Space,place and the midwife: Exploring the relationship between the birth environment,neurobiology and midwifery practice

BackgroundResearch indicates that midwives and their practice are influenced by space and place and that midwives practice differently in different places. It is possible that one mechanism through which space and place influence midwifery practice is via neurobiological responses such as the production and release of oxytocin, which can be triggered by experiences and perceptions of the physical environment.AimTo articulate the significance of space and place to midwifery and explore the relationship between the birth environment, neurobiology and midwifery practice.DiscussionQuality midwifery care requires the facilitation of trusting social relationships and the provision of emotionally sensitive care to childbearing women. The neuropeptide oxytocin plays a critical role in human social and emotional behaviour by increasing trust, reducing stress and heightening empathy, reciprocity and generosity.Principle conclusionThrough its role as a trigger for oxytocin release, the birth environment may play a direct role in the provision of quality midwifery care.     

The self reported confidence of newly graduated midwives before and after their first year of practice in Sydney, Australia

BackgroundGraduates from a new, 3-year Bachelor of Midwifery program joined those educated through the 1 year, postgraduate route (for those already qualified as nurses) for the first time in New South Wales (NSW) Australia in 2007. Many hospitals offer transition support programs for new graduates during their first year of practice though there is little evidence available to inform these programs.ObjectivesTo establish the new midwife's confidence in working to the 14 “National Competency Standards for the Midwife”¹ and the International Confederation of Midwives (ICM) Definition of a Midwife and to explore whether the new midwife's confidence changed over the new graduate year. In particular the study set out to determine whether there were any differences in the confidence of new graduates from undergraduate or postgraduate programs.DesignPre and post survey with comparisons longitudinally and within undergraduate and postgraduate cohorts.SettingsThree Area Health Services in Sydney and surrounding areas, Australia.ParticipantsA convenience sample of all new graduate midwives employed in the three Area Health Services in the early months of 2008.MethodsNew graduate midwives rated their level of confidence (1–10) in working to the 14 National Competency Standards for the Midwife and the ICM Definition of a Midwife during their first weeks of employment and after the completion of their first year of practice.ResultsMidwives prepared through the undergraduate and postgraduate routes commenced their first year of practice with similar levels of confidence. The confidence of these midwives increased modestly over the first year of practice. Those from postgraduate programs were significantly more confident than those from undergraduate programs on four competencies after the first year of practice. Participant's self reported confidence in working to the ICM Definition of a Midwife was low.ConclusionsOur profession and community need strong, confident midwives and it is in all our interests to look to ways we can best achieve this. While the findings of this study should be treated with caution, this study suggests that there is room for improvement in the way we support newly graduated midwives to build their confidence over their first year of practice. Further research is needed to identify the needs of newly graduated midwives and how best we can support them to develop as strong and confident practitioners through their first year of practice.