Objective:

To understand midwife perspective regarding risk factors, detection and management of high risk pregnancy in Jalisco, Mexico, 2013.

Materials and methods:

Qualitative phenomenological study conducted during the year 2013. A theoretical sampling was applied on the basis of the State Midwives Census and the sample size was defined by theoretical saturation of each axis: risk factors, detection and management of high risk pregnancy. The field work began by identifying key informants who then invited midwives to a "State Meeting", working with brainstorming techniques and group interviews. This was followed by 11 in-depth interviews with the midwives and a semiotic data analysis.

Results:

Overall, 82 informant midwives were included, with a median age of 53. Of them, 21.95 % were empirical, 42.69 % were traditional trained midwives, and 35.36 % were midwife nurses. In terms of practice, 59.75 % had been practicing for 20 years or more, 63.42 % had primary schooling or less, and 78.05 % had been working for more than 10 years without receiving institutional training. Qualitatively, high risk pregnancy for nurse midwives entails obstetric or neonatal complications, and antenatal control must take place in the hospital. As for traditional empirical and trained midwives, their perspectives include elements of institutional medicine whereby they refer these women to the physician because they assume that they cannot care for those pregnancies. For traditional midwives of indigenous origin, high risk pregnancy represents the "dangerous pregnancy" under the magical-religious model of health.

Conclusions:

Midwife perspective regarding high risk pregnancy is determine by traditional medicine and some elements of institutional medicine, differentiated according to the type of midwife and the geographic area where they perform their work. Midwives reported willingness to train in order to contribute to healthy, risk-free pregnancies.

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