Dissertations / Theses: 'Midwifery Australia'

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Cullen, Miriam C. "Australian midwives' practice domain." Thesis, Curtin University, 1997. http://hdl.handle.net/20.500.11937/51.

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This exploratory, descriptive research used a case study approach to analyse the role of the midwife in providing maternal and infant care in Australia. Midwives from the states of New South Wales, Victoria and Western Australia comprised the target population. These midwives were considered to be representative of the general midwifery population practising in the diverse settings of Australia.A triangulation of methods (Denzin, 1970) was used for data collection. This included observational field work, a questionnaire survey of a randomly selected sample of registered midwives (n=1754), and in-depth interviews (n=75), using a grounded theory approach (Glaser and Strauss, 1967; Strauss and Corbin, 1990).The questionnaire, in-depth interviews and observational field work addressed the practice of midwives:1. as documented in policies and procedures in practice settings.2. as defined by the Australian College of Midwives Incorporated in Standards for the Practice of Midwifery (1989), based on the International Confederation of Midwives' Definition of a Midwife (World Health Organisation, 1976).Data obtained through the survey questionnaire were analysed using descriptive analysis (Wilson, 1985) to portray a summarization of the entire data set. A thematic content analysis was used for the open-ended questions of the survey (Burnard, 1991). In an attempt to discover the 'how and why' questions associated with the study's survey findings, the constant comparative method of analysis of data from in-depth interviews was deemed appropriate (Glaser, 1978; Field and Morse, 1985; Chenitz and Swanson, 1986). This allowed a more abstract level of conceptualization that led to the development of a paradigm reflective of the midwives' practice domain (Strauss and Corbin, 1990).Lack of opportunities to practise throughout all stages of pregnancy and childbirth was identified as the major problem limiting the Australian midwives' practice domain. An explanatory process of Optimising Opportunities for Holistic Midwifery Practice emerged explaining midwives' actions and interactions throughout the four stages of optimising: revealing the image; influencing decision making; changing the paradigm; and expanding the profession.The findings of the study provide an analysis of Australian midwifery practice that considers factors facilitating and/or impeding the professional role and development of Australian midwives, and their ability to provide care that meets consumer needs.

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Monk, Amy Rachel. "Evaluating midwifery units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/13285.

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Objective: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in two freestanding midwifery units and two tertiary level maternity units in New South Wales, Australia. Design: Prospective cohort study. Participants: 494 women who intended to give birth at freestanding midwifery units and 3157 women who intended to give birth at tertiary level maternity units. Participants had low risk, singleton pregnancies and were less than 28+0 weeks gestation at the time of booking. Results: Women who planned to give birth at a freestanding midwifery unit were significantly more likely to have a spontaneous vaginal birth and significantly less likely to have a caesarean section. There was no significant difference in the adjusted odds ratio of 5 minute Apgar scores. Babies from the freestanding midwifery unit group were significantly less likely to be admitted to neonatal intensive care or special care nursery. The freestanding unit group had similar or reduced odds of other intrapartum interventions and similar or improved odds of other indicators of neonatal wellbeing. Conclusions: The results of this study support the provision of care in freestanding midwifery units as an alternative to tertiary level maternity units for women with low risk pregnancies at the time of booking.

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Cullen, Miriam C. "Australian midwives' practice domain." Curtin University of Technology, School of Nursing, 1997. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=12173.

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This exploratory, descriptive research used a case study approach to analyse the role of the midwife in providing maternal and infant care in Australia. Midwives from the states of New South Wales, Victoria and Western Australia comprised the target population. These midwives were considered to be representative of the general midwifery population practising in the diverse settings of Australia.A triangulation of methods (Denzin, 1970) was used for data collection. This included observational field work, a questionnaire survey of a randomly selected sample of registered midwives (n=1754), and in-depth interviews (n=75), using a grounded theory approach (Glaser and Strauss, 1967; Strauss and Corbin, 1990).The questionnaire, in-depth interviews and observational field work addressed the practice of midwives:1. as documented in policies and procedures in practice settings.2. as defined by the Australian College of Midwives Incorporated in Standards for the Practice of Midwifery (1989), based on the International Confederation of Midwives' Definition of a Midwife (World Health Organisation, 1976).Data obtained through the survey questionnaire were analysed using descriptive analysis (Wilson, 1985) to portray a summarization of the entire data set. A thematic content analysis was used for the open-ended questions of the survey (Burnard, 1991). In an attempt to discover the 'how and why' questions associated with the study's survey findings, the constant comparative method of analysis of data from in-depth interviews was deemed appropriate (Glaser, 1978; Field and Morse, 1985; Chenitz and Swanson, 1986). This allowed a more abstract level of conceptualization that led to the development of a paradigm reflective of the midwives' practice domain (Strauss and Corbin, 1990).Lack of opportunities to practise throughout all stages of pregnancy and childbirth was identified as ++
the major problem limiting the Australian midwives' practice domain. An explanatory process of Optimising Opportunities for Holistic Midwifery Practice emerged explaining midwives' actions and interactions throughout the four stages of optimising: revealing the image; influencing decision making; changing the paradigm; and expanding the profession.The findings of the study provide an analysis of Australian midwifery practice that considers factors facilitating and/or impeding the professional role and development of Australian midwives, and their ability to provide care that meets consumer needs.

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Cornell, Peta Kathleen. "An exploration of midwifery students’ perceptions of clinical facilitators and experiences of clinical facilitation during midwifery clinical placements in Perth, Western Australia." Thesis, Curtin University, 2022. http://hdl.handle.net/20.500.11937/89146.

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Clinical facilitation is a model of supervision for students during professional practice experiences, with little known about this important aspect of midwifery education. A qualitative descriptive exploratory approach with thematic analysis was used to develop knowledge and understanding of undergraduate midwifery students’ experiences with such supervision in Western Australia. Midwifery clinical facilitation was highly valued by midwifery students. Respondent insights and recommendations will be instrumental in further developing and enhancing midwifery models of clinical supervision.

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Pangerl, Sabine. "The adherence to group b streptococcus screening guidelines amongst pregnant women in Western Australia – A quantitative descriptive analysis." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2021. https://ro.ecu.edu.au/theses/2448.

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Colonisation with Group B Streptococci (GBS) is a major risk factor for neonatal infection acquired via vertical transmission during pregnancy, labour, or birth, potentially resulting in significant morbidity and mortality. Universal screening at 35 – 37 weeks gestation for maternal GBS colonisation and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of neonatal Early-Onset GBS Disease (EOGBSD). Women in Western Australia (WA) are offered GBS screening in pregnancy and intrapartum antibiotic prophylaxis. Anecdotal evidence suggests variations in viewpoints and thus low adherence to relevant clinical guidelines amongst midwives and pregnant women in the midwifery led model of care. To date, no research has been undertaken to provide empirical evidence for these anecdotal reports, suggesting the need for research. This study has aimed to investigate the adherence to recommended GBS screening guidelines across five maternity hospitals in metropolitan and regional WA. Three objectives guided this research conducted within two different cohorts (midwifery and non-midwifery led) plus subgroups including Midwifery Group Practice (MGP), Community Midwifery Program (CMP) and Private Midwives (PM): 1) determination of GBS colonisation rates; 2) the examination of adherence to antenatal GBS screening; and 3) examination of adherence to the intrapartum antibiotic prophylaxis protocol. This retrospective WA study has employed a quantitative research design using administrative health data that included 22,417 pregnant women who gave birth between 2015 – 2019. Descriptive statistics were applied using secondary data analysis to describe the characteristics and patterns of GBS screening guideline adherence. The results were compared between all involved study cohorts. The study revealed similar GBS colonisation rates amongst pregnant women in all included study groups. A lower adherence to the GBS screening guidelines was found in the midwifery led model of care when compared to the non-midwifery led model of care. Over the five-year period, screening rates trended down in the midwifery led population whilst the numbers remained stable in the non-midwifery led cohort. When the MGP groups were compared across the five hospitals, vast variations were discovered. Further, when rates of adherence were investigated in relation to intrapartum antibiotic prophylaxis, discrepant findings emerged between the study groups. This study not only fills an important gap in the existing literature, it also seeks to assist guidance and improvement of clinical protocols in relation to GBS screening to reduce the risk of neonatal infection. Recommendations include educational interventions and the need for further research.

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Beechey, Desley. "Eureka! Women and birthing on the Ballarat goldfields in the 1850s." Thesis, Australian Catholic University, 2003. https://acuresearchbank.acu.edu.au/download/c6d1aee19568b440dda2bda267dc14a0d8f67e9d66d5d51268ec4822289f479f/1799994/Beechy_2003_Eureka_women_and_birthing_on_the.pdf.

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The Ballarat goldfields were a raucous, noisy, exhilarating place that was a tent home for thousands of men, women and children in the 1850s. The Ballarat goldrush and the Eureka Rebellion are among the most significant events in the history of Australia. They set the scene for this study titled Eureka! Women and birthing on the Ballarat goldfields in the 1850s. This qualitative study utilised and historical research method informed by a feminist perspective. This account reveals the story of women’s lives and their birthing at this time as found in historical documents. These documents revealed that the women birthed in their tents with a female friend, relative or lay midwife present. Trained midwives were rare and doctors were too expensive for the majority of poor diggers with no guarantee they were genuine. While most women birthed safely the appalling conditions, infection and birth complications all contributed to high rates of maternal and neonatal mortality and morbidity. This study has implications for both women and midwives. Hearing voices through this story of their lives and birthing will expand the understanding of issues specific to women. The sharing of the story of birthing in the 1850s will raise awareness of the connections between midwifery history and the twenty-first century giving midwives an appreciation of the past along with different perspectives and greater understanding of women and birthing so their midwifery practice in the future will be enhanced.

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Cameron, Catherine (Catherine Clare). "Including fathers in childbirth : a grounded theory inquiry of the midwife's perspective." Thesis, Department of Family and Community Nursing, 2003. http://hdl.handle.net/2123/6431.

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Morris, Sara Elizabeth. "Breeching the system: An exploration of women’s experiences in Western Australia and breech birth recommendations." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2021. https://ro.ecu.edu.au/theses/2474.

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Breech presentation creates division in the consumer and healthcare communities. A number of studies report the use of scare tactics and bullying from clinicians, when women express a preference for vaginal birth after the diagnosis of a breech presenting fetus. Despite evidence showing that vaginal birth of a breech presenting fetus is safe in the presence of an appropriately skilled and experienced clinician, Caesarean Section is the primary mode of birth for breech presenting fetuses, which has resulted in a global lack of accessibility to breech birth experienced practitioners and birth mode options for women. Women planning a vaginal breech birth in a maternity care system, where the occurrence of this phenomenon is rare, face multiple challenges. Little is known of women’s breech pregnancy and birth experiences in Western Australia (WA). A mixed methods study involving semi-structured interviews, a multinational electronic Delphi (e-Delphi) study and clinical practice guideline review was designed to explore breech presentation from the perspective of women in Western Australia, and professionals with knowledge and/or experience of caring for women with a breech presenting fetus. The clinical practice guideline review provides insight into the parameters women with a breech presenting fetus planning a vaginal birth have to work within. For the clinical guideline review, clinical practice guidelines were purposively sought from leading obstetric organisations and reviewed using the International Centre for Allied Health Evidence (iCAHE) appraisal checklist. Key consistencies and inconsistencies between the guidelines were identified. Varying levels of evidence are used to support the recommendations made by professional organisations. The inconsistencies highlighted in the review have the potential to create confusion among clinicians and women and to cause issues related to valid consent, further emphasising the importance of balanced information and universal definitions for variations such as a footling presentation. The women’s aspect of this study illustrates the experiences of some women in WA. Critical theoretical concepts of knowledge and power as described by Michel Foucault, were used to describe power relations noted during clinical interactions between women and their care providers. These findings were consistent with previous reports of coercion and bullying when women’s preferences conflicted with those of their care provider. Also identified were five distinct phases women experienced throughout their breech experience – Reacting, Information, Bargaining, Decision Making and Acceptance - which showed some similarities to the Kübler-Ross model of grief. Combining the Five Stages of Breech and Foucauldian concepts of knowledge and power facilitated the identification of areas in practice which need improvement. Midwives were seen as supportive navigators of a restrictive system. The multinational e-Delphi study explored the panel’s knowledge views and recommendations of care for breech presentation. The main findings of this aspect of the study were the Breech Care Pathway provided in a midwifery-led multidisciplinary continuity of care model, a clinical skills development and maintenance framework and the proposal of a standard definition for a footling breech presentation. Providing woman-centred care in a midwifery – led multidisciplinary continuity of care model has the potential to improve the experiences and health outcomes for women and their babies. While continued improvement is needed, steps are being undertaken, particularly by midwives, to facilitate women’s autonomy and support their birth preferences. This thesis highlights current obstacles faced by women and clinicians in relation to breech presentation in contemporary maternity care. It suggests multiple ways in which this may be achieved and provides pathways and frameworks which may be used to support this process.

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Boon, Leen Ooi, University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "Exploring childbearing women's perception of the role of a midwife." THESIS_CSHS_NFC_Boon_L.xml, 2002. http://handle.uws.edu.au:8081/1959.7/762.

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In this study, the childbearing women's perception of the role of a midwife in Australia was explored using a descriptive study. Data was gathered using a semi structured questionnaire.The findings revealed that childbearing women in Australia overwhelmingly believed a midwife is specifically trained and qualified to deliver babies normally and to care for a woman in labour.In addition, the belief was that a midwife is trained to provide a comprehensive range of maternity related tasks.The overriding themes which emerged identified the midwife as a source of advice, information, support, education, guidance, specific midwifery knowledge and being a liason person between the doctor and the pregnant woman.Limitation of the role of a midwife was believed to be due to the nursing based training of a midwife.The findings from this study revealed that childbearing women in Australia, United Kingdom and Singapore have similar perceptions of a midwife's role.Recommendations were made for further studies to investigate the reasons for a persistent lack of information regarding the role of a midwife and the type of information required by pregnant women.
Master of Nursing (Hons.)

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Chan, Seung-chuen, and 陳湘銓. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong: a comparative analysis of nurse practitioner, clinical nursespecialist, nurse midwife, and nurse anesthetist." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31972809.

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Chan, Seung-chuen. "The development of four advanced nursing roles in the United States, the United Kingdom, Australia, and Hong Kong a comparative analysis of nurse practitioner, clinical nurse specialist, nurse midwife, and nurse anesthetist /." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B31972809.

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Henderson, Jan. "Delayed motherhood : exploring expectations, anxieties and emotional impact of the transition to motherhood at mid-life (37+ years)." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2008. https://ro.ecu.edu.au/theses/216.

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A qualitative study was conducted to explore the expectations, anxieties and emotional impact of eight women having their first child after the age of 37 years. The design used semi-structured interviews to collect data in two phases. The first were conducled when participants were in their third trimester of pregnancy (26+ wecks). The second phase was conducted four to six months post-birth. The rationale for the study was that despite the continuing trend for delayed motherhood (Australian Bureau of Statistics, 2002), research on the experience of'late' motherhood is extremely limited. Women are choosing to delay motherhood for many reasons, including the need to feel emotionally prepared, finding the right partner, or after years of career success and having achieved financial stability. However, the 'biological clock' may compel women to have a child simply because timc is running out. Rapid advanccs in fertility treatment and improved levels of obstetric care have extended the opportunities for childbearing, to the extent that women are having babies up to the time of menopause, which commonly begins in the late forties (Sowers, 2000). Risks associated with 'late' babies include hypertension (Mirowsky); anxiety (Windridge & Benyman, 1999), and foetal abnormality (Benke, Carver, & Donahue, 1995). In addition, women may feel unprepared for motherhood or may experience ambivalence about their decision after many years of career development and settled lifestyle (Heckhausen, Wrosh, & Fleeson, 200I). 'Elderly primigravidae,' as they are referred to, are deemed 'high risk' by the medical profession (Mirowsky, 2002) therefore women may be expos cd to a 'culture of anxiety' surrounding their choice to have a child at what is thc beginning of the midlife phase.

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Forrester, Kim, and n/a. "The Impact of Structural (Legislation and Policy), Professional and Process Factors on the Outcomes of Disciplinary Tribunals and Committees in Cases of Sexual Misconduct and Incompetent or Unsafe Practice." Griffith University. School of Nursing, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.144659.

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This study was conducted in the context of the regulation of professional nursing and midwifery practice in the Australian health care system. In this environment, professional regulatory authorities established by State and Territory legislation in all jurisdictions, regulate and control the work of health professionals. In Queensland, registered nurses, enrolled nurses and midwives are regulated by the Queensland Nursing Council, the statutory body created by the Nursing Act 1992 (Qld). Part of the regulatory role of this and other authorities is to discipline professionals whose conduct or behaviour falls short of appropriate and acceptable standards of practice. All regulated health professionals, including nurses and midwives, are potentially subject to professional disciplinary action if a complaint is lodged in relation to their conduct. This being an important issue in the management and delivery of health care, and an increased trend among health care consumers, the dearth of existing research into the disciplinary process is a major concern. This exploratory study examined the disciplinary role of the Queensland Nursing Council in adhering to its legislative mandate to ensure safe and competent nursing practice. The study focused on the extent to which structural (legislation and policy), professional, and process factors impacted on the outcomes of disciplinary Tribunals and Committees in cases of incompetent or unsafe practice and sexual misconduct. The study was situated within the interpretive paradigm using a case study approach. Specifically, it investigated cases of sexual misconduct by nurses and unsafe or incompetent practice by midwives. The study was guided by Donabedian's conceptual framework of structure-process-outcome. This framework was seen to be most suited to the aims of the study and provided a template for in-depth analysis of the data emerging from the two cases. The findings of this study provided insight into the factors underpinning the decisions of the disciplinary bodies in making determinations and formulating outcomes. There was found to be a lack of consistency and predictability in both the legislative frameworks and the interpretation of terms and concepts used to identify conduct warranting a disciplinary response from regulatory authorities. Although the processes of disciplinary proceedings are prescribed by both legislation and policy, their practical application was characterised by considerable challenges, which resulted in varying outcomes. The thesis reports this information so that it can be used as an initial basis to build a body of knowledge from practical experience with disciplinary proceedings that will inform future processes. Subsequent case studies in other contexts and systems will increase the level of knowledge available to nurses, other health care providers, health care institutions and regulatory authorities. The initial base of evidence suggests implications for practice, education and further research which are outlined in the final chapter of the thesis.

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Forrester, Kim. "The Impact of Structural (Legislation and Policy), Professional and Process Factors on the Outcomes of Disciplinary Tribunals and Committees in Cases of Sexual Misconduct and Incompetent or Unsafe Practice." Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366609.

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This study was conducted in the context of the regulation of professional nursing and midwifery practice in the Australian health care system. In this environment, professional regulatory authorities established by State and Territory legislation in all jurisdictions, regulate and control the work of health professionals. In Queensland, registered nurses, enrolled nurses and midwives are regulated by the Queensland Nursing Council, the statutory body created by the Nursing Act 1992 (Qld). Part of the regulatory role of this and other authorities is to discipline professionals whose conduct or behaviour falls short of appropriate and acceptable standards of practice. All regulated health professionals, including nurses and midwives, are potentially subject to professional disciplinary action if a complaint is lodged in relation to their conduct. This being an important issue in the management and delivery of health care, and an increased trend among health care consumers, the dearth of existing research into the disciplinary process is a major concern. This exploratory study examined the disciplinary role of the Queensland Nursing Council in adhering to its legislative mandate to ensure safe and competent nursing practice. The study focused on the extent to which structural (legislation and policy), professional, and process factors impacted on the outcomes of disciplinary Tribunals and Committees in cases of incompetent or unsafe practice and sexual misconduct. The study was situated within the interpretive paradigm using a case study approach. Specifically, it investigated cases of sexual misconduct by nurses and unsafe or incompetent practice by midwives. The study was guided by Donabedian's conceptual framework of structure-process-outcome. This framework was seen to be most suited to the aims of the study and provided a template for in-depth analysis of the data emerging from the two cases. The findings of this study provided insight into the factors underpinning the decisions of the disciplinary bodies in making determinations and formulating outcomes. There was found to be a lack of consistency and predictability in both the legislative frameworks and the interpretation of terms and concepts used to identify conduct warranting a disciplinary response from regulatory authorities. Although the processes of disciplinary proceedings are prescribed by both legislation and policy, their practical application was characterised by considerable challenges, which resulted in varying outcomes. The thesis reports this information so that it can be used as an initial basis to build a body of knowledge from practical experience with disciplinary proceedings that will inform future processes. Subsequent case studies in other contexts and systems will increase the level of knowledge available to nurses, other health care providers, health care institutions and regulatory authorities. The initial base of evidence suggests implications for practice, education and further research which are outlined in the final chapter of the thesis.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing
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Varol, Nesrin. "Towards the abandonment of female genital mutilation – healthcare provision in Australia within the framework of global collaboration on health system response, prevention, and prosecution." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/16402.

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Female genital mutilation (FGM) refers to all procedures involving removing parts or all of the external female genitalia for non-medical reasons. As a result of migration and asylum seeking from conflict and wars, FGM has become a transnational issue, affecting more than 200 million girls and women worldwide. It is a form of gender-based violence, a health and policy issue, and violates many human rights laws. FGM has serious physical, psychological, sexual, and reproductive consequences to girls and women. As FGM has a complex socio-cultural imperative, an understanding of the driving forces of this harmful practice is key to helping communities abandon it and to providing education to all stakeholders involved from the level of the community, to healthcare professionals, teachers, civil rights, law and policy makers, migration and law enforcement organisations. FGM is on the decline, and many communities do want it to end. Addressing the human rights priorities of communities and providing them power over their own development processes are key to helping them abandon this practice. In this thesis, I address two questions. The first one is, “How do we strengthen the response of the healthcare system in Australia to best care for women and girls with FGM?” The second one is, “Focusing on the socio-cultural imperatives of FGM, how could we change our path in the global abandonment program to help communities stop this harmful practice?” My review of the literature on this topic has shown that two of the main reasons that FGM continues to be practised are pressure of social obligation in communities and lack of discourse in the public arena between men and women. In the first systematic review conducted on the topic I have highlighted the ambiguity of men’s wishes in regards to the continuation of FGM. In general, men wished to abandon it because of the physical and psychosexual complications to both women and men. Education of men was found to be the most important indicator for men’s support for abandonment. Australia is home to many women and girls from countries where FGM is practised. My thesis shows that two to three percent of women, who gave birth in a metropolitan Australian hospital, had FGM. This is the first available data on prevalence of women with FGM in Australia. My analysis also showed that women who received specialised FGM care had similar obstetric and neonatal outcomes to women without FGM. An extension of such services would further alleviate the burden among affected women and reduce healthcare costs for the Government. Accurate data collection on prevalence and complications of FGM is needed in Australia to appropriately allocate funding and develop such services. The literature and my thesis provide evidence that healthcare professionals (HCP) in countries of prevalence and those of migration, including Australia, lack knowledge on and training in the management of women with FGM. Midwives expressed a lack of confidence in clinical knowledge, skills, and data collection, as well as cultural competence in caring for women with FGM. Doctors acknowledged barriers to effective care stemming from uncoordinated care, unclear professional responsibilities, and communication difficulties. There is a need for improved education and training, supportive supervision, and evidence-based best-practice clinical guidelines and policies to address knowledge gaps and provide better management of and prevention of FGM in children. Informed by the research presented in this thesis, I developed an e-learning module for HCP in Australia to improve their knowledge on the medical, cultural, legal, and advocacy aspects. The Australian Government has addressed violence against women as an important area of focus and has been implementing a 12-year National Plan to reduce violence against women and their children 2010 – 2022. In the final paper in this thesis I propose that HCP, teachers, welfare officers, child protection officers, and government and non-government organisations involved in prevention programs on FGM, need to form a network of experts within this national framework to develop, implement and evaluate national policy and guidelines on healthcare provision, protection of girls, and prevention of FGM. The abandonment process may be accelerated through a global collaboration between governments and organisations involved in FGM programs. I have been involved in the establishment of the Africa Centre for the abandonment of FGM (ACCAF) in Kenya in 2012. A similar centre is planned in the Asia Pacific region in a country of FGM prevalence, which would collaborate with ACCAF and its partners to share research and expertise. It is my hope that the research presented in this thesis will support the work of these centres and hasten the abandonment of FGM.

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Crevacore, Carol. "Delegation practices between the registered nurse and the assistant in nursing in the acute care setting in Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2021. https://ro.ecu.edu.au/theses/2477.

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Background: Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment. Aim: The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN. Methodology: This study used a mixed method explanatory sequential design. The participants were RNs and AINs working in an acute public hospital in Western Australia. The surveys completed by the RNs (n = 100) included their attitude to delegation, the risk management process undertaken prior to delegation and the tasks that they delegated to the AIN. The surveys completed by the AINs (n = 79) included their experience with RNs during delegation and the activities they complete while working in the clinical environment. The survey data were analysed using descriptive statistics. The findings from these data informed the questions for the semi structured interviews which formed the second phase of this research. Interviews with RNs (n = 12) and AINs (n = 11) were conducted, transcribed verbatim and analysed using Braun and Clarke’s thematic analysis. Results from both phases were triangulated to provide a richer understanding of the phenomena. Results: Five factors were identified that influence the RN’s decision-making surrounding delegation: 1) personality characteristics of the RN; 2) the multifaceted act of delegation, 3) understanding of the AIN scope of practice; 4) clinical decision-making, and 5) undergraduate nursing students working as AINs.Two factors were identified that influence an AIN’s decision to accept a delegation; wanting to be thought of as a valuable team member and, the quality of the handover. Conclusion: Shortages in skilled nursing staff, financial constraints, and increasing patient acuity within healthcare have resulted in the increased use of the AIN. Nursing staff need to work effectively with these staff to ensure safe, efficient care delivery. Therefore, it is essential that RNs have the skills, knowledge and experience to delegate effectively to the unregulated workforce.

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Boon, Leen Ooi. "Exploring childbearing women's perception of the role of a midwife." Thesis, View thesis View thesis, 2002. http://handle.uws.edu.au:8081/1959.7/762.

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In this study, the childbearing women's perception of the role of a midwife in Australia was explored using a descriptive study. Data was gathered using a semi structured questionnaire.The findings revealed that childbearing women in Australia overwhelmingly believed a midwife is specifically trained and qualified to deliver babies normally and to care for a woman in labour.In addition, the belief was that a midwife is trained to provide a comprehensive range of maternity related tasks.The overriding themes which emerged identified the midwife as a source of advice, information, support, education, guidance, specific midwifery knowledge and being a liason person between the doctor and the pregnant woman.Limitation of the role of a midwife was believed to be due to the nursing based training of a midwife.The findings from this study revealed that childbearing women in Australia, United Kingdom and Singapore have similar perceptions of a midwife's role.Recommendations were made for further studies to investigate the reasons for a persistent lack of information regarding the role of a midwife and the type of information required by pregnant women.

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Heyward, Karen Lesley. "An exploration of the role and experiences of the postnatal domiciliary midwife in Victoria, Australia." Thesis, Australian Catholic University, 2013. https://acuresearchbank.acu.edu.au/download/9aa52b791fd7dfec028858fe942dce2df281682fa9ad341bcf49a63bdf3b0ab8/4468729/HEYWARD_KAREN_LESLEY_2013.pdf.

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This study aimed to explore the current professional lives, roles and experiences of homecare midwives providing postnatal domiciliary care. The changing environment of maternity care in Australia, with limited resources, has resulted in a continual decrease in postnatal hospital length of stay. Early discharge has resulted in an increased number of clients requiring home visits and domiciliary midwives are attending to mothers and babies who are experiencing increased acuity. A literature review revealed there is a paucity of research pertaining to postnatal care in the home and postnatal care is marginalised in terms of the broader context of midwifery care. There were no available studies that specifically addressed domiciliary midwives’ experiences of care in the home environment. The research design for the study was critical ethnography. There were four ethnographic methods utilised: participant observation, critical conversations, field notes and reflective journalling. Seven domiciliary midwives participated in the study. Data analysis was comprised of three aspects: qualitative content analysis—summative, deep data immersion and qualitative thematic analysis—conventional. The results revealed the role of domiciliary midwives was embedded in their experiences and participants were expert practitioners. Seven themes exemplified their role: relating with intention, autonomy, assessment, prediction, management, education and advocacy. The experiences were characterised by three themes: role complexity and negotiation, personal validation and satisfaction, and professional undervaluing. This study has contributed to the existing body of knowledge by exposing the juxtaposed position of expert practitioners who are personally satisfied yet professionally undervalued. Domiciliary midwives are dedicated to excellent service provision, operating with a vast array of knowledge, skill and experience. Despite limited resources and a changing healthcare context the safety, health and well-being of mothers and babies was not compromised.

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Leinweber, Julia. "Prevalence and Risk Factors for Posttraumatic Stress among Australian Midwives." Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367351.

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Background Midwives are frequently exposed to traumatic birth events which may place them at risk of developing posttraumatic stress (PTS) symptoms. Posttraumatic stress can reduce empathic and cognitive abilities and increase perceptions of risk and danger. PTSD research and theory have identified personal, trauma event-related and work environment related variables as risk factors for PTSD. It is not known whether these factors also apply among midwives. Aims 1. To identify prevalence of posttraumatic stress among Australian midwives. 2. To identify risk factors for posttraumatic stress and use a socioecological model to explain posttraumatic stress in midwives. Methods A national internet survey of midwives who are members of the Australian College of Midwives was conducted. Trauma symptoms were assessed with the PTSD Symptom Scale Self-Report version (PSS-SR). Probable PTSD was assessed as meeting DSM IV PTSD diagnostic criteria B, C and D (a score of at least ‘one’ on the four-point frequency scale for a minimum of one intrusion, three avoidance and two arousal symptoms) and a total PSS-SR score ≥14. The Traumatic Experiences in Perinatal Care List (TEPCL) assessed which types of birth events were perceived as traumatic by midwives. The Sensitivity in Perinatal Care Scale (SPCS) was developed to assess sensitivity in perinatal caregiving. Other measures included the Interpersonal Reactivity Index (IRI) to assess empathy and the Job Content Questionnaire (JCQ) to assess job demands and job control.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Davison, Clare Louise. "The relationship is everything : women’s reasons for, and experience of maternity care with a privately practising midwife in Western Australia." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/2085.

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The aim of this descriptive qualitative study was to investigate women’s reasons for, and experiences of maternity care with a privately practising midwife. Data analysis from the fourteen women interviewed revealed three major categories characterising reasons for choosing private midwifery care: I knew what I wanted from my care provider; I knew what I wanted from my pregnancy and birth experience and I was willing to do the research to get what I wanted.

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Minhas, Gurjeet S. "Complementary therapies : familiarity and use by midwives and women." Thesis, View thesis, 1998. http://handle.uws.edu.au:8081/1959.7/513.

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This study is an exploratory study, descriptive in nature and investigates the familiarity and practices of midwives and women with regard to complementary therapies during pregnancy and labour. The study was conducted in four major hospitals in Western Sydney, namely Nepean, Jamieson, Blue Mountains Anzac Memorial and Hawkesbury hospitals. The findings showed that in the main the midwives and women were familiar and made use of four therapies, ie. aromatherapy, massage, music and hydrotherapy. The midwives practiced without any significant training in these therapies. Hospital policies were almost non existant in relation to the practice of complementary therapies and nurses often felt frustrated at not being able to implement complementary therapies. The main issues that emerged from the study were the need for education for the midwives related to specific complementary therapies, hospital policies conducive to the practice of complementary therapies and research into the efficacy of the different complementary therapies. The women need further exposure to complementary therapies and education in the respective therapies if they are to feel empowered in dealing with the stress of their daily lives

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"Counting maternity : the measure of midwifery in Australia, 2002." Thesis, University of Technology, Sydney. Faculty of Nursing, Midwifery & Health, 2002. http://hdl.handle.net/10453/20062.

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University of Technology, Sydney. Faculty of Nursing, Midwifery & Health.
The aim of this Professional Doctorate in Midwifery is to challenge the status quo in maternity services through scholarly reflection and research. Through the studies reported here I aim to provide women with information on which to make informed choices about the services available to them, and to ensure politicians become more responsive to the lack of options currently available in Australia. My aim is also to provide measures that would allow maternity service managers to deploy resources more efficiently to achieve the best care. The majority of the papers in the portfolio are derived from population data that is routinely collected in Australia. One of the cornerstones of healthcare improvement is creating meaningful information and measurement from these collections. True comparisons from accurate data can be used to better understand the nature of the system, and to gauge whether changes have been effective. Thus, the information derived from various collections of routinely collected data is used to measure and evaluate the maternity services. This measures only part of the experience of childbirth, however. The Doctorate is a collection of nine major works undertaken in the years 1999 to 2002, during my appointment as a research midwife with the Australian Midwifery Action Project (AMAP). The first paper is an essay that tells of the juxtaposition of two different worldviews and the paradigmatic issues that shape the professional differences between obstetrics and midwifery. The second consists of a brief overview of the Australian maternity system described within the terms of reference for a Senate Inquiry into Childbirth Procedures. The third and fourth papers explore the levels of obstetric intervention for low risk women and the cost of these interventions using a new costing model derived from population data. The fifth paper reviews the contemporary issues in the workforce and education of midwives. The sixth paper outlines a proposal for funding reform and a new model of midwifery care. The seventh paper compares midwifery in Australia and New Zealand, in terms of a public health strategy. The eighth paper explores the concept of a new research method called Graffiti; and the final paper continues the theme of measurement in an essay titled 'Evidence based Everything. The portfolio explores a number of issues around public funding and the call for reform of the maternity services in Australia. In particular it argues for reforms to fund a more responsive service, based on values outlined by women who experience maternity care in Australia, as opposed to those guided by obstetrics and technology who currently set the agenda and determine the way maternity services will be offered and funded. Although I have articulated and measured some of the characteristics of midwifery and obstetric care in Australia, this disentangling or quantification merely underlies and emphasises the many more continuations and complexities that coexist beyond that, which is 'measured'.

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"Counting Maternity: The Measure of Midwifery in Australia, 2002." University of Technology, Sydney. Faculty of Nursing, Midwifery & Health, 2002. http://hdl.handle.net/2100/292.

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The aim of this Professional Doctorate in Midwifery is to challenge the status quo in maternity services through scholarly reflection and research. Through the studies reported here I aim to provide women with information on which to make informed choices about the services available to them, and to ensure politicians become more responsive to the lack of options currently available in Australia. My aim is also to provide measures that would allow maternity service managers to deploy resources more efficiently to achieve the best care. The majority of the papers in the portfolio are derived from population data that is routinely collected in Australia. One of the cornerstones of healthcare improvement is creating meaningful information and measurement from these collections. True comparisons from accurate data can be used to better understand the nature of the system, and to gauge whether changes have been effective. Thus, the information derived from various collections of routinely collected data is used to measure and evaluate the maternity services. This measures only part of the experience of childbirth, however. The Doctorate is a collection of nine major works undertaken in the years 1999 to 2002, during my appointment as a research midwife with the Australian Midwifery Action Project (AMAP). The first paper is an essay that tells of the juxtaposition of two different worldviews and the paradigmatic issues that shape the professional differences between obstetrics and midwifery. The second consists of a brief overview of the Australian maternity system described within the terms of reference for a Senate Inquiry into Childbirth Procedures. The third and fourth papers explore the levels of obstetric intervention for low risk women and the cost of these interventions using a new costing model derived from population data. The fifth paper reviews the contemporary issues in the workforce and education of midwives. The sixth paper outlines a proposal for funding reform and a new model of midwifery care. The seventh paper compares midwifery in Australia and New Zealand, in terms of a public health strategy. The eighth paper explores the concept of a new research method called Graffiti; and the final paper continues the theme of measurement in an essay titled 'Evidence based Everything. The portfolio explores a number of issues around public funding and the call for reform of the maternity services in Australia. In particular it argues for reforms to fund a more responsive service, based on values outlined by women who experience maternity care in Australia, as opposed to those guided by obstetrics and technology who currently set the agenda and determine the way maternity services will be offered and funded. Although I have articulated and measured some of the characteristics of midwifery and obstetric care in Australia, this disentangling or quantification merely underlies and emphasises the many more continuations and complexities that coexist beyond that, which is 'measured'.

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Reid, FM. "From alchemy to epistemology : intuition and private midwifery in Australia." Thesis, 2014. http://hdl.handle.net/10453/34418.

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University of Technology Sydney. Faculty of Health.
Background Intuition entered the lexicon describing midwifery practice as early as the 14th Century and it has remained a component ever since. The Australian College of Midwives (2009) philosophical statement of midwifery identifies evidence, experience and intuition as the central responsibilities of the midwife. Many fields of science have investigated intuition however limited research has been undertaken with midwives. The aim of the study was to explore how midwives in private practice understand and use intuition in an Australian context. Method A qualitative, descriptive study was undertaken using a feminist framework. Ethical approval from UTS was sought and received prior to the study commencing. Twelve midwives in private practice were recruited using purposive and snowball sampling and advertisements were placed in two midwifery magazines. Data were collected using semi structured interviews and analysed using thematic analysis. Findings All the midwives used intuition in their practice. There were two themes, trust and knowledge, showing how the occurrence of intuition was influenced by relationships and environment. Issues related to trusting the relationship with women in their care, trusting the women and trusting themselves affected the use of intuition. Midwives also identified aspects of knowledge gained from environments that either enhanced or diminished their intuition. A lack of autonomy within institutions that are dominated by a biomedical hegemony that has become mainstream for the management of women with normal, low risk pregnancy and birth was described. Using Intuition was a fundamental part of this practice. Discussion Private midwives utilise skills that are relational, involve emotion work and use knowledge that is unique to midwifery, including intuition. This research describes private midwives’ understanding of intuition and explores their use of it by using a current neuroscience interpretation called Intelligent Memory. Midwives in private practice have often removed themselves from the governance of the institution and are more autonomous than midwives practising within hospitals. Issues about authoritative knowledge and feminist theory are discussed in light of the findings. Implications for practice The study raises implications for midwifery education and practice in light of the attributes and skills that were associated with the midwives use of intuition. Further research is required to confirm the findings of this study amongst a larger group of midwives but also to investigate midwives use of intuition within an institution. This study indicates that an understanding of intuition (Intelligent Memory) could enhance the analysis and use of intuition in midwifery training, curriculum and practice.

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"Rhetoric and Reality: Narrowing the Gap in Australian Midwifery." University of Technology, Sydney. Faculty of Nursing, Midwifery and Health, 2005. http://hdl.handle.net/2100/265.

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This study draws on multiple modes of expression in texts that have been generated by my experience of midwifery development since I moved from England to Australia in early 1997. The Professional Doctorate in Midwifery at the University of Technology, Sydney (UTS) has enabled me to produce and study my work as a midwifery practitioner, researcher, educator, writer and activist and to engage in a process of scholarship that both informs and is generated by practice. This has allowed me to analyse the complex issues that I, and other midwives in Australia, face as we strategise to narrow the gap between our ideals and the realities of the professional and political constraints that challenge midwifery. The study analyses the rhetorical communications I have employed as both carriers of 'vision' and 'means of persuasion' and the deliberate strategies to make changes that I believe will benefit childbearing women. My portfolio challenges me and others, to explore how we are able to identify, enact, and convince others of the emancipatory potential of midwifery. Rhetorical innovations are therefore linked to the exposition of woman centred midwifery care; an overall goal being to enable situations in which women can experience the potential power that transforms lives, through their experiences of childbirth. In the process, I aim to produce new knowledge that will equip midwives to understand practice, policy and political situations and see new possibilities for responding and taking action. I have analysed and explained my work using a framework appropriated from rhetorical theory and drawing on a range of feminist perspectives. This involves identifying and critiquing the rhetorical innovations that I have used when trying to create possibilities and persuade others of the value of midwifery and the need to make changes happen in practice, education and regulation. My study analyses the rhetorical nature of my own work as presented in my portfolio in a range of carefully selected texts that I have authored during my candidature. These include journal and newsletter articles, conference papers, research activities, policy submissions, education and training materials, the development of midwifery standards, formal and informal communications, and other documents, all aimed in one way or another at the rhetorical strategy of stimulating interest and action. The portfolio texts that arise from this work form the empirical data that is studied. However, in varying ways these texts elicit understandings about the rhetoric and reality of Australian midwifery and the deliberate strategies that are employed by midwives to make changes that will benefit childbearing women. They therefore stand in their own right as contributions to the thesis with their own discursive and epistemological intent. The reflexive process employed in this thesis highlights comparisons between what is being positioned as the potential of midwifery with what is also presented as the reality played out in contemporary Australian maternity service provision and in midwifery education and regulation. The thesis weaves its way around the portfolio documents, attempting to bring to life and discuss the culture in which rhetorical innovations and intentional strategies are aimed at narrowing the gap between 'rhetoric and reality'.

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Gray, Joanne Elizabeth. "Learning and the follow-through experience in three year Bachelor of Midwifery programs in Australia. ‘Placements with women, not institutions’." 2010. http://hdl.handle.net/2100/1081.

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Background This research explored the follow-through experience in three year, pre-registration Bachelor of Midwifery programs in Australia. The follow-through experience involves midwifery students following women on their journey through pregnancy, labour and birth and into the early parenting period. The concept was introduced to midwifery education in Australia in 2001 when it was embedded in the foundational Australian College of Midwives. National Education Standards for Bachelor of Midwifery programs. The inclusion of the follow-through experience in Bachelor of Midwifery education programs was a deliberate strategy to ensure midwifery students would experience midwifery continuity of care. Aims The aims of this research were to: explore the follow-through experience in order to better understand its impact on students, midwifery education providers and midwives, and, to identify the learning that is associated with this experience. Setting This research was conducted in Australia. Students from all three-year pre-registration Bachelor of Midwifery programs were invited to participate. Design A qualitative study was undertaken. In-depth interviews were conducted with key stakeholders who had been involved in the development and implementation of the follow-through experience. Data were collected from former and current Bachelor of Midwifery students through an online survey and telephone interviews. A thematic analysis was undertaken and situated learning and constructivist theories were used to identify whether learning occurred in the context of the follow-through experience. Results The findings provided a unique insight into the follow-through experience from the perception of students and stakeholders. This research established that students do learn from their engagement in this experience. This learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced in undertaking these experiences, including problems with recruitment and time commitment. Difficulties were identified around requirements of the follow-through experience, the lack of support at times for students, and the lack of congruence with the existing Australian maternity system. These difficulties were identified as having a significant impact on the students. ability to engage in, and to maximise their learning from, this experience. A conceptual model was developed to provide a synthesis of the results of this research and a framework for effective implementation and management of the follow-through experience. Implications This research has implications for midwifery education, particularly in Australia but also internationally. This experience does indeed provide unique learning opportunities for students. It is however essential that the student is given adequate support to aid their learning and to ensure they gain the most from these experiences. Conclusions The follow-through experience is an innovative education strategy and this research identified that learning occurred within this experience. This learning was identified as being situated in the context of students being placed with women. This research clearly identifies the value of the follow-through experience as an important component of student learning.

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Coddington, Rebecca Lauren. "Midwives' experiences of providing publicly-funded homebirth in Australia." Thesis, 2018. http://hdl.handle.net/10453/128006.

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University of Technology Sydney. Faculty of Health.
Background: Homebirth is an uncommon event in Australia, with only 0.3% of all births occurring at home. Despite this low rate, there is evidence of consumer demand for out of hospital births. In order to meet this demand, 14 publicly-funded homebirth programs have been established in Australian maternity hospitals over the past two decades. Aim: The aim of this study was to explore midwives’ experiences of providing publicly-funded homebirth in Australia. Methods: Twenty one semi-structured interviews were conducted with midwives and midwifery managers who had recent experience of working in publicly-funded homebirth programs. A constructivist grounded theory approach was taken to enable exploration of the underlying social interactions and processes in the area of inquiry. Findings: Four overarching categories emerged from the data. These were: ‘Making the leap from hospital to home’, ‘Seeing birth in a new light’, ‘Building trust’ and ‘Recognising the benefits of publicly-funded homebirth’. Hospital-based midwives who were exposed to homebirth for the first time found their perspective of birth was transformed. Midwives noted a shift in the power dynamics when on the woman’s territory and many felt they were witnessing undisturbed birth for the first time. Midwives and midwifery managers faced challenges in establishing and maintaining publicly-funded homebirth programs. They needed to develop strong, collaborative working relationships with doctors and endured a high level of scrutiny regarding their practice. Overall, the majority of midwives enjoyed working in the model and felt it helped normalise homebirth as an option for low-risk women. Discussion: Homebirth has previously been regarded as being both geographically and ideologically distant from the hospital. The operation of publicly-funded homebirth programs, however, defies this characterisation by providing a homebirth service via public maternity hospitals and hospital-based midwives. The establishment of publicly-funded homebirth programs within Australian hospitals appears to have had a positive effect on attitudes towards homebirth, not only for women and midwives, but for allied healthcare providers who were previously mistrustful of homebirth. Conclusion: The transition from hospital-based to homebirth care provided an opportunity for midwives to work to the full scope of their practice. When well supported by colleagues and managers, transitioning into publicly-funded homebirth programs can be a positive experience for midwives. Additionally, exposure to homebirth has the potential to transform maternity care provider’s attitudes towards homebirth and significantly deepens their understanding of normal physiological birth.

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Hewitt, Leonie M. "What attributes do Australian midwifery leaders identify as being essential to effectively manage a midwifery group practice (MGP)?" Thesis, 2017. http://hdl.handle.net/1959.7/uws:44549.

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Background: Midwifery Group Practice (MGP) is a service where women are cared for by one primary midwife, supported by another midwife or group of midwives, who work in partnership with them across all stages of the pregnancy, birth and postnatal period, within the public hospital system. MGP outcomes consistently show reduced medical interventions and high levels of satisfaction for women yet only 8% of women in Australia have access to this option of care. Midwives working in MGP are shown to display a higher job satisfaction and occupational autonomy compared to midwives providing standard hospital care. Management of services is closely aligned with staff retention and satisfaction and so is critical to MGP sustainability. Since little is known about the attributes of a manager for effective management of these services, this research is urgently needed to help ensure these models of care are sustainable. Aims: The aim of this project was to discover the attributes required in a manager of a MGP in Australia in order to effectively manage the service. Methodology: A qualitative approach using thematic analysis was used in this study. Eight midwifery leaders were purposively sampled and interviewed ace-to-face using semi-structured open-ended questions. The interviews were audio-taped and transcribed for analysis. Findings: The overarching theme ‘Holding the ground for midwifery, for women’, described the role of the MGP manager as someone who stands up for midwives and women. Three themes demonstrate the complexity of the role of the manager and the intrinsic traits that make an effective leader, described as ‘having it’, the actual job of management captured under the theme ‘someone with their hand on the steering wheel’ and the job of ‘juggling forces’ that surround MGP. The theme ‘Helping managers to manage better’ describes the preparation for the role and the support required to help the manager in this demanding position. Conclusion: The findings of this study will contribute to knowledge about what is required for effective MGP management to help enhance sustainability of these services and how best to prepare the managers for this role. Development of effective management and leadership styles could contribute to adopting a healthy, progressive culture within the hospital hierarchy. It is hoped this study will contribute to further research into midwifery management, MGP sustainability and barriers to MGP.

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"The Invisibility of Midwifery - Will developing professional capital make a difference?" University of Technology, Sydney. Faculty of Nursing, Midwifery and Health, 2003. http://hdl.handle.net/2100/339.

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Serious questions need to be asked about the current status of midwifery in Australia. This doctorate examines the lack of recognition of midwifery as an autonomous profession and its consequential invisibility in Australian maternity care.Despite the significant amount of evidence that continues to accumulate to support the expansion of midwifery models of care, such changes have not been widespread in Australia. An examination of international, national and local health policy and strategic direction in maternity services, together with a critique of contemporary Australian midwifery and the role of the midwife within the public health system, provide the rationale and context for the study. The 'case' for introducing improved systems and models of maternity care is developed with regard to the evidence for increasing the utilisation of midwifery. The doctorate argues for greater visibility and recognition of midwifery in Australia with a focus on the role of midwifery leadership and its potential to improve collaboration. A number of case studies report experiences and insights of leadership and collaboration across different contexts: clinical practice, organisation of health services and health policy leadership in maternity services. The result is a comprehensive understanding of the reasons for the lack of visibility of midwifery and the potential costs of such a situation continuing. The exploration of this situation highlights the barriers to recognising and acknowledging midwifery itself. Attention is drawn to the continuing lack of voice and visible leadership in Australian midwifery, with midwives being absent from decision-making in situations whereothers, predominantly nurses and doctors, speak 'for' them. This work examines the barriers to midwives forming alliances and working to influence government agendas at the social, organisational and political level. Exploration of the power structures and hierarchical constraints that exist reveals particular barriers and highlights what is needed to address the impending decline of the profession in Australia. The enhanced capacity that midwives would experience if their work were to be understood, recognised and valued in the provision of maternity services in Australia, is postulated through the development of a construct called 'professional capital'. Drawing on several theoretical perspectives, it is argued that the notion of 'professional capital' is dependent on a strategy of focused and deliberate leadership and collaboration within maternity services and the creation of positive social networks and affiliations amongst midwives. Professional capital would enable greater visibility and recognition of midwifery and a more effective midwifery contribution to maternity services. It is suggested that improved professional and societal recognition will ultimately enhance the professional performance and self image of midwives. Such developments will enable new and effective ways of supporting and strengthening inter-professional relationships and systems of care that will, in the long term, improve the outcomes and experiences of women who access maternity services.

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Gilmour, Carole. "Renovating midwifery care : the complexity of organisational change for midwives in Victoria, Australia." 2009. http://hdl.handle.net/2100/1072.

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The importance of the role of the midwife in providing safe, quality care for women has until recently, been underrated in Victoria, Australia. Acknowledgement of the need for midwife-led models of care in state maternity service policies provided opportunities for midwives to become recognised within the healthcare system and the wider community. This professional doctorate aims to examine the ways in which the role of the midwife and her practice has been impacted on by organisational renovations of midwifery care. It identifies the complexity of the factors that affect the midwife’s ability or choice to work in midwife-led models of care. Furthermore this doctorate highlights the need for ongoing debate into midwifery in Australia. Concepts related to midwifery practice are examined as they form the foundations for the research and policy components of the portfolio. This includes an exploration of midwifery philosophy, the antecedents to autonomous practice and the experience midwives have of midwife-led care. An examination of the concepts of continuity of care and woman-centred care provides a platform upon which to review models of midwifery care. This review highlights the development of an ongoing relationship as a source of satisfaction for midwives and women. The second part of the doctorate reviews policies that guide the provision of maternity services in Victoria. Analysis of these policies using Kingdon’s multiple streams framework identifies the problems, the political actors and the policy developed, establishing the context for organisational change in maternity care. The antecedents for successful integration of organisational change are explored through a review of change theory and leadership. A case study approach utilised for the research component of the doctorate provides insights into organisational change that occurred at two maternity sites in Victoria. The findings of the study suggest there was a dichotomy between those midwives desiring autonomous practice and wanting to work in midwife-led care and those wishing to remain in one specialised area. Recommendations stemming from these findings include the need for sufficient education and support during change, a review of terminology used to describe midwifery models of care and research into the use of integrated maternity units. Complexity science is examined in order to bring the different strands of the doctorate together, providing an explanation for the different outcomes that occur despite the implementation of similar models. The connective leadership model was suggested as the means to provide leadership that is inclusive of providing direction, mentoring new leaders and providing support and opportunities for midwives to become empowered to practice autonomously. Attention to the complexity of organisational change is vital to ensure the future of midwifery.

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Brown, Elvira. "Professional Identity in Interprofessional Education: Midwifery Narratives." Thesis, 2019. https://vuir.vu.edu.au/40591/.

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Interprofessional education (IPE) has been found to improve patient outcomes and increase health practitioner career satisfaction according to The World Health Organization (2010). Despite these identified benefits arising from over thirty years of IPE research in a global context, there is still surprisingly little evidence with regard to how midwives develop their professional identity within the context of IPE. This study examined the interprofessional aspects of professional identity development for students and qualified clinicians in midwifery, including midwifery clinical educators and midwifery academics. This study utilised the theoretical framework of social constructionism. There were fifteen participants involved from three Australian universities, one hospital and one community setting. Using narrative inquiry as the methodology, stories were collected using in-depth interviews and a narrative approach. The individual stories were examined for revelations into the meanings drawn by each participant using a thematic analysis approach. Five themes emerged from the data. These were: shared misconceptions; shared understandings; shared misdirections; shared professional values; and shared misgivings. Then each story was examined for commonalities and differences of meaning drawn across all of the participants, congruent with Clandinin and Connelly’s (2000) narrative inquiry space (NIS) analytical approach of relational, temporal and spatial. From this interpretive analysis, a further lens was developed to more adequately present the interpretation of the participants’ narratives which could not be accommodated with the NIS. This resulted in the fourth element of ‘fluidity’ comprised of the influencers of ‘empowerment’, ‘competence’, ‘value’, and ‘respect.’ It is through the element of fluidity that the nascent nature of professional identity of the midwife in interprofessional education has been explored and presented. Thus, a theoretical understanding of the intersection between IPE and professional identity development in midwifery has been illuminated as a way to potentially enhance the efficacy of interprofessional practice, education and research. Moreover, the focus on student and registered midwives, both in the education sector and in the clinical environment is critical because, as the midwifery workforce, they are charged with the ongoing development of midwifery as a profession promoting improved patient outcomes, their own professional identity and interprofessional practice.

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"Birthing business in the Bush: It's time to listen." University of Technology, Sydney. Centre for Family Health & Midwifery, 2005. http://hdl.handle.net/2100/320.

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The challenge of ameliorating or preventing the health problems of Indigenous Australians living in remote areas is compounded by the profound professional, cultural, social and personal isolation of the health professionals who work there. This isolation has direct effects on the recruitment and retention of health professionals to remote communities, and their ability to work effectively in this unfamiliar environment. The overarching goal of this research was to strengthen the capacity of these professionals to improve the quality of remote area maternity services in Australia and the experiences and outcomes for birthing women and their families. This was achieved by investigating a process of engagement with a wide range of stakeholders and utilising contemporary communication technology through the Internet. A case study approach was undertaken using participatory action research (PAR) with the elements off rapid assessment, response and evaluation methods (RARE). The research explored, described and analysed the development of resources aimed at decreasing isolation and increasing communication in the remote setting. Identifying the barriers, facilitators and utility of an information technology intervention was an integral part of the investigation process. The first case study saw the development and evaluation of the Maternity Care in the Bush Web Based Resource Library, designed to decrease the isolation of practitioners from the educational resources and professional expertise available in current literature, guidelines and reports. The second case study targeted isolation from peers, with the development and evaluation of the Remote Links Online Community. This was designed to build partnerships between isolated practitioners, for the purpose of interactive peer support, information exchange and mentoring. The third and fourth case studies were guided by Aboriginal researchers and resulted in the development of the Birthing Business in the Bush Website, designed to decrease practitioners' isolation from cultural knowledge. An integrated component of this Website is the Primary Health Care Guide to Planning Local Maternity Services, designed to decrease the isolation of the health care practitioner from the community in which they are working. Issues related to conducting research in the Australian Indigenous setting have been explored, analysed and detailed. Each case study contributed new knowledge and learning about the challenges and contemporary contexts of remote area maternity service provision in Australia. The use of PAR, and, most particularly, how this can be used in Indigenous research to produce goals that extended beyond the individual researcher's goals, has been described. The current difficulties associated with computer mediated communication, as experienced by remote practitioners, have been highlighted. The research has identified areas of need within the workforce that, if addressed, could contribute to improved health services. Importantly, the research has documented, acknowledged, honoured and disseminated the voices of Aboriginal women, through the far reaching communication technology that is the Internet. Furthermore, the voices, concerns and conditions of remote maternity services providers were also documented and acknowledged. This workforce, often invisible and poorly valued, was assisted and supported to provide evidenced based, culturally appropriate maternity care, through the resources that were developed. To further progress the lessons taken from the research, recommendations have been developed and are listed in the Conclusion.

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Passant, L. "Exploring the key elements required for midwives to develop a new model of postnatal care within an acute care setting." Thesis, 2012. http://hdl.handle.net/10453/20419.

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University of Technology, Sydney. Faculty of Nursing, Midwifery and Health.
Aim This research aimed to explore the key elements to improve the quality of postnatal care provided to women in a public hospital postnatal ward in Sydney and to attempt to implement a new model of postnatal care. Background Reports, internationally and nationally, indicate that women are least satisfied with hospital-based postnatal care when compared with antenatal, labour and birth care. Many researchers have identified the components of postnatal care that women find most helpful however, there continues to be barriers to develop and test innovative approaches or models of postnatal care within hospital settings. The focus of this project was to try to move the postnatal ward to a culture that is woman and baby centred rather than illness or institution-centred. The development process drew on Practice Development approaches that would enable midwives to facilitate change in the environment and culture of the postnatal ward with a view to improving postnatal care for women and their families. Method A qualitative descriptive study, using a three phased approach, was adopted for this research. Phase one was to identify the issues and concerns by conducting focus groups with staff. Phase two challenged usual practices and explored new ways of providing care in the postnatal ward. This phase incorporated working with the staff utilising Practice Development approaches. The third phase explored with key stakeholders the outcomes and issues of phase two including the barriers and limitations to enable midwives to implement a new model of postnatal care. Findings There were a number of barriers for change to occur including the current system of maternity care provided to women. This has also been reported by others over the past few decades. Within an acute care hospital environment, the midwives struggled to provide quality midwifery care with a philosophy of care counter to that which had been imbedded over many years. Midwives were caught up managing the day to day issues and most were unable to reflect on the care women received or to have the time to contemplate changes. Challenging the usual rituals and routines with the midwives generated some attainable changes that included providing women with more information about what to expect following birth and updated policies for healthy women and babies. The policies reflect the latest evidence and a more woman and baby centred approach to a daily assessment. This research also explored ways for midwives to be able to spend more time with women, and included challenging the everyday non-midwifery tasks undertaken by midwives working within the hospital system. These non-midwifery tasks included managing administration, security, catering and domestic duties. Barriers towards providing a more woman and baby centred way of providing postnatal care included the need for further professional development of the midwives and more professional support. There was also a need for role modelling of womancentred approaches to care and the development of a different way of providing care that included midwifery continuity of care. Conclusion Maternity services in hospitals have been subsumed into the general wards often governed by sickness priorities and it is acknowledged changing to a more womancentred approach was challenging. Without support from leaders, the change towards a woman-centred approach may not happen within the constraints of the medicalised model. Implications for Practice My research found a number of implications for others planning improved postnatal care for women in an acute care setting. Key elements included the need for midwives to have a clear articulation of their vision for the ward. Change may not happen if midwives do not believe the benefits of providing individualised care that meets the needs of the women. For this to be realistic and achievable, strong visionary leadership is key to moving the ward vision forward and implementing a new model of care. The timing for change in this setting is critical. It is unreasonable to implement change with midwives during a period of restructure. This can have a negative impact on successful change by threatening the midwives personal sense of control. In summary, this research found that effective leadership, adopting a shared vision, providing high support and high challenge were all important elements to support moving towards a more woman-centred care approach. Threatening the midwives sense of control over their professional world was also found to be an important factor when attempting to bring about change and will be discussed in this thesis.

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Browne, Jenny. "The midwife's present." Thesis, 2008. http://handle.uws.edu.au:8081/1959.7/489966.

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This thesis develops an approach to midwifery that is more open to the (un)known, to the (un)thought, to the (im)possible. It argues for practitioners who have an ethical responsibility to embrace difference and to welcome the other. In this thesis I write of ways midwives and others ‘word the world’ and act in it, in order to understand how midwives can and do embrace opening themselves to possibilities and difference, in order that childbearing women will not have their possibilities for personhood closed. As a midwife and a midwife-academic, I ask how current discursive practices in midwifery and childbearing function as they do. Using the techniques of ‘writing as inquiry’ and genealogy I bring to the foreground ways in which midwives think and act with and against the grain in the maternity health care system. Interrogating overlapping and competing discourses in midwifery, I work to understand how discourses produce at the same time numerous identities and accompanying ambivalence. In seeking understandings of the work that women do to constitute themselves as midwives, I write of midwives’ political and ethical moves towards and away from difference and towards and away from sameness, rules and order. While midwifery does not generally recognise itself in poststructuralism, midwifery is (sometimes often) a poststructural practice. As I spotlight moments in which midwives already move in poststructural ways, I argue that a serious reflexive turn for midwives towards poststructural theory and practice is easily imaginable, and desirable. The thesis argues that theories and practices which help midwifery move closer to the (un)known, the (un)thought, the (im)possible are ethically and politically responsible. In embracing difference and welcoming the other, childbearing women and midwives together may create their best chances yet for viable mothering and midwifery lives. This is the ‘possibilities work’ midwives and midwife-academics can do.

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James, Jennifer P. "An analysis of the breastfeeding practices of a group of mothers living in Victoria, Australia." Thesis, 2003. https://vuir.vu.edu.au/15279/.

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This research attempted to identify the causes of and variables associated with early weaning (during the first three months) by breastfeeding women. Prior to 1970, there was a decline in breastfeeding rates, with a gradual increase during the 1970's and 1980's. Since the late 1980's, even with increased knowledge, evidence about the benefits and health promotion activity, rates remain relatively static. Of particular concern is the early postnatal through to three months of age group, where there continues to be a marked drop out of almost 50%. This was a descriptive longitudinal study of 682 primiparous and multiparous mothers and their babies that collected both qualitative and quantitative data via a series of self-administered questionnaires. They were completed at three monthly intervals over a period of up to twelve months. Participants exited the study following weaning or at the baby's first birth.

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Sheehy, Annabel Dorothy. "The early workforce experiences of midwives who graduated from two different education courses in Australia." Thesis, 2016. http://hdl.handle.net/10453/52938.

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University of Technology Sydney. Faculty of Health.
[Background] There are workforce shortages in the nursing and midwifery professions in Australia. Many factors have been associated with these shortages such as high workloads, an inadequate skill mix, low nurse/midwife-to-patient/woman ratios, and heightened acuity, all of which can lead to professional burnout for staff. Connected to these shortages are perceptions of inadequate remuneration, experiences of bullying and work-related stresses, the lack of managerial action to tackle these issues and a perceived lack of opportunities for career diversity and progression. Much of this is well known in the nursing discipline, however it is unclear how these factors are similarly impacting midwifery and therefore, research into the workforce experiences of Australian midwives is timely. [Objective / Purpose] To explore early workforce participation trends, experiences and choices of midwives who graduated from one Australian university (graduating years 2007 and 2008). Participants were educated either in Bachelor of Midwifery or Graduate Diploma of Midwifery programs (n = 113). Further objectives of the study were to identify work environment and personal factors that may influence workforce experiences, and to compare any workforce trends by midwifery course. [Methods] A sequential explanatory mixed methods design was conducted. Phase 1 survey collected mainly quantitative demographic and workforce participation data. Three validated instruments were also used: Maslach Burnout Inventory (MBI); Practice Environment Scale of the Nursing Work Index (PES-NWI); and Perceptions of Empowerment in Midwifery scale (PEMS). Due to sample size restrictions, analysis was restricted to non-parametric measures including frequency distribution and simple correlations (p ≤ 0.01). Phase 2 was a qualitative study using semi-structured interviews with qualitative content and contextual analysis. [Results] In Phase 1, the survey response rate was 66 percent (n = 75). Fifty-nine were working as midwives, half of them in full-time employment. Personal factors contributing to workforce choices were only a cause of concern for a small number of midwives. The main reason for having exited from the profession was child rearing. There was a low degree of burnout and high levels of empowerment. Inadequate clinical resources and ineffective managerial support in the workplace were also identified. Bachelor of Midwifery participants were older than the Graduate Diploma midwives but no other relationship between the midwifery course and any of workforce measure existed. In Phase 2, 28 participants were interviewed. Three themes, each comprising of subthemes, were generated: (i) ‘sinking and swimming’; (ii) ‘needing a helping hand’; and (iii) ‘being a midwife… but’. The initial transition into midwifery was overwhelming for most participants, particularly when providing intrapartum care. Coping within the experience was dependent upon support. Job satisfaction was strongly related to the midwife-woman relationship and working to the full scope of practice ability, both which encouraged midwives to remain in midwifery. Dissatisfaction stemmed from poor remuneration, inflexibility of rostering, high workloads and poor managerial approaches. Experiences of bullying were ubiquitous. Factors inducing midwives to stay in the midwifery profession were not the absence of those that caused dissatisfaction. The midwife-woman relationship sustained their practice despite those factors that generated job dissatisfaction. [Conclusion] Elements of the early workforce experiences of these midwives paralleled many of those evident in the Australian nursing profession and similar workforce factors contributing to job satisfaction and dissatisfaction were identified. The midwife-woman relationship was a source of job satisfaction and inspired these midwives to remain in midwifery. Exiting the profession- temporarily or permanently- was mainly due to child rearing. [Implications for practice] Any vacuum created by eliminating factors of job dissatisfaction will require an amplified investment of factors that bring job satisfaction in order to have genuine content in midwives. Strategies that deliver transitional support, rostering flexibility, leadership training and address workplace bullying, will be ameliorative in the face of staffing shortages. Employment models that enhance relational aspects of midwifery are integral for job satisfaction in midwives. Health systems and services have a duty to support the continued professional development and accessibility of career progression for midwives, to allow individuals to cultivate their midwifery skills and work to their potential.

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Garvan, Joan Frances. "Maternal ambivalence in contemporary Australia: navigating equity and care." Phd thesis, 2010. http://hdl.handle.net/1885/49388.

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The thesis argues that an important step in an agenda calling for change is a re-signification of the mother–infant connection from a role to a relationship so as to embed the subject position of the woman-as-mother and enhance her reflexive stance. It identifies intersections between structure and agency as played out in the lives of a small group of women in the early years after the birth of their first child. It contributes to a call for transformational change so as to accommodate dependency while attending to gender equal outcomes. The study is multidisciplinary, bringing together gender, sociology, psychoanalysis and health through a conceptual framework informed by the work of Pierre Bourdieu, Cornelius Castoriadis, Jessica Benjamin and Lois McNay. It locates the work of care through the dependency theory of Eva Feder Kittay and Martha Fineman and the proposition that both the state and the market rely on the family for care. Data are drawn from in-depth and semi-structured interviews with sixteen first-time mothers from Sydney and Canberra. The participants self identified from posters circulated through playgroups and childcare centres from northern, southern, eastern and western suburbs to ensure a diverse sample. What has generally been thought of as a paradox between the rights of women and an assertion of gender difference associated with the maternal body can be recast in terms of tensions. The family as a social unit in the early twenty-first century is marked by tension and change evidenced through the experience of women when they first become mothers. Research that focuses on the early years after the birth of an infant under the banner of the Transition to Parenthood brings to light gendered economic outcomes, maternal stress, depression and a decline in marital satisfaction; in essence a mismatch between expectations and experience that is played out through the sense of self. This is a consequence of a divergence between cultural trends and social structuring with a lack of recognition of both intersubjective dynamics between women-as-mothers and their infants and intrapsychic processes of the self. I cast this dissonance in terms of tensions between macrosocial and microsocial factors. A disjuncture is evident through the ambivalences of these new mothers. In the interview data there is a sense of displaced self, difficulties reconnecting with former lives through the workplace, and often disruptions within families arising from unfulfilled expectations. There is nevertheless a strong and abiding connection with their infants. Motherhood is often characterized as selfless. The needs and interests of the infant/child became paramount and this is seen as a good thing, a moral imperative. Identifications with one’s mother and/or the projected interests of the child or family promote continuity while everyday expectations and practices within families point to change. Women have historically promoted both social and cultural capital through asserting the interests of their families and child/ren. However, attending to these related tasks generally comes at an economic cost and at a cost to their health. There is a significant body of both academic and popular texts reflecting on the experience of being a mother at the microsocial level which is accompanied by a common experience of ambivalence in locating the maternal self. There is evidence of movement for change at the macrosocial level through a rethinking of welfare economics, feminist proponents calling for a public ethic of care, trends towards a gender equal or egalitarian family form, a feminist mothers’ movement, and the emergence of a concept of social care.

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English, Carolyn J. "The experience of the menopause and climacteric of women in Australia from a non-English speaking background." Thesis, 1997. https://vuir.vu.edu.au/33014/.

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Naturalistic inquiry was the method used in this qualitative study, examining the experience of the menopause and climacteric of women in Australia from a non-English speaking background. Women form over one-half of the Australian population, with 12% of this number being from a non-English speaking background country, and 14% of these women speaking a language other than English (LOTE) in the family home. These women seek health-care in a care system which was established and is maintained in the Anglo-Celtic tradition. As these women approach the menopause and the climacteric years, how culturally appropriate is our health-care service for these women? The study was conducted in the Western suburbs of Melbourne which has a higher percentage of people born overseas (34.6%) than the national or Victorian percentage of 22%. Data was collected by in-depth interviews with 33 women from the countries of Vietnam, the Philippines, China, Malta, Italy, Greece and Lebanon. Issues explored and contained in the data included the women's difficulties with their own health at the time of menopause, the significant beliefs and practices about menopause in their countries of origin, availability of culturally relevant information and treatment in the health care system. Findings included negative attitudes to menopause and usage of hormone replacement therapy, cultural overtones in the women's beliefs about menopause, religion being a determinant in acceptance and coping with menopause and the climacteric, inadequate information provided by health-care professionals, and the unavailibility of printed information in the appropriate language. The provision of Medicare was an important factor in the women's ability to access health care. As Australia is a multicultural country, it would appear from this study that the health-care system needs to address the issue of culturally congruent care.

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Burns, Elaine. "Mining for liquid gold : an analysis of the language and practices of midwives when interacting with women who are establishing breastfeeding." Thesis, 2011. http://handle.uws.edu.au:8081/1959.7/538420.

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This thesis reports on a qualitative study of midwifery support for women who are breastfeeding during the first week after birth. In Australia, nine out of ten women initiate breastfeeding, yet the average duration of breastfeeding is well below World Health Organization recommendations. Approximately one quarter of women who commence breastfeeding, cease, or introduce supplemental formula, during the first few weeks after birth. This is a time when midwives are available to provide support. However, women report widespread dissatisfaction with midwifery care during the early postnatal period, particularly hospital-based care. The aim of this study was to examine the nature and impact of the language and practices used by midwives when providing breastfeeding support in the early postpartum period. Identification of the facilitative or inhibitive components of support, as well as insight into the impact on women, can lead to improvements in midwifery practice and inform the education and training of midwives. This study is underpinned by a social constructionist epistemology, situating an understanding of reality within a social and cultural frame. A post structuralist approach informed the methodology and discourse analysis has been used to examine the way in which language and discourse shaped the beliefs and practices of participating midwives, and postpartum women, around breastfeeding. Data were collected from midwives and breastfeeding women at two geographically distant maternity units in New South Wales. This study is based around the observation of midwife-woman interactions during the provision of breastfeeding support in hospital, and, to a lesser extent, in home environments, during the first week after birth. In total, 85 breastfeeding interactions between women and midwives were observed, audio recorded and then transcribed verbatim. Additional perspectives were gathered from participants at 34 individual interviews and four focus group discussions. Nine antenatal breastfeeding education sessions were also observed and audio-recorded, to gain an insight into the language used to describe breastfeeding during pregnancy.

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Ferrigno, Peter A. "A reading of qi: being in a world of qi in contemporary Melbourne." Thesis, 2007. https://vuir.vu.edu.au/16071/.

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This thesis begins with the author reflecting on his practice experience, as a traditional acupuncturist, through which the research question is posed. The research represents a kind of cross-cultural encounter whereby the interpenetration of cultures and ideas alerts us to new and different ways on how knowledge is garnered and impacts on lived experience with reference to the Chinese medical idea of qi. Unlike the usual interpretation of a cross-cultural encounter, the cross-cultural meeting to which I refer is occurring in a local Australian setting, whereby ancient medical ideas and practices are being interpreted, applied and experienced. Construed as a form of naturalistic inquiry and as a critique of the Western episteme, Chinese medical ideas and the worldview it presents provided the base from which this thesis emerges. Guided by contemporary interpretations of naturalistic inquiry, the thesis sets out to explore how Australian born and trained acupuncturists, working with Australians, reflect on their experience of and with qi. The thesis is premised on the idea that being in the world may be construed as qi manifest. At the same time, qi offers a praxis for apprehending our being in the world.

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Taylor, Ann. "Childbirth practice and feminist theory:re-imagining birth in an Australian public hospital." Thesis, 2003. http://hdl.handle.net/1959.13/41751.

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Research Doctorate - Doctor of Philosophy (PhD)
The thesis involves a re-examination of feminist views of the childbearing body from a post-structuralist perspective and applies these theoretical ideas to an empirical investigation into contemporary childbirth and midwifery. Critiques of medicalised childbirth developed in Australia, Britain and the USA in the 1970s are related to debates within feminism about appropriate ways to theorise motherhood and the female body as well as to understand the role played by midwives and doctors in childbirth. It is argued these critiques were the product of three strands of feminism that differed in their analysis of gender politics, their philosophy of knowledge and their understanding of power. The three critiques are also related to differences between the USA, Britain and Australia in respect of their medical system, ways in which the history of childbirth practices are viewed and differences between the professional roles of midwives. It is argued that these critiques need to be modified by more recent post-structuralist feminist approaches, particularly the way in which bodies are shaped by language and power is related to the distribution of knowledge The empirical study concentrates on a maternity unit in a regional town in New South Wales. The unit was studied through repeat interviews with mothers attending the hospital for the birth of their second or a later child, interviews with the midwives and doctors working in the unit and observations over several months. Childbirth is re-imagined as a drama and found to be an intense embodied experience shaped in turn by the practices of the hospital and the changing boundaries between medicine and midwifery, relationships of the women with the staff and the women’s own diversity. This approach to the analysis of the interview data demonstrates the limitations of the liberal feminist critique that there is insufficient rational and ‘scientific’ evaluation of childbirth practices, the radical feminist critique that the key issue is men’s domination of women’s bodies and the materialist feminist critique of the lack of fairness and support given to childbearing women, while showing how these discourses continue to circulate in debates over the management of childbirth.

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Taylor, Ann. "Childbirth practice and feminist theory:re-imagining birth in an Australian public hospital." 2003. http://hdl.handle.net/1959.13/41751.

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Research Doctorate - Doctor of Philosophy (PhD)
The thesis involves a re-examination of feminist views of the childbearing body from a post-structuralist perspective and applies these theoretical ideas to an empirical investigation into contemporary childbirth and midwifery. Critiques of medicalised childbirth developed in Australia, Britain and the USA in the 1970s are related to debates within feminism about appropriate ways to theorise motherhood and the female body as well as to understand the role played by midwives and doctors in childbirth. It is argued these critiques were the product of three strands of feminism that differed in their analysis of gender politics, their philosophy of knowledge and their understanding of power. The three critiques are also related to differences between the USA, Britain and Australia in respect of their medical system, ways in which the history of childbirth practices are viewed and differences between the professional roles of midwives. It is argued that these critiques need to be modified by more recent post-structuralist feminist approaches, particularly the way in which bodies are shaped by language and power is related to the distribution of knowledge The empirical study concentrates on a maternity unit in a regional town in New South Wales. The unit was studied through repeat interviews with mothers attending the hospital for the birth of their second or a later child, interviews with the midwives and doctors working in the unit and observations over several months. Childbirth is re-imagined as a drama and found to be an intense embodied experience shaped in turn by the practices of the hospital and the changing boundaries between medicine and midwifery, relationships of the women with the staff and the women’s own diversity. This approach to the analysis of the interview data demonstrates the limitations of the liberal feminist critique that there is insufficient rational and ‘scientific’ evaluation of childbirth practices, the radical feminist critique that the key issue is men’s domination of women’s bodies and the materialist feminist critique of the lack of fairness and support given to childbearing women, while showing how these discourses continue to circulate in debates over the management of childbirth.

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Long, Debbi. "Dissolving the solid body: an ethnography of birthing in an Australian public hospital." Thesis, 2016. http://hdl.handle.net/1959.13/1312082.

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Research Doctorate - Doctor of Philosophy (PhD)
Based on ethnographic fieldwork undertaken in the maternity unit of an urban Australian public hospital, this thesis explores metaphors derived from material density as major ordering principles in western understandings of the world, and argues that logics of solidity and fluidity underpin lines of contestation in scientific, academic, and biomedical/health discourses. Through an exploration of social and scientific understandings of the human body, the thesis argues that the body as a fluid, dynamic phenomenon is frequently understood, in biomedical culture, through a logic that is inherently ‘solid’. Solid logic is privileged over fluid logic in hospital environments, which has particular consequences for maternity and birthing care. While medicalised birthing has contributed to improvements in maternal and infant safety and well-being across the western world, inappropriately medicalised birth can be both traumatising and iatrogenic. Feminist contestations to the medicalisation of pregnancy and birth, and obstetric resistance to these contestations, can be seen as contestations between epistemologies centered on (more) fluid or (more) solid understandings of the world. Risk management is shown to be reliant on strategies of material and symbolic solidification, often to the detriment of the inherent fluidity of the maternal body. Constructions of individual autonomy rely on the construction of a bounded body that is often in contradiction with experienced biological corporeality. The thesis argues that fluid logic offers space for maternal corporeality, however the individual autonomy required by the western health consumer is only achievable within a framework of solid logic. Ethnographic engagement with pregnant and birthing women, their partners and families, midwives, obstetricians and other hospital professionals allows for an analysis of embodied and discursive beliefs and practices. The rich complexities of technologised birthing are highlighted in explorations of clinical encounters and key decision making moments in birthing and maternity care.

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Nunn, Julie M. "A sample of female Australian tourists' travel health intentions and behaviour while holidaying in south east Asia." Thesis, 2001. https://vuir.vu.edu.au/17918/.

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Over 456,000 Australians spend time holidaying in South East Asia each year; it is Australia's top tourist destination. Much of the attraction of South East Asia is the novelty of exotic tropical environments. However, these can result in strange and diverse health hazards. This exploratory research used sequential in-depth interviews to explain the relationship between the travel health advice tourists receive and their behaviour while holidaying in South East Asia. When providing travel health advice to tourists travel health advisers need to understand the psychology underlying reasoned behaviours such as travel health behaviours if they want to persuade tourists to practice preventative health measures. After review of the relevant literature it would appear that this is the first time that the theory of reasoned action, developed by Ajzen and Fishbein in 1980, had been used to explore travel health beliefs, attitudes, intentions and behaviours. The research found that the travel health advice received by tourists had marginal effect on their travel health behaviours as the source, extent and relevance of the advice was left wanting. The tourists hoped to relax and desired a good time on their holiday by entering into the 'holiday spirit' offered by South East Asia. This impeded their ability to recognise the very real travel health risks they faced.

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Cooper, Melissa Kaye. "Australian Regulatory Requirements for Migration and Registration of Internationally Qualified Health Practitioners." Thesis, 2020. http://hdl.handle.net/2440/130112.

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Internationally qualified health practitioners (IQHP) seeking to live and work in Australia are required to obtain the appropriate skilled migration visa through an assessment by the Department of Home Affairs and the approved assessing authority and registration by the relevant health practitioner board. Regulators create policy frameworks, standards and assessment models to meet the requirements of the Health Practitioner Regulation National Law (as in force in each state and territory) and the legislation governing Australia’s General Skilled Migration program. This research investigated the current policies and processes governing skilled migration and registration for internationally qualified nurses, midwives and doctors in Australia. The study was informed by rich qualitative data extracted from 28 in-depth semi-structured participant interviews. Shared experiences were mapped and examined for four key participant groups: assessors operationalising the current policies and processes governing skilled migration and registration; educators offering preparatory and training programs to IQHP; workforce agencies engaging with and recruiting IQHP; and internationally qualified doctors, nurses and midwives from across the globe. Key themes and points of intersection between the participants’ experiences and the regulatory frameworks were identified using theory and data-driven coding and thematic analysis via NVivo 12 plus software. The findings were presented in three papers. Paper one, a policy perspective, examined current views, regulatory reviews and overall governance of skilled migration and registration of IQHP in Australia. Paper two, a case study, presented key themes and points of intersection identified between regulatory frameworks and shared experiences of 28 research participants separated into four discrete groups. The final paper presented the lived experiences of the second participant group, 15 IQHP, who described their complex, culturally challenging and costly journeys seeking their shared dream of living and working in Australia. The research provides information and recommendations to assist regulators in ensuring that the standards, policy frameworks and organisational processes used to assess the suitability of IQHP for skilled migration and entry onto the Australian health practitioners register and ultimately into the health workforce are fair, transparent, consistent, equitable and robust, and assist in ensuring IQHP demonstrate the necessary qualifications and experience for protection of the Australian public. It is clear from the research that further exploration and more innovative and evidence-based solutions are required to support and reform the standards, guidelines and policy which are used to regulate and assess IQHP.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Nursing School, 2020

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Finn, Joanne. "The Rhetoric and Reality of Continuing Professional Development for Critical Care Nurses: A Critical Ethnographic Perspective." Thesis, 2018. https://vuir.vu.edu.au/38653/.

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Current research and evidence into Continuing Professional Development (CPD) has mostly centred on effective delivery formats to engage consumers. The perceptions and approaches that influence an individual engaging in CPD have yet to be explored, particularly in nursing. This qualitative research grounded in critical social constructionism and critical ethnography explores the perceptions and influences for regional intensive care nurses from Victoria, Australia as they engage in CPD. Participants from three field sites participated in semi-structured interviews. Through interviews the major themes of fear and vulnerability, isolation, professional inconsistencies and a myriad of concern for the nursing profession were identified. Threaded throughout each theme was the social influence of workplace upon nurses’ perceptions and their approaches toward CPD and the sharing of acquired knowledge amongst colleagues. The theoretical perspective of Pierre Bourdieu have been used to explore and discuss the findings of the research through the positions of orthodoxy and heterodoxy. These two positions allow the reality and the rhetoric of mandatory CPD for Australian nurses to be revealed, as shared by the participants. Orthodoxy and heterodoxy bring to light a disconnect between the regulatory body of the Australian Nursing and Midwifery Board (NMBA), and the nurses it registers. Nurses engage in CPD influenced by peers and often as a means of protection or a strategic tool to acquire and hold capital and power. The NMBA mandates CPD for knowledge growth and practice change. The findings reveal that nurses’ and the NMBA appear to be playing a game creating a state of illusio, with many nurses looking to mandatory CPD to maintain their employability rather than, public protection. This research highlights the symbolic power of CPD exposing the influences of social culture, habitus and the field in which nurses’ practice. Recommendations of this research suggest that the current model of CPD is fundamentally flawed. Significant changes need to be undertaken to achieve the goal of public protection through a contemporary and knowledgeable workforce.

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Dissertations / Theses on the topic 'Midwifery Australia'

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