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Zoe Bradfield Ravani Duggan Yvonne Hauck Michelle Kelly 《Women and birth : journal of the Australian College of Midwives》2018,31(2):143-152
Background
Midwives being ‘with woman’ is embedded in professional philosophy, standards of practice and partnerships with women. In light of the centrality of being ‘with woman’ to the profession of midwifery, it is timely to review the literature to gain a contemporary understanding of this phenomenon.Aim
This review synthesises research and theoretical literature to report on what is known and published about being ‘with woman’.Methods
A five step framework for conducting an integrative literature reviews was employed. A comprehensive search strategy was utilised that incorporated exploration in electronic databases CINAHL, Scopus, Proquest, Science Direct and Pubmed. The initial search resulted in the retrieval of 2057 publications which were reduced to 32 through a systematic process.Findings
The outcome of the review revealed three global themes and corresponding subthemes that encompassed ‘with woman’: (1) philosophy, incorporated two subthemes relating to midwifery philosophy and philosophy and models of care; (2) relationship, that included the relationship with women and the relationship with partners; and (3) practice, that captured midwifery presence, care across the childbirth continuum and practice that empowers women.Conclusion
Research and theoretical sources support the concept that being ‘with woman’ is a fundamental construct of midwifery practice as evident within the profession’s philosophy. Findings suggest that the concept of midwives being ‘with woman’ is a dynamic and developing construct. The philosophy of being ‘with woman’ acts as an anchoring force to guide, inform and identify midwifery practice in the context of the rapidly changing modern maternity care landscapes. Gaps in knowledge and recommendations for further research are made. 相似文献4.
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Susan Crowther Liz Smythe Deb Spence 《Women and birth : journal of the Australian College of Midwives》2018,31(1):e59-e66
Background
Rural midwifery and maternity care is vulnerable due to geographical isolation, staffing recruitment and retention. Highlighting the concerns within rural midwifery is important for safe sustainable service delivery.Method
Hermeneutic phenomenological study undertaken in New Zealand (NZ). 13 participants were recruited in rural regions through snowball technique and interviewed. Transcribed interview data was interpretively analysed. Findings are discussed through the use of philosophical notions and related published literature.Findings
Unsettling mood of anxiety was revealed in two themes (a) ‘Moments of rural practice’ as panicky moments; an emergency moment; the unexpected moment and (b) ‘Feelings of being judged’ as fearing criticism; fear of the unexpected happening to ‘me’ fear of losing my reputation; fear of feeling blamed; fear of being identified.Conclusions
Although the reality of rural maternity can be more challenging due to geographic location than urban areas this need not be a reason to further isolate these communities through negative judgement and decontextualized policy. Fear of what was happening now and something possibly happening in the future were part of the midwives’ reality. The joy and delight of working rurally can become overshadowed by a tide of unsettling and disempowering fears.Implications
Positive images of rural midwifery need dissemination. It is essential that rural midwives and their communities are heard at all levels if their vulnerability is to be lessened and sustainable safe rural communities strengthened. 相似文献7.
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Lois McKellar Julie Fleet Shona Dove 《Women and birth : journal of the Australian College of Midwives》2018,31(3):177-183
It’s more than just luck: A qualitative exploration of breastfeeding in rural Australia
Problem
Despite significant public health benefits, breastfeeding for six months continues to be challenging for women.Background
In the Mid North of South Australia, healthcare professionals were concerned that breastfeeding rates were lower than the national average and that a collaborative approach was needed to promote breastfeeding.Aim
To explore the experiences of women and health professional in the Mid North, to inform interventions to improve breastfeeding longevity.Method
Two focus groups were conducted to examine breastfeeding experience in the region. Focus group one included nine mothers who had breastfed more than six months and focus group two consisted of ten health professionals from the Mid North. Thematic analysis was used to analyse the data.Findings
Two overarching themes were identified; ‘breastfeeding: It’s more than just luck’ represented the voices of the mothers and ‘breastfeeding: It’s everybody’s business’ captured the discussion between the health professionals. Women described themselves as lucky while acknowledging that their own persistence, as well as positive support was vital. Health professionals identified education and support as key foci, and a need for a holistic approach to improve breastfeeding rates.Discussion
Breastfeeding should be understood as a relationship, in which broadly applied solutions do not necessarily influence longevity, particularly in rural communities. Strategies should also reflect a realistic picture of breastfeeding and safeguard against idealistic expectation of the experience.Conclusion
A holistic approach to improve breastfeeding rates is imperative. One of the most promising antidotes to the breastfeeding dilemma is the provision of midwifery continuity of care. 相似文献9.
Helle Johnsen Jette Aaroe Clausen Dorte Hvidtjørn Mette Juhl Hanne Kristine Hegaard 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e105-e114
Background
Information and communication technologies are increasingly used in health care to meet demands of efficiency, safety and patient-centered care. At a large Danish regional hospital, women report their physical, mental health and personal needs prior to their first antenatal visit. Little is known about the process of self-reporting health, and how this information is managed during the client-professional meeting.Aim
To explore women's experiences of self-reporting their health status and personal needs online prior to the first midwifery visit, and how this information may affect the meeting between the woman and the midwife.Method
Fifteen semi-structured interviews with pregnant women and 62 h of observation of the first midwifery visit were carried out. Conventional content analysis was used to analyse data.Findings
Three main categories were identified; ‘Reporting personal health’, ‘Reducing and generating risk’, and ‘Bridges and gaps’. Compared to reporting physical health information, more advanced levels of health literacy might be needed to self-assess mental health and personal needs. Self-reporting health can induce feelings of being normal but also increase perceptions of pregnancy-related risk and concerns of being judged by the midwife. Although women want to have their self-reported information addressed, they also have a need for the midwife's expert knowledge and advice, and of not being perceived as a demanding client.Conclusion
Self-reported health prior to the first midwifery visit appears to have both intended and unintended effects. During the midwifery visit, women find themselves navigating between competing needs in relation to use of their self-reported information. 相似文献10.
Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction
Lucia Floris Olivier Irion Jocelyne Bonnet Maria-Pia Politis Mercier Claire de Labrusse 《Women and birth : journal of the Australian College of Midwives》2018,31(2):124-133
Background
According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period.Aim
The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care.Methods
This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women’s Experiences Maternity Care Scale, two months after giving birth.Findings
In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care.Conclusions
Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care. 相似文献11.
Kim Russell 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e134-e141
Problem
In hospital units, the network of interdependent relationships between midwives and doctors has positioned midwives within hierarchical relationships of power. Others argue that the physical layout of hospital wards created by biomedicine makes it difficult for midwives to provide midwifery led care. The aim of this review is to identify factors that support change in the delivery of the midwifery led care in hospital settings.Methods
A narrative review was chosen as this method allows for greater flexibility in the selection of studies and can lead to the inclusion of a wider range of literature.Results
Eight high quality papers from the UK, Sweden, Canada and Australia were selected for review. Papers focused on improving the delivery of midwife led care in hospital midwifery units, labour and postnatal wards. Key themes were identified as supporting change in the delivery of midwifery led care were ownership of change, capability to change and transformational leadership.Conclusion
The findings demonstrate the importance of social support and clinical leadership in bringing about subtle changes in hospital based midwifery led care. Ultimately improved understanding of the factors that support the delivery of the midwifery led care in hospital settings may improve women’s choice and highlight the role of the midwife as the practitioner of normal childbirth. 相似文献12.
Valgerdur Lisa Sigurdardottir Jennifer Gamble Berglind Gudmundsdottir Hildur Kristjansdottir Herdis Sveinsdottir Helga Gottfredsdottir 《Women and birth : journal of the Australian College of Midwives》2017,30(6):450-459
Background
Several risk factors for negative birth experience have been identified, but little is known regarding the influence of social and midwifery support on the birth experience over time.Objective
The aim of this study was to describe women’s birth experience up to two years after birth and to detect the predictive role of satisfaction with social and midwifery support in the birth experience.Method
A longitudinal cohort study was conducted with a convenience sample of pregnant women from 26 community health care centres. Data was gathered using questionnaires at 11–16 weeks of pregnancy (T1, n = 1111), at five to six months (T2, n = 765), and at 18–24 months after birth (T3, n = 657). Data about sociodemographic factors, reproductive history, birth outcomes, social and midwifery support, depressive symptoms, and birth experience were collected. The predictive role of midwifery support in the birth experience was examined using binary logistic regression.Results
The prevalence of negative birth experience was 5% at T2 and 5.7% at T3. Women who were not satisfied with midwifery support during pregnancy and birth were more likely to have negative birth experience at T2 than women who were satisfied with midwifery support. Operative birth, perception of prolonged birth and being a student predicted negative birth experience at both T2 and T3.Conclusions
Perception of negative birth experience was relatively consistent during the study period and the role of support from midwives during pregnancy and birth had a significant impact on women’s perception of birth experience. 相似文献13.
Bridget Kerkin Susan Lennox Jean Patterson 《Women and birth : journal of the Australian College of Midwives》2018,31(3):232-239
Background
Midwives have a professional, ethical and legal obligation to effectively and thoroughly document the care provided to women and the decisions made within the partnership relationship. To appreciate the best approach to documenting midwifery care, it is important to first understand the purpose of midwifery documentation.Aim
The aim of this article is to explore the literature in relation to the purposes of midwifery documentation.Method
A literature search was performed using the CINAHL and Pubmed databases. Hand searching of reference and citation lists was employed to deepen the literature pool.Findings and discussion
No research articles with a midwifery focus were found addressing the purpose of documentation. Broader searching of literature from other healthcare fields was drawn on to identify the contribution of record keeping to: partnership and continuity of care; communication between health professionals; improved standards of care; audits and clinical reviews; research and education; the visibility of midwifery work; the reflective practices of midwives; professional accountability; the legal record of care; the narrative record of experience for women.Conclusion
The purpose of midwifery documentation is complex and multi-factorial, involving much more than the recording of clinical and legal details of a woman’s care. Midwifery documentation may potentially enhance the maternity care experience for women, support the role of the midwife, positively impact collaboration between health professionals, and contribute to organisational processes and research. Further research is needed to clarify how to address the documentation priorities of women and midwives, within the context of the maternity record. 相似文献14.
Tania Fleming Debra K. Creedy Roianne West 《Women and birth : journal of the Australian College of Midwives》2017,30(3):245-252
Background
Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety.Aim
To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success.Methods
A pre-post intervention mixed methods design was used. Academics (n = 13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants’ journal entries, and researcher’s reflections.Findings
Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants’ awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants’ journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress.Conclusion
Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a ‘sense of paralysis’ and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. 相似文献15.
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Carolyn M. Bailey Jennifer M. Newton Helen G. Hall 《Women and birth : journal of the Australian College of Midwives》2018,31(5):414-421
Background
Midwives use telephone triage to provide advice and support to childbearing women, and to manage access to maternity services. Telephone triage practises are important in the provision of accurate, timely and appropriate health care. Despite this, there has been very little research investigating this area of midwifery practice.Aim
To explore midwives and telephone triage practises; and to discuss the relevant findings for midwives managing telephone calls from women.Methods
A five-stage process for conducting scoping reviews was employed. Searches of relevant databases as well as grey literature, and reference lists from included studies were carried out.Findings
A total of 11 publications were included. Thematic analysis was used to identify key concepts. We grouped these key concepts into four emergent themes: purpose of telephone triage, expectations of the midwife, challenges of telephone triage, and achieving quality in telephone triage.Discussion
Telephone triage from a midwifery perspective is a complex multi-faceted process influenced by many internal and external factors. Midwives face many challenges when balancing the needs of the woman, the health service, and their own workloads. Primary research in this area of practice is limited.Conclusion
Further research to explore midwives’ perceptions of their role, investigate processes and tools midwives use, evaluate training programs, and examine outcomes of women triaged is needed. 相似文献17.
Linda Sweet Maryam Bazargan Lois McKellar Joanne Gray Amanda Henderson 《Women and birth : journal of the Australian College of Midwives》2018,31(1):59-68
Background
There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning.Objective
This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings.Design
A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors.Findings
Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9); valid—data extraction loaded predominantly onto one factor; and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n = 83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student’s practice performance and competence.Conclusion
The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs. 相似文献18.
Jeni Stevens Virginia Schmied Elaine Burns Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2018,31(6):453-462
Problem
Providing skin-to-skin contact in the operating theatre and recovery is challenging.Background
Barriers are reported in the provision of uninterrupted skin-to-skin contact following a caesarean section.Aim
To explore how health professionals’ practice impacts the facilitation of skin-to-skin contact within the first 2 h following a caesarean section.Methods
Video ethnographic research was conducted utilising video recordings, observations, field notes, focus groups and interviews.Findings
The maternal body was divided in the operating theatre and mothers were perceived as ‘separate’ from their baby in the operating theatre and recovery. Obstetricians’ were viewed to ‘own’ the lower half of women; anaesthetists were viewed to ‘own’ the top half and midwives were viewed to ‘own’ the baby after birth. Midwives’ responsibility for the baby either negatively or positively affected the mother's ability to ‘own’ her baby, because midwives controlled what maternal-infant contact occurred. Mothers desired closeness with their baby, including skin-to-skin contact, however they realised that ‘owning’ their baby in the surgical environment could be challenging.Discussion
Health professionals’ actions are influenced by their environment and institutional regulations. Further education can improve the provision of skin-to-skin contact after caesarean sections. Skin-to-skin contact can help women remain with their baby and obtain a sense of control after their caesarean section.Conclusion
Providing skin-to-skin contact in the first 2 h after caesarean sections has challenges. Despite this, health professionals can meet the mother's desire to ‘own’ her baby by realising they are one entity, encouraging skin-to-skin contact and avoiding maternal and infant separation. 相似文献19.
Leonie Hewitt Holly Priddis Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2019,32(2):168-177
Background
Despite well-known benefits of continuity of midwifery care, less than 10% of women have access to this model of care in Australia. Staff retention and satisfaction are strongly related to the quality of management; however, little is known about the attributes required to effectively manage a midwifery group practice.Purpose
To explore the attributes midwifery group practice managers require to be effective managers and how these attributes can be developed to promote service sustainability.Methods
A qualitative interpretive approach, employing in-depth interviews with eight midwifery leaders was undertaken and analysed using thematic analysis.Results
The overarching theme described the ideal midwifery group practice manager as someone who stands up for midwives and women and is ‘Holding the ground for midwifery, for women’. Subthemes demonstrate midwifery group practice management is complex: ‘having it’, describes the intrinsic traits of an effective leader; ‘someone with their hand on the steering wheel’ illustrates the day to day job of being a manager and the role of ‘juggling the forces’ that surround group practice; ‘helping managers to manage better’ explored the need for managers to be educated and supported for the role.Conclusions
Managers require certain attributes to effectively manage these unique services, whilst also juggling the needs of the organisation as a whole. Having transformational leadership qualities with vision to lead the practice into the future are key. There needs to be better support and preparation for the role if midwifery group practice is to be a sustainable option for women and midwives. 相似文献20.
Ingrid Jepsen Edith Mark Maralyn Foureur Ellen A. Nøhr Erik E. Sørensen 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e61-e69