Dissertations / Theses: 'Midwives 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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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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Teate, Alison Judith. "The experiences of midwives involved with the development and implementation of CenteringPregnancy at two hospitals in Australia /." Electronic version, 2009. http://utsescholarship.lib.uts.edu.au/iresearch/scholarly-works/handle/2100/1005.

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Hall, Brandi M., and L. Lee Glenn. "Detection and Management of Perinatal Depression by Midwives." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7488.

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Davison, Clare Louise. "Looking Back and Moving Forward: A History and Discussion of Privately Practising Midwives in Western Australia." Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/77506.

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The aim of this historical narrative research study was to fill a gap in the literature by investigating, analysing and describing the history of privately practising midwives in Western Australia (WA) from colonisation to the present day (approximately 1830-2018). This study embedded within a naturalistic, feminist paradigm analysed oral history interviews from fifteen midwives and three doctors, and archival documents to reconstruct the history, and explore the experiences of privately practising midwives in WA.

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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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Nicholls, Sarah Louise. "A qualitative descriptive study exploring the perception of confidence within midwives facilitating water birth in Western Australia." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/1291.

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This qualitative study explored midwives' perceptions of 'becoming and being confident' in supporting water birth. Twenty six midwives participated. Three categories emerged: What came before the journey describes influences prior to initial exposure such as education and personal attitudes. Becoming confident – the journey offers insight into the impact of another midwife in the room, getting enough exposure and 'unlearning' ingrained practices. Staying confident highlights factors that ‘knock’ confidence plus empowering experiences that sustained confidence.

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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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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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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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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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Walker, Laura. "Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an advanced life support in Obstetrics (ALSO) course in Australia." Thesis, Walker, Laura (2011) Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an advanced life support in Obstetrics (ALSO) course in Australia. Masters by Research thesis, Murdoch University, 2011. https://researchrepository.murdoch.edu.au/id/eprint/7960/.

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Aims: This study investigated perceived changes in knowledge and confidence to manage specific obstetric emergency situations following completion of an Advanced Life Support in Obstetrics (ALSO) course in Australia. Methodology: A prospective repeated measures survey design was employed using three questionnaires. From a sampling frame of all course attendees from May to September 2010 throughout Australia (N = 242), 68% (n = 165) completed pre- and immediate post-course questionnaires, and 61% (n = 101) completed a six-week post-course questionnaire. Descriptive statistics were reported as median and interquartile range. Statistical data were analysed using a Friedman two way repeated measures analysis of variance and the Wilcoxon signed rank test. All p levels lower than .05 were considered significant. Results: There was a significant overall improvement in perceived knowledge and confidence of the recommended management of all 17 emergency situations immediately post-course (p < .001) and at six weeks post-course (p < .001) when compared to pre-course levels. However, a significant decrease in knowledge and confidence for many emergency situations from immediately post-course to six weeks post-course (p < .05) was also observed. The midwives believed the interprofessional aspects of the course had increased their ability to learn (p = .014) and practise new skills (p < .001), work as a team member (p = .002) and communicate effectively with different professional colleagues (p = .008), whereas the doctors experienced no significant changes in their beliefs regarding these variables. The midwives also significantly increased their confidence in all four aspects of interprofessional interaction measured at six weeks following the course (p < .001), whereas the doctors only perceived a significant increase in confidence that their clinical decisions were respected by the midwives with whom they worked (p = .016). Conclusions: These results indicate that completion of the ALSO course in Australia has a positive effect on the knowledge and confidence of doctors and midwives to manage obstetric emergencies. There was also evidence that the course influenced midwives‟ confidence when working and communicating within an interprofessional team.

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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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Bradfield, Zoe. "Western Australian Midwives’ Perceptions and Experiences of Being ‘With Woman’ During Labour and Birth." Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/75843.

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Being ‘with woman’ is an important construct of the midwifery profession and is included in philosophy statements of leading midwifery organisations globally. Despite its centrality, little research has been conducted to offer evidence around this phenomenon. A phenomenological approach was undertaken to explore Western Australian midwives’ perceptions and experiences of being ‘with woman’ in a variety of models. Findings revealed that while midwives perceived the phenomenon similarly, experiences were distinct to the model worked in.

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Jones, Cindy Jingwen. "Emotional Disturbances During Pregnancy & Postpartum: A National Survey of Australian Midwives & an Educational Resource." Thesis, Griffith University, 2009. http://hdl.handle.net/10072/367307.

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Pregnancy and the postpartum are critical stages in women’s adjustment to motherhood and can have a significant impact on childbearing women’s overall psychological well-being (Chokka, 2002; Stocky & Lynch, 2000). According to the National Midwifery Guidelines for Consultation and Referral (ANMC, 2006), the physical, emotional, social and cultural aspects for both women and their infant(s) need to be addressed as part of best practice standards in maternity care. To accomplish this, midwives need to be well-educated, competent and resourced in these areas of practice. Midwives are reported to provide poor intrapartum and postpartum emotional care to childbearing women that could in part, be attributed to low self-efficacy and knowledge inadequacies in regards to the provision of emotional care (Brown, Davey & Bruinsma, 2005; Bruinsma, Brown, & Davey, 2003; Gamble, Creedy, & Moyle, 2004b; Rudman, El-Khouri, & Waldenström, 2007a, 2007b). However, very few studies have been undertaken to both determine and improve Australian midwives’ knowledge of emotional care issues and address their professional development needs (Eden, 1989; Buist et al., 2006). Therefore, the aims of this research study were to: 1. Determine knowledge levels, attitudes and self-reported practices of midwives in relation to emotional disorders (i.e. antenatal and postnatal depression and anxiety disorders) during pregnancy and postpartum. 2. Develop, implement and evaluate an educational resource to improve the knowledge, attitudes and practices of midwives in the provision of emotional care. In addressing these aims, two research phases were undertaken. The first phase was a scoping study in the form of a national survey to examine midwives’ knowledge of perinatal emotional disorders and their attitudes and self-reported practices in providing emotional care to childbearing women. Information gathered from the first phase informed the development of an online educational resource designed to enhance midwives’ knowledge and abilities in this neglected area of midwifery practice so as to improve childbearing women’s emotional health needs and overall well-being. Thus, the second phase was to examine the efficacy of this online educational resource which was piloted and evaluated with a small group of Master of Midwifery students. Results of the national survey identified that midwives acknowledged their role in the provision of emotional care and support to childbearing women with perinatal emotional disorders. However, knowledge deficits in relation to incidence rate, onset period, assessment and treatment options for both antenatal and postnatal depression as well as the use of the Edinburgh Postnatal Depression Scale in practice were also highlighted. Results from the Phase 2 study suggested that the online educational resource was useful in improving midwives’ knowledge of perinatal emotional disorders. Nevertheless, revisions are needed to further enhance the overall quality of the online educational resource with emphasis given to the translation of knowledge into practice and improving midwives’ self-efficacy in emotional care work. In view of the increasing importance on the provision of emotional care to childbearing women, it is essential that midwives develop their knowledge and understanding of perinatal emotional disorders and ways to assess and manage childbearing women affected by these disorders in order to provide better support and emotional care.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Chan, Ai Wen. "The cultural suitability of the Edinburgh Postnatal Depression Scale (EPDS) examined through lived experiences of Aboriginal Australian mothers and midwives." Thesis, Chan, Ai Wen (2019) The cultural suitability of the Edinburgh Postnatal Depression Scale (EPDS) examined through lived experiences of Aboriginal Australian mothers and midwives. Masters by Research thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/55079/.

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Despite Australian perinatal initiatives and policies, Aboriginal1 Australian women continue to face significant health and mental health disparities compared to non-Aboriginal counterparts. Perinatal mental health is of particular importance given the implications for mother, child, and family. This study explored cultural attitudes toward, and experiences of, the Edinburgh Postnatal Depression Scale (EPDS). Thirteen antenatal Perth-based Aboriginal mothers and ten non-Aboriginal midwives were interviewed. Midwives expressed some reservations about using the EPDS and reported adapting the current Australian guidelines of the EPDS by using it as a prompt for conversation. Mothers (n = 9/13) reported generally favourable views of this adapted EPDS implementation, especially when empathic and non-judgemental midwives facilitated stronger relationships with mothers. However, it was unclear how much variability there was in implementation between practitioners and consequently, how this non-standard EPDS was implemented with each mother. Moreover, demand characteristics of the interviews resulted in a range of acquiescent-style and socially desirable responses. The presence of response biases most likely reflected the power imbalance in the relationship between mothers, clinicians, and researchers. These underlying forces appeared to influence how mothers responded to being questioned by researchers, and raised questions about whether mother’s responses to the EPDS by practitioners could be influenced in the same way. The observations of midwives in these interviews were congruent with these concerns. In the absence of any other culturally suitable tool for use in this context, this conversational adaptation of EPDS that focuses on client-midwife relationship and an individualised approach to antenatal care was suggested. However, validation through a closer examination of demand characteristics, in parallel with the development of more suitable alternatives should be prioritised. Both researchers and clinical practitioners should be aware of and attend to these deeper challenges in working with Aboriginal mothers, possibly perpetuated by a post-colonisation dominance narrative.

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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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Kuliukas, Lesley Jane. "The phenomenon of intrapartum transfer from a Western Australian birth centre to a tertiary maternity hospital: The experiences of women, partners and midwives." Thesis, Curtin University, 2017. http://hdl.handle.net/20.500.11937/54166.

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A descriptive phenomenological study was carried out in 2013-2014, to describe the experiences of women, partners and midwives when transfer in labour took place from a birth centre to an obstetric unit. Analysis of 48 interviews, using Giorgi’s method of thematic analysis, revealed unique and shared experiences, both positive and negative, which can now inform midwives, empowering them to better support parents whose plans for labour do not eventuate as they originally anticipated

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Kelson, Lynette. "An exploration of the reasons why 10 women from central Victoria chose to birth at home." Thesis, University of Ballarat, 2004. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/40029.

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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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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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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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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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McLaughlin, Karen. "Asthma and pregnancy: a qualitative descriptive study of midwives' current knowledge about asthma in pregnancy and their perceived role in antenatal asthma management in Australia." Thesis, 2014. http://hdl.handle.net/1959.13/1051134.

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Masters Research - Masters of Philosophy (Midwifery)
Asthma continues to be one of the most common potentially serious conditions that can complicate pregnancy. At least 12% of pregnant women in Australia are affected by asthma. Many studies have examined the link between poorly controlled asthma and increased exacerbations during pregnancy with increased foetal and maternal morbidity. Despite asthma management guidelines advocating a collaborative approach to antenatal asthma management among health professionals, the role of the midwife in antenatal asthma management has not previously been examined. This study set out to explore what midwives currently know about asthma in pregnancy and their perceived role in antenatal asthma management. A qualitative descriptive design was used and data were collected via face-to-face interviews with 13 midwives who consented to participate in the study. Data collected from these interviews were digitally recorded, transcribed and analysed using qualitative content analysis. The findings from these data are as follows: that midwives’ current knowledge about asthma in pregnancy varies among the sample group with some participants having an awareness of possible changes in asthma symptoms during pregnancy but few participants knowing the range of potential consequences of poor asthma management for both mother and baby. The perceived role of midwives in antenatal asthma management also varies with some midwives stating that they feel their role is to educate women regarding their asthma and others stating that their role is to refer women to other health professionals. Barriers to providing antenatal asthma management were also identified by the midwives. Participants also offered suggested solutions to the barriers that were identified. Overall, there was found to be no uniform approach to the antenatal asthma management being undertaken in the facility in which this study took place. The development of an antenatal asthma clinical pathway could help to change current clinical practice regarding asthma management of pregnant women, and make that process more uniform. Increasing opportunities for asthma education for those who provide antenatal asthma management could also help determine the role of the midwife when caring for a pregnant woman with asthma. The findings of this study also have implications for further research into the role of the midwives working with women who have complex needs during the antenatal period.

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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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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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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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Teate, Alison Judith. "The experiences of midwives involved with the development and implementation of CenteringPregnancy at two hospitals in Australia." 2010. http://hdl.handle.net/2100/1005.

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Aims : The aims of the study were to describe the experiences of the midwives who were part of the first Australian CenteringPregnancy Pilot Study and to inform the future development of CenteringPregnancy. Background CenteringPregnancy is a model of group antenatal care that has evolved over the past two decades in North America. A pilot study that explored the feasibility of implementing CenteringPregnancy in Australia was undertaken in 2006-2008. I was the research midwife employed to coordinate this study and I explored the experiences of the midwives who were participants as the focus of my Master of Midwifery (Honours) research. Method : An Action Research approach was undertaken to study the implementation of CenteringPregnancy in Australia. This included a qualitative descriptive study to describe and explore the experiences of the midwives who were participants. The study was set in two hospital antenatal clinics and two outreach community health-care centres in southern Sydney. Eight midwives and three research team members formed the Action Research group. Data collected were primarily from focus groups and surveys and were analysed using simple descriptive statistics and thematic content analysis. Findings : CenteringPregnancy enabled midwives to develop relationships with the women in their groups and with their peers in the Action Research group. The group antenatal care model enhanced the development of relationships between midwives and women that were necessary for professional fulfilment and the appreciation of relationship-based care. The use of supportive organisational change, enabled by Action Research methods, facilitated midwives to develop new skills that were appropriate for the group care setting and in line with a strengths-based approach. Issues of low staffing rates, lack of available facilities for groups, time constraints, recruitment difficulties and resistance to change impacted on widespread implementation of CenteringPregnancy. Conclusions : The experience of the midwives who provided CenteringPregnancy care suggests that it is an appropriate model of care for the Australian midwifery context, particularly if organisational support and recruitment strategies and access to appropriate facilities are addressed. The midwives who undertook CenteringPregnancy engaged in a new way of working that enhanced their appreciation of relationship-based care and was positive to their job satisfaction. Implications for practice Effective ways to implement CenteringPregnancy models of care in Australia were identified in this study. These included a system of support for the midwives engaging in facilitating groups for the first time. It is important that organisations also develop other supportive strategies, including the provision of adequate group spaces, effective recruitment plans and positive support systems for change management. In the light of current evidence the development of continuity of care models which enhance the relationship between an individual women and her midwife, it is important to explore the effects of group care on this unique relationship.

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Teate, AJ. "The experiences of midwives involved with the development and implementation of CenteringPregnancy at two hospitals in Australia." Thesis, 2010. http://hdl.handle.net/10453/20260.

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University of Technology, Sydney. Faculty of Nursing, Midwifery and Health.
Aims : The aims of the study were to describe the experiences of the midwives who were part of the first Australian CenteringPregnancy Pilot Study and to inform the future development of CenteringPregnancy. Background CenteringPregnancy is a model of group antenatal care that has evolved over the past two decades in North America. A pilot study that explored the feasibility of implementing CenteringPregnancy in Australia was undertaken in 2006-2008. I was the research midwife employed to coordinate this study and I explored the experiences of the midwives who were participants as the focus of my Master of Midwifery (Honours) research. Method : An Action Research approach was undertaken to study the implementation of CenteringPregnancy in Australia. This included a qualitative descriptive study to describe and explore the experiences of the midwives who were participants. The study was set in two hospital antenatal clinics and two outreach community health-care centres in southern Sydney. Eight midwives and three research team members formed the Action Research group. Data collected were primarily from focus groups and surveys and were analysed using simple descriptive statistics and thematic content analysis. Findings : CenteringPregnancy enabled midwives to develop relationships with the women in their groups and with their peers in the Action Research group. The group antenatal care model enhanced the development of relationships between midwives and women that were necessary for professional fulfilment and the appreciation of relationship-based care. The use of supportive organisational change, enabled by Action Research methods, facilitated midwives to develop new skills that were appropriate for the group care setting and in line with a strengths-based approach. Issues of low staffing rates, lack of available facilities for groups, time constraints, recruitment difficulties and resistance to change impacted on widespread implementation of CenteringPregnancy. Conclusions : The experience of the midwives who provided CenteringPregnancy care suggests that it is an appropriate model of care for the Australian midwifery context, particularly if organisational support and recruitment strategies and access to appropriate facilities are addressed. The midwives who undertook CenteringPregnancy engaged in a new way of working that enhanced their appreciation of relationship-based care and was positive to their job satisfaction. Implications for practice Effective ways to implement CenteringPregnancy models of care in Australia were identified in this study. These included a system of support for the midwives engaging in facilitating groups for the first time. It is important that organisations also develop other supportive strategies, including the provision of adequate group spaces, effective recruitment plans and positive support systems for change management. In the light of current evidence the development of continuity of care models which enhance the relationship between an individual women and her midwife, it is important to explore the effects of group care on this unique relationship.

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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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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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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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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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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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