy in care has suffered persistent erosion, creating conflict between care technocracy and management for good practices, obscuring international guidelines. It is urgent to clarify professional autonomy to create a new paradigm in Portuguese maternal care.

OBJECTIVES:
To reveal the lived experience of nurse midwives in the autonomy of care for women in labour in Portugal.

METHODS:
Qualitative study with an interpretative phenomenological approach. Sixteen in-depth interviews were conducted online between January and March 2025. Authorized by the Ethics Committee of the National School of Public Health. Snowball sampling, with the following inclusion criteria: nurse midwives working in public delivery wards with ≥ 2 years of professional experience.

RESULTS:
The average age of the 16 participants was 43.68 (SD=5.32) years. Approximately 81% were female and had a master's degree 56%. Experience in the field ranged from 3-18 years (M=14, SD=4.29). All worked in public institutions, but three also worked in the private sector. In the analysis of narrative reflections on professional autonomy, three terms essentially recur: “responsibility”, “scientific knowledge” and “competence.” This suggests the triangulation of concepts that empower professionally. Perhaps these are the cornerstone terms on which the theoretical and practical knowledge that supports autonomy is based and can contribute to better care.

CONCLUSIONS:
This study, still in development, may encourage reflection among providers, decision-makers, and clients. In Portugal, the autonomy of nurse midwives is precarious, and the full application of their competencies is urgently needed. This will benefit the National Health Service and the uniqueness of the woman in labour.

KEY MESSAGE:
Break the silence and raise your voice in defence of the professional autonomy of nurse midwives in Portugal. Poster session 3 (Group B)