Affordances in midwifery across time: a narrative review of embodied and affective care

Midwifery is a paradigmatic case of embodied, affective, and relational cognition, a midwife's expertise consists in perceiving and acting on the shifting possibilities for action offered by a laboring woman's body, emotions, and environment. The literature has described this expertise mainly as intuition or tacit knowledge, without a systematic account of how it is organized over time. This narrative theoretical review examines whether the Dynamic Affordance Trajectory Framework, a model of how behavior and identity are shaped by opportunities for action across short-, medium-, and long-term timescales, can provide such an account. Sources from embodied cognitive science, phenomenology, midwifery, nursing, and anthropology, published in English, Spanish, and Portuguese, were selected purposively for their conceptual relevance and analyzed by mapping findings on birth attendance onto the framework's three temporal scales. The review proposes that the relationship between midwife and woman is best understood as a jointly constructed trajectory unfolding at three levels: real-time attunement during labor; skill-building across a midwife's career and across pregnancy, birth, and the postpartum period; and long-term professional identity shaped by cultural narratives about birth. It further interprets humanized childbirth as the deliberate construction of an environment that supports calm, trust, and agency, and illustrates the model with the coexistence of traditional and professional midwifery in Mexico. The framework offers midwifery studies a systematic vocabulary for tacit expertise, while midwifery offers the framework a high-stakes domain for empirical testing. Implications for midwifery education, perinatal mental-health care, and health policy are outlined.