Identifying the priorities for midwifery education across Australia and New Zealand: A Delphi study

ProblemIn countries where education programmes are assessed as meeting international standards there is limited knowledge about the challenges facing midwifery education.Background/aimThe positive impact of quality midwifery education on maternal and newborn health is acknowledged by the World Health Organisation. However, there is limited research identifying the issues faced in providing quality midwifery education. The aim of this study was to identify the challenges and determine priority projects to strengthen midwifery education across Australia and New Zealand.MethodsA two-round Delphi study with experts in midwifery education was undertaken.FindingsIn round one, 85 participants identified an initial 366 issues for midwifery education. Through thematic content analysis these were categorised into 89 statements reflecting five major themes: In round two, 105 midwifery experts from Australia n = 86 (79%) and New Zealand n = 23 (21%) rated the 89 statements in order of priority. Across the combined data (Australia and New Zealand) a total of 19 statements gained consensus of ≥80%.DiscussionFive priority themes were identified including; (1) enabling success of First Peoples/Māori midwifery students; (2) increasing the visibility and influence of midwifery within regulation, accreditation and university governance; (3) determining how best to deliver the clinical practicum component of programmes; (4) reviewing midwifery programmes to enhance design, content and delivery; and (5) ongoing education and support for the midwifery workforce.ConclusionIn Australia and New Zealand, it is imperative that collaborative work is undertaken to design and action identified projects addressing these priorities.     

寻找"有意义的另一个人"--论审美活动中的从众心理机制

审美活动是一种社会的行为.审美活动中的社会影响不仅体现在欣赏者审美观念形成的历史过程中,而且也体现在每一个具体的审美进程中.社会促进是影响个体审美进程的一个重要方面,而相比于社会促进,从众行为对审美主体的影响要更广泛而普遍、全面而深刻.导致审美从众的既有外部的原因,也有内部的原因.审美从众的社会心理机制是暗示和感染.     

A call for action that cannot go to voicemail: Research activism to urgently improve Indigenous perinatal health and wellbeing

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.     

Navigating the migration industry: migrants moving through an African-European web of facilitation/control

ABSTRACT

This paper approaches the African-European migration industry as a complex web of relations in which different actors liaise, objectives oppose each other, and roles overlap. Starting from this notion, the question emerges: How do migrants navigate this fuzzy web of migration facilitation/control? To answer this question, this paper uses a ‘trajectory ethnography’ that follows the im/mobility processes of migrants from West – and Central Africa to, and inside, Europe. In so doing, it particularly focuses on two practices that are related to the concept of social navigation. First, it concerns débrouillardise, a term that points to the power of improvisation, creativity and hustling. Second, it regards social negotiation, a term referring to the process of how migrants ‘massage’ their relations with important actors in the field. The findings stress the relational dimension of the migration industry in the sense that the functioning of one actor depends so much on the intentions and efforts of others. I conclude that we could enhance our knowledge on migration industries with studies that constantly shift between the perspective of the migrant, the social network, the facilitator and controller. Such a dynamic approach unpacks further the multiple efforts that produce migrant im/mobility.     

中国及TTIP国家贸易便利化水平测评

准确测度中国与TTIP主要成员国之间的贸易便利化差异,便于深刻把握TIP催生的国际贸易便利化新趋势,应对全球贸易规则变迁的挑战.文章首先构建了贸易便利化测评指标体系,采用《全球竞争力报告》《腐败指数》以及《世界竞争力年鉴》的相关数据,对2008-2014年TTIP主要成员国及中国的贸易便利化水平进行了对比测评.研究发现,虽然中国的贸易便利化水平整体上升了,但与TTIP发达成员国的差距依然较大,在口岸效率、海关环境、规制环境和电子商务方面均低于其平均水平.为此,中国应进一步简化海关程序和手续,改善海关环境,提升政策制定的透明度,加大对电子商务中的新信息技术的应用力度,防范TTIP区域内贸易转移效应对我国的影响.     

Rumour of angels and heavenly midwives: anthropology of transpersonal events and childbirth

Some contemporary women can experience non-ordinary states of consciousness when childbearing. The purpose of this paper is to bring a ‘transpersonal’ frame to these non-ordinary states of consciousness (hereafter: NOSC). Transpersonal psychology is an interdisciplinary movement in Western science that studies ‘religious’, ‘peak’ or ‘healing’ experiences in different cultures and social contexts. Between 2001 and 2006 in Auckland, New Zealand, while engaged in anthropological fieldwork, I collected stories from mothers, fathers, and midwives who had participated in transpersonal events during childbirth.I will compare the local women's NOSC with ethnographic accounts of spirit-possession and its relationship to indigenous midwifery then revisit and reconstruct the witch-hunts of Medieval Europe from this perspective. Midwives are encouraged to learn to identify and support women's NOSC during labour and birth as many women find strength and wisdom by passing through these states in labour. The subject is also critical to men, whether they are present with women and birth as fathers or health professionals. The hoped for result of this inquiry is to revalorise NOSC among birth-giving mothers, and to educate birth attendants in this field.     

An Australian history of the subordination of midwifery

This paper analyses the history of the subordination of midwifery to medicine and nursing. With the important exception of Evan Willis’ work on medical dominance and Annette Summers’ work on the takeover of midwifery by nursing, other histories of Australian midwifery have taken a neutral approach to issue of power and control. The aim of analysing this period is to identify the strategies of power that were used to subordinate midwifery. With increased consciousness of how power has operated in the past, midwives and woman of today can be more empowered when seeking to promote normal birth and midwifery models of care.Concepts of ‘power’, ‘the state’ and midwife are defined and discussed. A summary of the decline of midwifery and the rise of obstetrics in Europe and the United Kingdom (UK) gives a background against which to understand the Australian experience. The historical account given here draws to a climax by focussing on the period 1886–1928. It was during this time that medicine forged an alliance with nursing and achieved both legal and disciplinary control of midwifery. Knowing how this was done is important because it helps us to recognise the power strategies that are currently being used by medicine. This is helpful when planning how these strategies might be matched or countered by contemporary woman and midwives when seeking to promote normal birth and midwifery models of care.     

Shared learning on an international clinical placement: Promoting symbiotic midwifery practice knowledge

AimThe aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia.BackgroundCultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women’s individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs.MethodsThis study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n = 9), a Balinese private midwifery school (n = 4) and a Balinese public midwifery school (n = 4). Thematic analysis was used to analyse the data.FindingsThe findings were categorised into major themes under the headings of “Learning together despite differences”; “Cultural differences”, “Communication, Resources”, and “Recommendations for future placements”.ConclusionThis study provides a valuable insight into how shared learning increases students’ midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students’ clinical midwifery practice.     

Salutogenic qualities of midwifery care: A best-fit framework synthesis

BackgroundAlthough midwifery care is wellness-based and promotes normal physiology, it exists within a medical model that focuses on risk aversion and disease prevention. Salutogenic theory could provide an alternative approach to midwifery care, supporting health-promoting factors, rather than solely avoiding adverse events.AimsThe aim of this study was to explore women’s experiences of their midwifery care and identify salutogenic aspects of midwifery care.MethodsBest-fit framework synthesis was used to analyse 349 quotes about women’s experiences of midwifery care from 31 qualitative studies in ten high-income countries. Key salutogenic concepts of comprehensibility, manageability and meaningfulness were used as the basis for coding, and thematic analysis was used to expand and clarify the framework to best fit the data.FindingsDefinitions for the salutogenic aspects of midwifery care were developed. Comprehensibility (cognitive aspects of health): ways that midwives help women increase predictability and preparation during childbearing through apredictable caregiver, a predictable system and preparation for an unpredictable experience. Manageability (behavioural aspects of health): ways that midwives enhance and support a woman’s internal resilience, adding extra support when needed, and strengthen women’s external resources through connections to family, community and specialist care. Meaningfulness (emotional/spiritual aspects of health): ways that midwives encourage the commitment and engagement of childbearing women by providing care through a personalised relationship, by cultivating a woman’s autonomy.ConclusionFindings of this study may be used to further research into ways that salutogenic theory can bring a health and wellness-focused agenda to midwifery policy and practice.