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Stevens, Trudy. "Midwife to midwíf : a study of caseload midwifery". Thesis, University of West London, 2002. https://repository.uwl.ac.uk/id/eprint/1079/.
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This thesis explores the implications of individual caseload practice for midwives. Over the past fifty years childbirth in England has become predominantly hospital oriented, with midwives forced to meet the needs of the institution rather than those of childbearing women. In 1994, a change in government policy for the maternity services attempted to address the dissatisfaction felt by mothers and midwives. The model for caseload midwifery was developed from their recommendations. Midwifery retains an ideology of independent practice yet the reality of working in a subservient position to obstetricians and controlled by the dictates of an institution have been seen in some studies to have undermined midwives' practice. However, their willingness and ability to work in a more independent manner was questioned. This study explored the implementation of caseload midwifery within a highly medicalised inner-city NHS maternity service. Working in partnership, within small groups, each midwife carried a caseload of 40 women per year. No longer based in the conventional hospital or community services, the midwives worked where and when appropriate, to meet the needs of their women. The research was undertaken over 46 months using an ethnographic approach and a variety of data collection methods. The prolonged study period facilitated an understanding of the development of caseload practice from its implementation into an established service. This thesis explores the adaptations the midwives needed to make on moving from conventional practice into caseload practice. Comparison of the difference services offers an understanding of the ways in which organisational features can influence the practice and meaning of midwifery. The control over and uses of time emerged as an important theme in this regard. Of particular note was the high level of job satisfaction expressed by the caseload midwives and their consideration that this model enabled them to practice "real midwifery", phenomena which are explored within the thesis. In working 'with' women, it is argued, the midwives developed a form of authority that had not been facilitated with the conventional services, and which contributed towards a new form of professionalism for the midwives. Although considered by many to be independent and 'isolationist', the strengths of caseload practice were seen to be in the context of group and inter-professional relationships, and the relationships midwives formed with mothers and their families as their work became re-embedded in the society in which childbirth occurred and had its meaning.
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Storrie, Leslie H. "Learning midwifery : perceptions of the registered midwife". Thesis, University of Strathclyde, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428171.
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Fergusson, Lindsay. "Working as a coordinator midwife in a tertiary hospital delivery suite a phenomenological study : a thesis submitted to Auckland University of Technology in partial fulfilment of the requirement for the degree of Master of Health Science (Midwifery), 2009 /". Click here to access this resource online, 2009. http://hdl.handle.net/10292/725.
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This phenomenological study has been conducted to reveal midwives’ experiences working as coordinator/charge midwives in tertiary hospital delivery suite settings. The methodology is informed by Heidegger’s interpretive phenomenological, hermeneutic philosophy (1927/1962). Data analysis is based on van Manen’s (1990) research methodology. Five coordinator/charge midwives who work at three tertiary hospitals were interviewed. These interviews were tape recorded, transcribed and analyzed to uncover commonality of themes which revealed what it felt like ‘being’ a coordinator/charge midwife. The three themes which emerged and are discussed in the data analysis chapters are: “The performing art of leadership”, “Time as lived” and “In the face of the ‘known’ and the ‘unknown’”. The findings of this study reveal coordinators are the ‘hub’ or the ‘pivot’ at their workplace with their art and soul of midwifery at the very core of their ‘being’. They ‘know’ the unpredictability of childbirth and are regularly challenged by ‘lived time’ as they ‘leap in’ to situations and ‘leap ahead’. Their ability to facilitate teamwork and their resilience in the face, at times, of seemingly insurmountable obstacles shines through.
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Barnes, Margaret. "Becoming a midwife : a case study of a women-centred midwifery curriculum". Thesis, Griffith University, 1998. http://hdl.handle.net/10072/380712.
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Midwifery education is in transition in Australia. Courses are being implemented in the university sector at a time when there is increasing debate and concern over the provision of maternity services. The idea of women-centred midwifery practice is developing as a guiding philosophy for midwifery, in order to focus the activities of midwifery practice on the needs of the childbearing woman. In response to these issues in midwifery, the Graduate Diploma Of Midwifery (Griffith University) was developed and implemented with an underpinning philosophy of women-centred practice and a commitment to teaching and learning approaches which emphasised self-direction, reflection and the idea of praxis. This research project has sought to under students' experiences of learning midwifery. In doing so, particulars of the curriculum are evaluated. The research approach draws on a feminist theoretical underpinning and uses processes and approaches congruent with qualitative evaluation.
The findings of this research are expressed in terms of students' experience of learning midwifery in this program but reflect broader concerns of the profession. These broader concerns include the potential of the relationship between woman and midwife and the issues of power in the progression. These issues have an impact on students' impressions of midwifery and their ability to interact with the midwifery community in the process of learning. The findings in relation to what helps students learn midwifery point to a different perception of clinical learning and have significance for developments of relationships between university and clinical agencies.
The findings of the study will contribute to midwifery knowledge as new insights, particularly in relation to the midwifery relationship and professional issues, are drawn. In considering the students experiences, professional concerns and the identified needs of childbearing woman, a theoretical framework for midwifery education is proposed. This theoretical framework has significance for the profession as it is applicable at the level of curriculum development, course planning or development of learning activities, and importantly, it contributes to knowledge in area of midwifery as a beginning theory of midwifery education.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health and Behavioural Sc.
Griffith Health
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Bloxsome, Dianne Kim. ""I love being a midwife; it's who I am": A Glaserian grounded theory study of why midwives stay in midwifery [thesis]". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2020. https://ro.ecu.edu.au/theses/2282.
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Midwifery shortages and the trend towards an inability to retain midwives in the profession is a global problem. The World Health Organisation (WHO) expressed concern about this issue in 2006, and despite efforts to implement remedial change, the retention of midwives continues to pose a large problem for healthcare internationally. The WHO (2006) asserted that midwives are the cornerstone to the reduction of maternal mortality and predicted that if the workforce retention issue was not addressed, then increases in maternal and neonatal mortality would ensue. In 2014, the United Nations Population Fund identified that, despite extensive worldwide efforts to address the midwifery shortage issue, the problem still existed and was worsening; an ageing workforce compounded by rising birth numbers means the issue is likely to persist. Consequently, the need for implementation of effective midwifery staff retention strategies is urgent, as is the need for evidence to inform these strategies.
No research about why midwives stay has been undertaken in Australia since that conducted by Sullivan, Lock and Homer in 2011. There is more current research around reasons underlying midwifery workforce attrition; however, it cannot be assumed that simply addressing these issues will correct the problem.
The aim of the study reported in this thesis was to understand why midwives across Western Australia (WA) choose to remain in the profession. The purpose of the research was to expose the factors leading to midwives staying in their jobs. Knowledge of why and how midwives stay in midwifery is imperative for recruitment into the profession and its sustainability and longevity.
This WA study was undertaken using the Glaserian version of grounded theory methodology. Fourteen midwives currently working in clinical practice were interviewed about why they remain in the midwifery profession. Data were collected from December 2017 to November 2018 and were generated through open ended semi-structured interviews, together with memos and field notes. The interviews were digitally recorded, transcribed verbatim and analysed and interpreted with the guidance of Glaser and Strauss’s coding stages.
The core category derived from the data was: “I love being a midwife; it's who I am.” Two interrelated major categories emerged from the data that represent why midwives stay in midwifery; the factors that enable them to stay are comprised of eight sub-categories. The data revealed that, broadly, midwives’ ability to be “with woman,” the difference they feel they make to these women, the people they work with, and the opportunity to “grow” the next generation of midwives are crucial influences on whether they remain in the profession.
The theory of “I love being a midwife; it's who I am” provides new information about why midwives working in various models of maternity care across WA stay in the profession, and the factors that enable them to do so.
A number of recommendations arose from this study for practice, policy, organisational processes, further research and pre-registration midwifery education.
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Forde, Maria. "Phenomenon of becoming a midwife". Thesis, Liverpool John Moores University, 2014. http://researchonline.ljmu.ac.uk/4495/.
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My research explored student experiences of becoming midwives. It focused specifically on understanding their lived world experiences. The research is located in a hermeneutic framework as described by van Manen (1990). I chose to undertake a longitudinal study as the length of the students’ course of study was three years. My study recruited two cohorts of student midwives from two universities in the North West of England (n=90). Each university had a different recruitment target for their midwifery programme of study; University A (n=60), University B (n=30). I prepared a PowerPoint presentation and an information leaflet which supported the recruitment strategy (Appendix B). My approach proved successful as the study originally consisted of a purposive sample of student midwives (n=22); University A (n=10) which equated to 20% of the cohort and University B (n=12) equated to 33% of the cohort. Four students from University B dropped out of the research following the first focus group, thereby reducing the total sample to 18. This reduced the sample size of university B (n=8) which equated to 27% of the cohort. My use of narrative inquiry within focus groups enabled a hermeneutic cyclical process of gathering and interpreting the student holistic experiences in a constructivist paradigm (Clandinin and Connelly, 2000). I also used reflective diaries which enabled the students to reflect on their personal experiences. This added richness to the empirical data (Berg, 2009). The interviews were recorded and transcribed verbatim. Thematic analysis was undertaken using the principles of van Manen (1990). I gained ethical approval from LJMU and the two universities where the students were studying. The aims of my research directed the focus of the study. Discovering their interpretations of their experiences of becoming midwives brought an understanding of the influences the working environment had on the process. The findings of my study brought new knowledge in respect of the education of student midwives. It also highlighted some of the restrictions imposed on their training within a medical model of care in an NHS Trust. The research also highlighted some of the challenges experienced by the students as they progressed through their training. The findings suggested there were many tension experienced by the students. The broad themes were related to: the students’ understandings of their learning and development, the ideology of the role of the midwife and the role of the midwife within the philosophy of the medical model of care in NHS Trusts. This brings new knowledge in respect of the education of student midwives.
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Nicholls, L. C. "What makes a good midwife?" Thesis, Exeter and Plymouth Peninsula Medical School, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701061.
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Martin, Kerstin. "The midwife as teacher : dialogue with and confidence in the woman". Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79794.
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Midwifery care is often described as "woman-centred" and "empowering," yet the concrete or specific practices underlying this kind of care are not well understood. The study examined what midwives say and do in the process of care-giving during pregnancy, and how their care enhances clients' sense of personal competence and capability. Using qualitative methods, the researcher observed, recorded, transcribed and analyzed prenatal visits with nine midwives and their clients in Quebec birth centres. Findings revealed that relaxed conversation was a pivotal feature of the visits and primarily served the client's purposes. At multiple levels, the reciprocal, genuinely dialogic nature of the conversational process allowed the client to take charge and encouraged her to name her world. Educational aspects of care started with the client's agenda, assumed that she had expertise of her own, and affirmed that she could know and act for herself. The key characteristic of midwives' work was the communication of confidence in the essential normalcy of pregnancy and birth, and in the inherent strengths of women in these experiences.
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Mettler, Gretchen G. "Growing into a Midwife: A Theory of Graduate Nurse-Midwife Students' Process of Clinical Learning". Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1271258271.
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Sosa, Georgina. "Midwifery one-to-one support in labour : ethnographic study of midwife-led birth environments". Thesis, University of East Anglia, 2016. https://ueaeprints.uea.ac.uk/63941/.
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Background: This research is about midwifery one-to-one support in labour. One-to-one support in labour is associated with improved birth outcomes. Uncertainty exists however as to what it is that produces such positive birth outcomes. UK publications advocate the midwife to provide one-to-one support in labour, but research findings question their ability to focus entirely on women due to their medical, technological and documentation responsibilities. All of these studies were based within hospital environments and none were completed in the UK. This indicates a gap in knowledge concerning how midwifery one-to-one support translates into practice in the UK and within midwife–led environments. Methods: The aim of this research was to explore midwifery one-to-one support in labour in a real world context of midwife-led care. An ethnographic approach was completed over three case study sites (Alongside midwife-led unit, freestanding midwife-led unit and women’s homes) each including ten labouring women receiving midwifery one-to-one support in labour. Findings: Two main themes: Balancing the needs of the woman and balancing the needs of the NHS organisation. Inside the birth environment midwives used their knowledge, experience, intuition and motivation to synchronise six components. These included presence, midwife-woman relationships, coping strategies, labour progress, birthing partners and midwifery support. Outside the birth environment midwives experienced surveillance and territorial behaviours which were heightened during transfer from a midwife-led birth environment to the labour ward. Conclusion: When a ratio of one midwife to one woman was achieved, midwives were 100% available for a woman in their care. This enabled midwives to be constantly present when required and provide total focus to tune into the needs of women and synchronise their care. Although midwives balanced the needs of the NHS organisation this did not impact on midwives capability to be present with women in labour.
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Davies, Jacqueline. "Blurring the boundaries between midwifery and obstetrics : an exploration of the role of midwife practitioner in a maternity unit in Wales". Thesis, University of South Wales, 2008. https://pure.southwales.ac.uk/en/studentthesis/blurring-the-boundaries-between-midwifery-and-obstetrics(40182058-a1b5-4628-961a-5a5d7ab92fc6).html.
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This thesis explores the newly established role of midwife practitioner (MP) and its impact on midwives and obstetricians in a maternity unit in Wales. MPs manage the care of women at high obstetric risk and carry out aspects of care, such as assessment, diagnosis and the development of management plans, which in the past were predominantly performed by obstetricians. This qualitative study employs a focused ethnographic approach and uses a purposive sample. Phase one consisted of seven focus groups, which were held between May and August 2004, with midwives (n=48) from maternity units in Mid and South Wales. In Phase two, participant observation was undertaken with MPs (n=3) over a two-week period encompassing eight 12-hour night shifts, during November and December 2004. For Phase three, semi-structured interviews were conducted with midwives (n=10), clients (n=10) and obstetricians (n=7), between July and December 2005. Phases two and three were carried out in a maternity unit in South Wales. The key findings of this study demonstrate that the lack of planning for the MP role inadvertently resulted in the creation of a distinct health care role, which encompasses positive aspects of both midwives' and obstetricians' work to provide safe and acceptable care for clients. The MPs in this study are committed to providing holistic care that takes into consideration the emotional and social needs of women and their families. In addition, these MPs are developing confidence and analytical skills, normally demonstrated by medical staff. However, further initiatives such as allowing MPs to prescribe, or to refer to other specialties, have not yet been adapted to support these new roles. It is too early to see the full impact of this role, but it is argued that it will have no significant effect on the work of the other midwives. MPs, however, do have the potential to impact upon the work of the obstetricians. This study contributes to the current body of knowledge concerning policy and practice for maternity care by examining a new role early in its genesis. This study makes a number of recommendations, including extending the number of MPs employed in Wales, the need for careful planning of future extensions to the midwives' role and further research into the safety and effectiveness of the MP role.
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Borrelli, Sara E. "The kaleidoscopic midwife : a conceptual metaphor illustrating first-time mothers' perspectives of a good midwife : a grounded theory study". Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/31006/.
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Background: The literature review reveals information about what makes a good midwife from several perspectives. However, there is a dearth of knowledge around women’s perceptions of a good midwife in different birthplaces. Aim. The aim of the study was to explore and explain first-time mothers’ expectations and experiences of a good midwife during childbirth in the context of different places of birth. Methods: A qualitative grounded theory methodology was undertaken. Fourteen first-time mothers planning to birth in different settings in England (Home, Freestanding Midwifery Unit, Obstetric Unit) were recruited. Data were collected through two semi-structured interviews for each participant (before and after birth). Data analysis included the processes of coding and conceptualising data, with constant comparison between data, literature and memos. Ethical approval was gained. Informed consent was obtained from participants and women were free to decline participation or to withdraw at any time. Confidentiality was guaranteed. Findings: The model named ‘The kaleidoscopic midwife: a conceptual metaphor illustrating first-time mothers’ perspectives of a good midwife’ was developed. The model is dynamic and woman-centred, operationalised as the midwife’s characteristics that should adapt to each woman’s individual needs in the context of each specific labour, irrespective of the birth setting. Four pillars of care are encompassed in the care provided by a good midwife in the labour continuum: promoting individuality; supporting embodied limbo; helping to go with the flow; providing information and guidance. As a kaleidoscopic figure, a good midwife should be multi-coloured and ever changing in the light of the woman’s individual needs, expectations and labour journey (e.g. stage of labour and events occurring during childbirth), in order to create an environment that enables her to move forward despite the uncertainty and the expectations-experiences gap. The following elements are harmonised by the kaleidoscopic midwife: relationship-mediated being; knowledgeable doing; physical presence; immediately available presence. Conclusion: The model presented has relevance to contemporary debates about quality of care and place of birth and can be used by midwives to pursue excellence in caring for labouring mothers. Independently from the place of birth, when the woman is cared for by a midwife demonstrating the above characteristics, she is more likely to have an optimum experience of birth.
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Garratt, Rosemary. "Connecting with women : the working lives of independent midwives and their perceptions of the mother-midwife relationship". Thesis, De Montfort University, 2014. http://hdl.handle.net/2086/9707.
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This study aimed to explore the lived experience of the working lives of midwives in the UK who practice independently of the NHS. It was designed to understand their motivations for working in this way and to explore their beliefs and values about midwifery care with particular emphasis on their perceptions of building and maintaining relationships with childbearing women. Hermeneutic phenomenology informed the methodology for the study and an adapted biographical narrative interpretive method (Wengraf 2001) was used for data collection. In depth qualitative interviews were carried out with twenty Independent midwives in the UK between 2007 & 2009. Data were analysed using Ricoeur's theory of interpretation (Ricoeur 1981). Keys findings indicate that motivated by a very strong sense of what it means to be 'with woman'; these midwives initially chose a career path in the NHS that enabled them to better enact this philosophy. However, constraints on their ability to enact this philosophy in the NHS combined with a desire to form more meaningful relationships with childbearing women and to support their individual needs informed a final move from the NHS into independent practice. Independent midwifery is experienced as very positive career move which results in considerable job satisfaction and an opportunity to use the full range of midwifery skills. Formation of the mother midwife relationship is perceived as a pivotal midwifery tool which facilitates understanding of individual childbearing women and their needs. Ricoeur's theory of interpretation (1981) is utilized to explain how Independent midwives form relationships with their clients in this context. The concepts of 'time', 'autonomy' and 'risk' are discussed in the light of study findings, contributing a unique insight into the working lives of Independent midwives, the mother midwife relationship and enactment of the 'with woman' philosophy in this context. The study also demonstrates that whilst there are many positive aspects of working as an Independent midwife there are also several constraints and potential vulnerabilities. These include the blurring of work/life boundaries, financial insecurity and the consequences of working with clients who often have very complex needs and particular expectations of the midwife-client relationship. Supporting women's choices, working flexibly to meet the needs of clients and respecting their right to autonomous decision making can place Independent midwives in a position of potential vulnerability and leave them subject to professional criticism.
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Martin, Sedeeka. "Quality care during childbirth at a midwife obstetric unit in Cape Town, Western Cape: Women and midwives’ perceptions". University of the Western Cape, 2018. http://hdl.handle.net/11394/6892.
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Magister Curationis - MCurGlobally, there has been significant progress in reducing preventable maternal deaths and disability, and growing attention on improving the quality of care in maternal health care facilities. The World Health Organization (WHO) describes quality care as delivering healthcare that is effective, efficient, accessible, acceptable, patient–centred, equitable and safe (WHO, 2014). Midwives are the backbone of midwifery and therefore the primary care giver for pregnant women accessing maternal care and women’s ability to access quality midwifery care during the antenatal, labour and postnatal period is the key component in midwifery care. The Primary Level Protocol of South Africa is under the umbrella of the Primary Health Care System, and according to this system low risk women are expected to seek antenatal, intrapartum and postnatal care from the nearest Midwife Obstetric Unit (MOU). The choice a woman makes regarding access to maternity care depends on the social norms in her society and what services are offered. However, the services that are available may not meet the needs of pregnant women. Women may need detailed information about the availability of the maternity care system in order to make an informed decision on where to access the health system. The gap between the perceived needs of pregnant women and the care provided by midwives can be bridged by listening to women to create a reciprocal understanding of quality care. In South Africa, limited research has been conducted on midwives and women’s perceptions of maternity care. In the absence of such information, this study was conducted at an MOU in the Western Cape, with the aim of exploring women and midwives’ perceptions of quality care during childbirth.
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Wilkins, Ruth. "Sociological aspects of the mother/community midwife relationship". Thesis, University of Surrey, 1993. http://epubs.surrey.ac.uk/1004/.
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Boon, Leen Ooi, University of Western Sydney, College of Social and Health Sciences i 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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Britt, Cynthia. "Midwife and Mother: Maternal Metaphors in the Composition Classroom". TopSCHOLAR®, 2003. http://digitalcommons.wku.edu/theses/582.
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This study examines the maternal metaphors of midwife and mother used to describe instructors and teaching practices in the composition classroom. In the introduction the author describes her interest in the topic based on her own experiences as a mother and as a beginning composition instructor. The paper explains the initiation of the metaphors, what the metaphors and maternal pedagogy mean in terms of classroom practices and philosophies, criticisms of maternal practices, and the relevancy and legitimacy of the metaphors and maternal pedagogy in classrooms today. Section one explores the development of the metaphors to describe composition teachers related to the composition and literature agendas created in the nineteenth century American university system. Other influences discussed in the metaphors usage and in the development of a maternal pedagogy are the 1970s revitalization of the women's rights movement and of the process pedagogy revolution. Section II surveys literature describing the philosophies of maternal pedagogy and maternal metaphors and their translations into classroom practices. Section III outlines the criticisms developed in reaction to maternal practices. Section IV details the results of surveys completed by freshmen composition students and composition instructors at Western Kentucky University. In the conclusion, the author considers the information and opinions presented and the survey results and draws conclusions about the relevancy of maternal metaphors and maternal pedagogy to the composition field and for her own teaching practices and philosophies.
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Thomas, B. Gail. "Learning to be a midwife : the need to believe". Thesis, University of West London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398573.
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Olsson, Agneta. "Med den inre känslan som drivkraft - barnmorskors upplevelser av att förmedla trygghet och en god omvårdnad". Thesis, University of Skövde, University of Skövde, School of Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-2919.
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The expectations of a successful outcome are great during childbirth. The overall objective of prenatal care and birth care is that midwives contribute in creating the most positive experience of pregnancy, child birth and infancy as possible. During the past 30 years there has been a significant increase in sectiofrequency both in Sweden and the rest of the Western world. More parents feel an overall insecurity when it comes to child labour. The purpose of this study was to describe how midwives experience the work of creating a sense of security and good nursing when meeting the expectant parents. A phenomenological approach was chosen with the use of eleven qualitative interviews that were analyzed with Giorgis' method of analysis. The result revealed three themes: organizational - professional conditions, the communicative ability and the reflective - emotional competence. Trusting your inner sensibility and intuition was something that characterized all the interviews and was the essence of the results. The way work was lead and organized, as well as the utilization of competence effected the midwives’ possibility of contributing to a sense of security and good care. When the communication was based on sensibility, midwives’ could create a good and trustful relationship with the expectant parents. The emotional involvement was an essential requirement for carrying out the work in a satisfying way. A question for the future is how inner knowledge based on practical experience can benefit new personnel and how the organization and education for healthcare givers can utilize the specialist knowledge of midwives with experience.
Förväntningarna i samband med barnafödande är stora på att en graviditet ska sluta lyckligt. Det övergripande målet inom mödrahälsovård och förlossningsvård är för barnmorskor att medverka till en så positiv upplevelse av graviditet, förlossning och spädbarnstid som möjligt. De sista trettio åren har sectiofrekvensen ökat betydligt både i Sverige och västvärlden. Fler föräldrapar upplever idag en allmän otrygghet i samband med barnafödande. Syftet med denna studie var att beskriva barnmorskors upplevelser av att förmedla trygghet och en god omvårdnad i mötet med det blivande föräldraparet. Fenomenologisk ansats valdes med elva kvalitativa intervjuer som analyserades enligt Giorgis analysmetod. Resultatet visade tre teman: Organisatoriska - professionella förutsättningar, den kommunikativa förmågan och den reflektiva - emotionella kompetensen. Att lita på sin inre känsla och intuition var en upplevelse som genomsyrade hela intervjumaterialet och blev resultatets essens. Hur arbetet leds och organiseras och hur kompetens tillvaratas påverkade i hög grad barnmorskors möjligheter att förmedla trygghet och en god omvårdnad. Genom att vara lyhörd i sitt sätt att kommunicera kunde en god och förtroendefull relation skapas mellan barnmorskor och det blivande föräldraparet. Det känslomässiga engagemanget var en nödvändig förutsättning för att utföra ett bra jobb. En fråga inför framtiden är på vilket sätt den erfarenhetsbaserade inre kunskapen kan komma ny personal tillgodo och hur omvårdnadsarbetets organisation och vårdutbildningar kan ta tillvara det expertmässiga kunnandet hos erfarna barnmorskor.
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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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Hertfelt, Wahn Elisabeth. "Teenage childbearing in Sweden : support from social network and midwife /". Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-289-7/.
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Boon, Leen Ooi. "Exploring childbearing women's perception of the role of a midwife /". View thesis View thesis, 2002. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030407.100627/index.html.
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BOWNE, SHELL L. "MIDWIVES IN A PRECARIOUS BALANCE OF POWER WITHIN THE HEALTH CARE SYSTEM OF THE UNITED STATES". University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1016569336.
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Thompson, Faye E. "The ethical nature of the mother-midwife relationship: a feminist perspective". University of Southern Queensland, Faculty of Sciences, 2001. http://eprints.usq.edu.au/archive/00001517/.
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This research explored the ethical nature of the mother-midwife relationship in order to refine our understanding of the place of ethics in the context of everyday midwifery practice – the practice of ‘being with woman’ in childbirth. The ethics explicitly available to midwives are derived from practices such as moral philosophy and bioethics, whose ethical frameworks are reductionist in their exclusion of context and relationship. Given that the midwifery profession is currently promoting a model of practice built on partnership and relationship, existing codes and frameworks are examined for their adequacy. An assumption of the study was that a distinctive midwifery ethic was implicitly available in the lived realities and shared engagement of mothers and midwives, embedded in practice. Conceptual theoretical research methodology facilitated exploration of the taken-for-granted assumptions of established theory, official policies such as Codes, and the profession’s literature. Feminist-constructivist theory formed the epistemological basis for gaining insight into the implicit ethics of midwifery. Personal narratives of mothers and midwives were analysed and interpreted for meaning, and transcripts returned to participants for validation. These constructed meanings were then compared and contrasted with those explicit in Codes and current literature. The central theme to emerge from the narratives was the use and abuse of power in relationships. Other major themes were institutional dominance consistently used to describe the status quo, values conflict especially linked to workplace/service provider versus personal/professional midwifery ethics, and the ethical adequacy of a ‘being with woman’ relationship. Findings indicate that midwifery does need a different ethic to that of bioethics and problem-solving principlism, and that such a new ethic would look like those promoted by feminist-virtue ethics. The latter not only redress the politics of the existing hegemonic maternity services system, but they also place women’s concerns central to practice and deliberation. The aspirations, values and lived reality of mothers and midwives, and the commitment of the professional-friend midwife to the particularity of the birthing woman, are the focus of a reconstructed ethic for midwifery practice, an ethic which reunites morality and personal interest. Implications and recommendations are discussed.
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Winterbone, Elizabeth Wilson. "Midwife at the rebirth of the great goddess: an organic inquiry". Thesis, Wichita State University, 2012. http://hdl.handle.net/10057/5543.
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In this thesis I use organic inquiry as a method to understand the transformative process when studying the collective history of the Great Goddess. The study shines a light on the history of the ancient Great Goddess, the impact of the invention of the alphabet, and how the written word influenced women’s roles and the role of the Divine Feminine as seen through the lens of Leonard Shlain, and additionally, the artistic work of contemporary mystic Meinrad Craighead. The transformative impact of the study is explored through the use of stories as a tool for reclaiming connection to a grounding, creative source. Conclusions are that a sense of wholeness can be lost when a woman loses the tethering balance of both right and left-brained integration and this disconnect can be overcome by seeking connection through telling of personal stories.Thesis (M.A.)--Wichita State University, Fairmount College of Liberal Arts and Sciences, Dept. of Communication
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Wilde, Min. "The jakes of genius : Christopher Smart, 'Mary Midnight' and the Midwife". Thesis, University of Exeter, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391215.
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Callwood, Alison. "Developing and evaluating the multiple mini interview in student midwife selection". Thesis, University of Surrey, 2015. http://epubs.surrey.ac.uk/808262/.
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The multiple mini interview (MMI) is an admissions instrument designed to replace the personal interview in health care student selection. Its effectiveness has been evaluated in medical student recruitment processes (Eva et al., 2004a, Roberts et al., 2014). At the commencement of this research no reliability, validity, or acceptability studies had been published specifically in relation to student midwife selection. Study objectives: to develop, pilot and evaluate the reliability, validity and acceptability of MMIs in student midwife selection in a Higher Education Institution (HEI) in the United Kingdom (UK). A dual paradigmatic dialectical enquiry was used in a multi-method case study. A literature review and qualitative work were conducted to identify the desirable personal qualities of a student midwife. This was followed by the systematic development of a customised eight station, five-minute MMI model. Sixty-two students from the BSc Midwifery Studies, September 2011 and 2012 cohorts, at the University of Surrey, volunteered to undertake ‘mock’ MMIs in the first week of their programme. Fifty-seven participants were followed up having completed their first year. Predictive validity was assessed using students’ end of year OSCE and mentor grading; station reliability, including inter-station and internal consistency, were also examined. Interviewers’ (n=9) and candidates’ (n=62) views of MMIs were obtained from a focus group and semi-structured questionnaires respectively. The literature review revealed that acknowledgement of the importance of ‘emotionality’ or an emotional dimension in the relationship between a woman and her midwife was missing from key professional, regulatory (Nursing and Midwifery Council, 2009, 2010, International Confederation of Midwives, 2011) and government documentation (Department of Health, DH,2012). According to the Department of Health (DH, 2013), selection to all National Health Service (NHS) funded training posts should incorporate recruitment for the NHS Constitution values (DH, 2012). In the absence of any mention of ‘emotionality’ it is suggested that this requires more specific recognition in considerations of what is important to appraise at selection. No statistically significant associations were found between students’ MMI score and their subsequent performance in clinical practice. The University Registrar would not consent to ‘live’ selection using MMIs in the absence of midwifery-specific evidence; participants were therefore students who had already been accepted onto an undergraduate midwifery programme. This has been addressed in an on-going longitudinal follow up-study. Reliability (internal consistency) was ‘excellent’ with Cronbach’s alpha scores between 0.91-0.97 across eight stations. Inter-station reliability findings suggested that each station measured different independent constructs with only a moderate positive correlation between two stations, kindness, compassion and respect for privacy and dignity (p<0.01). All other stations indicated little or no relationship offering additional support to the reliability of the scales. Candidates stated that undertaking MMIs would not discourage them from applying to the University as they felt they were a fair assessment instrument. They suggested that the multi- interview format was a positive feature which allowed them to recover from a poor performance at any one station. Overall, 23 participants (37%) reported a preference for MMIs compared to 22 (35%) who preferred a one-to-one personal interview format; 44 participants (71%) found the personal interview more daunting than MMIs. Interviewers appreciated the parity of opportunity afforded to candidates through the standardisation of the interview process. They were willing to adopt MMIs in future selection processes provided any anticipated complications were resolved. MMIs were shown to be reliable in the context and model defined. The insightful information obtained has informed a ‘roll out’ to MMIs across all health care student selection at the University of Surrey as well as being used by Health Education England as a case study example (HEE, 2014).
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Lewis, Marie. "Exploration of the concept of trust within the midwife-mother relationship". Thesis, Cardiff University, 2015. http://orca.cf.ac.uk/74712/.
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Background: Evidence from midwifery research, policy and guidelines indicates that trust within the midwife-mother relationship is an important element of care provision, yet it is poorly defined as a concept. Aim: The aim of the study was to explore the concept of trust within the midwife-mother relationship increasing understanding of the individual’s experience of trust and its meaning to women. Methodology: The Hybrid model for concept analysis was the framework for the study, combining theory and empirical data enabled the researcher to develop a deeper analytic understanding of the phenomenon and the meaning behind how it was experienced. Longitudinal semi-structured interviews were carried out at the beginning of pregnancy, thirty-seven weeks and eight weeks postnatal with a purposive sample of ten women with straightforward pregnancy. Participants were a mix of first time mothers and those having subsequent babies selected from a Health Board that provides midwife-led care. Analysis: Data analysis was conducted using Nvivo 9 software to organise the data into initial themes. Themes were taken back to participants to guide subsequent interviews clarifying their meaning, authenticity and ensuring that the data gathered reflected their personal insight. Findings: “Building blocks” were an analogy identified within the participant interviews which capture the evolving nature of trust. The participants described an initial trust associated with an expectation of assumed competence in the midwife. The core attribute was identified as the relationship between midwife and mother. The concept of trust was interwoven with women’s agency, women expressed a desire to develop a two-way trust that included the midwife trusting the woman. Implications: In order to develop evolved trust, maternity services need to develop systems that allow midwives to establish empathetic, reciprocal relationships and work in partnership with the women.
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Rowley, Iain. "Midwife of An-arché : toward a poetics of becoming-with-woman". Thesis, University of East Anglia, 2014. https://ueaeprints.uea.ac.uk/56847/.
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This project explores the connections between midwifery and the ethical demands attendant to poetic practice. Through verse and prose, I unfold a figuration of the midwife that traverses the boundaries between Levinasian heteronomy and Deleuzian heteromorphism, and is a constitutive factor in sites of resistance to the biomedical territorialisation of the creative body. Chief archival and methodological components that inform the thesis include: a historiography of childbirth - tracing the development of ‘holistic’ and ‘interventionist’ paradigms, and the ideological underpinnings of the phallocratic takeover of the birthing room in certain Western countries; idiographic insights gathered from dialogues with maternal practitioners and mothers, including residents of The Farm in Tennessee - where I participated in a midwifery workshop week; an experiential inquiry into Holotropic Breathwork - to facilitate access to non-ordinary states of consciousness; and a negotiation between Marxist-feminist and poststructuralist articulations of ethico-political agency. Subject matter ranges from a consideration of the ethical import of the placental economy to the bio-intelligent tissue of the psoas, the banishment of Anne Hutchinson from Massachusetts Bay to the legacy of the ‘Twilight Sleep’ movement. Sustained critical attention is devoted to Mina Loy’s “Parturition”, and contemporary poets that have acknowledged Loy as an influence, such as Lara Glenum. I suggest that, despite the absence of a birth attendant on the symbolic level, Loy’s poem resonates with the investments of midwifery, instating a ‘subjectin- process’ that woks through and against abstruse and instrumental discourses, defying both the technocratic erasure of maternal knowing and the fetishistic reduction of labour to an end-product. Art’s capacity for opening up a corporeallycharged zone of between-ness is further elaborated in an essay on Andrei Tarkovsky’s Stalker - through which the treatment of spatiotemporality is aligned with the imperatives of midwifery guardianship.
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Moore, Robin D. "The impact of introduced predators on the Mallorcan midwife toad Alytes muletensis". Thesis, University of Kent, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269109.
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Bush, Sarah Louise. "Courtship and male parental care in the Mallorcan Midwife toad Alytes muletensis". Thesis, University of East Anglia, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.359320.
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Sexual selection theory predicts that the sex with the lower parental investment, usually the male, will be the more competitive and more highly adorned sex. Species in which males have a high investment In the form of parental care or nuptial gifts are instructive for testing the predictions of sexual selection theories. In the Mallorcan Midwife toad (Alytes muletensis), the male performs the parental care by carrying the eggs wrapped in a string around his legs. In laboratory experiments, both sexes were active in courtship and females were observed to compete more frequently than males. Both males and females incurred growth costs as a result of reproduction; males were also susceptible to physical injuries including the loss of limbs during brooding. Because the costs of reproduction are high for both sexes, either sex might be expected to exercise choice when finding a mate. Large males were not significantly better at caring for the eggs than were small males, and there was no correlation between female size and clutch size. Both sexes could benefit by choosing large mates, however, because hatchling size was significantly associated with both male size and female size, and large hatchlings are likely to enjoy fitness benefits. No evidence for female mate choice was evident in two-speaker arena experiments, but it is possible that mate choice in this species is mediated by non-acoustic cues. Double clutching, which enables brooding males to reduce the mating cost of providing parental care, is less common in A. muletensis than in the other species of midwife toads. Experiments and models indicated that the low frequency of double clutching is probably due to a time limit which constrains males to obtaining the second clutch within three days of the first. The potential reproductive rate of females was higher than that of males, suggesting that a female-biased OSR is responsible for the observed competition between females, but the reproductive rates of both sexes are expected to vary with the seasons. The resulting shifts in the OSR should be accompanied by seasonal shifts in the competitive sex
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Goodwin, Laura. "The midwife-woman relationship in a South Wales community : a focused ethnography of the experiences of midwives and migrant Pakistani women in early pregnancy". Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/95597/.
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Background In 2014, 27.0% of births in England and Wales were to mothers born outside of the UK. Compared to their white British peers, minority ethnic and migrant women are at a significantly higher risk of maternal and perinatal mortality, along with lower maternity care satisfaction. Although existing literature highlights the importance of midwife-woman relationships in care satisfaction and pregnancy outcomes health professionals report difficulty in providing services to minority ethnic and migrant women. However little research has explored the factors contributing to the midwife-woman relationship for migrant and minority ethnic women. Research Aims To explore relationships between migrant Pakistani women and midwives in South Wales; focusing on the factors contributing to these relationships, and the ways in which these factors might affect women’s experiences of care. Method A focused ethnography in South Wales; semi-structured interviews with 10 migrant Pakistani participants (eight pregnant women, one husband and one mother) and 11 practising midwives, fieldwork in the local migrant Pakistani community and local maternity services, observations of antenatal booking appointments, and longitudinal reviewing of relevant media outputs, such as UK news reports of issues relating to migrant people. Data were analysed concurrently with collection using thematic analysis. Findings The midwife-woman relationship was important for participants’ experiences of care. A number of social and ecological factors influenced this relationship; including family relationships, culture and religion, differing healthcare systems, authoritative knowledge, and communication of information. However, differences were seen between midwives and women in the perceived importance of these themes. Findings therefore suggest that in order to understand how midwife-woman relationships are created and maintained, more needs to be done to recognise and address these differences. Due to the complexity of the relationships between themes a social ecological model of relationships is forwarded as a means of visually capturing the complexity of the findings, as well as potentially shaping midwifery education and clinical midwifery practices. Conclusions and Implications Findings from this study provide new theoretical insights into the complex social and ecological factors at play during maternity care for migrant Pakistani women. These findings can therefore be used to create meaningful dialogue between women and midwives, encourage collaborative learning and knowledge production, and facilitate future midwifery education and research.
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Haigh, Jackie. "Exploring the transition from graduate midwife to professional practitioner : a personal development perspective". Thesis, Lancaster University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.551630.
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This multi-case study explores the transition experience of graduate midwives during the first months of registered practice. These midwives had experienced a curriculum designed to produce midwives fit for practice at the point of registration but also equipped with the capability for self- directed personal development. Dramaturgical analysis of data collected from on line blog and telephone interviews explores the midwives' significant learning experiences to consider how their individual dispositions impact on their learning practices, and further analysis for workplace affordances clarifies how the ongoing development of these new midwives is affected by the community, structures and artefacts of the workplace. Findings suggest that the affordances of the workplace in terms of the activities available to these new midwives support a high quality learning experience, which promotes their rapid development as fit for purpose autonomous practitioners. The interdependencies of the workplace are structured to maintain the status quo rather than support change and development. Issues identified as conflicting with personal development are lack of time or resources to perform to their full potential, opposition from more established members of staff to their initiatives, and a culture of medicalisation which undermines a model of woman centred care and the promotion of normal childbirth. High academic achievers continue to make use of academic practices and tools to support learning and critique of practice but all learn mainly through experience and consulting others. The study concludes by recommending areas for further study. These relate to evaluating different models of preceptorship, exploring the dissonance between learning cultures in the university and practice setting and exploring the dissonance between ideals of midwifery practice and current structures of maternity care.
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Derrah, Scott Hilton. "Father or midwife?, Lester B. Pearson and the origins of United Nations peacekeeping". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0001/MQ46245.pdf.
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Robertson, Judith Helen. "An Exploration of the Effects of Litigation on the Midwife and her Practice". Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517821.
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Rawnson, Stella. "Stories of companionship and trust : women's narratives of their student midwife caseloading experience". Thesis, Bournemouth University, 2018. http://eprints.bournemouth.ac.uk/31188/.
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It is national policy that midwifery students, as part of the undergraduate midwifery curriculum, gain experience of providing continuity of care for women throughout the childbearing continuum via caseload practice (NMC 2009). Student midwife caseloading has been cited as an example of best practice (DH 2003). However, whilst there is robust evidence of women’s experiences of continuity from qualified midwives (Sandall et al. 2016), there is a lack of information regarding student’s care. Although a small number of studies have been conducted in Australia and Norway, no formal research into women’s experiences of this approach to student involvement in their care appears to have been undertaken in the United Kingdom. This study focussed on hearing women’s personal stories to develop an understanding of how being part of a student midwife’s caseload may have impacted on their childbearing experience. Utilising qualitative methods, the study followed women’s experiences of continuity of care provision from a student midwife, supervised by a qualified midwife, throughout pregnancy, birth and the early days of mothering. I was interested to hear women’s stories of their relationships with students and how these were developed, how they described the care provided in relation to their holistic needs and how, and if, they linked the continuity of care by the student with the outcome of their experience. Data were collected within a longitudinal model through story accounts from six women who had agreed to be part of a student’s caseload. Participant stories were sought on three occasions: twice during pregnancy, and once in the postnatal period. The data gathered at these points in time were viewed as a continuing story that unfolded over the woman’s childbearing event. The story accounts were analysed through a narrative framework using a three phase re-storying model to uncover themes of significance to the individual women within the study, and the women as a group. Phase 1 involved the analysis of the three interview transcripts of the individual woman’s unfolding story. Phase 2 included the construction of an interpretative story or personal experience narrative poem for each participant. Phase 3 provided a synthesis of the data to construct a collective story that encapsulated the emergent narratives themes of significance to the women as a group. The three longitudinal narrative themes of significance to the women as a group were identified as: ‘mutually supportive partnerships’; ‘just like a midwife’ and ‘extra special care’. All women recognised the status of their caseloading student as that of learner, as someone working to become a qualified midwife, and described the reciprocal supportive relationships they developed with students through relational continuity within this context. While identifying the caseloading student as requiring supervision from a qualified midwife, women expressed high levels of trust and confidence in ‘their’ student’s knowledge, clinical competence and caregiving abilities. Being with a student in a continuity relationship, and the extra support it engendered, was highly valued by women. The student’s perceived ‘constant’ presence across the childbearing experience was welcomed and described as central to the women’s comfort and contentment. Study findings provide evidence that this group of women highly valued the student contribution via continuity to their care and this experience may be transferable to other women participating in student caseloading. This understanding adds weight to the Nursing and Midwifery Council expectations and reinforces the value of continuity educational schemes. The knowledge gained provides useful insights for curriculum developers nationally and internationally, educators and practitioners. Recommendations from the study are made for research, education and practice.
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Robinson, A. "The role of consultant midwife : an exploration of the expectations, experiences, and intricacies". Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/349088/.
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Consultant nurse and midwife roles, with the expectations of significantly moving forward the professions in relation to practice development, effective leadership and quality care provision, have been a major UK policy initiative since 2000. Whilst consultant nurses have received much attention, consultant midwives have been relatively little researched. This study aimed to explore the intricacies of the consultant midwife role. Using an in-depth qualitative case study design, the roles of eight consultant midwives across eight NHS Trusts in England were studied. Data were collected via in-depth interviews with consultant midwives, their heads of maternity services and consultant obstetricians; additionally, the consultant midwives were observed in practice and documentary evidence (their job descriptions) were examined. Data were analysed thematically and aggregated, revealing three dominant themes related to clinical wisdom, taking control and shaping the future. Findings showed that the consultant midwife is in a position of power, built on a foundation of clinically acquired wisdom, transformational leadership skills and a belief in woman centred care, essential to a profession fit for the future. Individually and collectively, the consultant midwives conveyed a passion for their role, whilst aware of the demands of their position. Their impact lay in relation to the way they used their experience, skills and understanding, to undertake complex roles in practice, juggling responsibilities to effect change and improve services for childbearing women and their families. Their strength was born out of acquired knowledge and expertise, as leaders and as role models, influencing not only practice but the midwives of the future. This thesis provides the first in-depth exploration of the consultant midwife role and as such greatly strengthens the hitherto limited evidence base. As well as focusing on the particular aspects of day-to-day consultant midwifery it also gives detailed recommendations for further development of the role organisationally.
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Lenaway, Dennis David. "Evaluation of a public-private certified nurse-midwife maternity program for indigent women /". Thesis, Connect to this title online; UW restricted, 1995. http://hdl.handle.net/1773/10872.
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Van, der Klei Jannine Daphne. "Health promotion for primiparous women in the puerperium : the role of the midwife". Thesis, The University of Sydney, 1995. https://hdl.handle.net/2123/26796.
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The purpose of this descriptive study was to explore the role of the midwife in health promotion for primiparous women in the puerperium, as perceived by midwives and primiparous women. Perceptions of midwives and primiparous women in the puerperium were sought in relation to the midwife’s role in health promotion for primiparous women in the puerperium.
The sample consisted of twenty-three midwives and forty-nine primiparous women from three public hospitals in the central, southern and western areas of Sydney. Two questionnaires, one for the midwives and one for the primiparous women, consisting of quantitative and qualitative components, were developed and used for data collection in the study. The relationship between the perceptions of the two groups was examined by comparison of the results.
Health promotion methods used by midwives for primiparous women in the puerperium were perceived as occurring to a much greater extent by the midwives than reported as experienced by the women. All of the midwives thought that they educated the women for health in the puerperium and that they gave adequate health information to the women. However, a number of the women felt that the health information given to them was inadequate and that midwives could have helped to promote health better for them during the puerperium. Nevertheless, the majority of the women indicated their comfort in asking midwives questions that concerned them during their postpartum hospital stay.
There were many areas of difference between the midwives’ perceptions of how commonly various health concerns or problems occurred for prirniparous women in the puerperium and the incidence of their occurrence reported by the women. A number of women felt either only minimally prepared or not prepared at all for the health concerns or problems experienced by them during the puerperium and thought that midwives could have provided them with further health information in the early days after birth.
Only forty-one percent of the primiparous women were debriefed by midwives concerning their labour and birth and all of these women found it helpful. The majority of women who were not debriefed after birth would have liked this opportunity.
Conflicting information given by midwives in the early puerperium was reported by almost half of the prirniparous women as occurring often or always, particularly with regard to breastfeeding. Most of the women commenced breastfeeding in hospital but by six weeks after birth, thirty-one percent had ceased breastfeeding, with many experiencing breastfeeding difficulties.
The majority of the midwives identified constraints in their health promoting role for prirniparous women in the early puerperium and provided a variety of suggestions of how they could promote health better for puerperal women.
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Turnbow, Angela C. "Midwife, Young Maiden, and Physician: Image and Authority in Karen Cushman's Female Healers". DigitalCommons@USU, 2014. https://digitalcommons.usu.edu/etd/3302.
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This study focuses on the characterization of Cushman’s healers in her three medieval novels The Midwife’s Apprentice; Catherine, Called Birdy; and Matilda Bone. I specifically look at the physical descriptions, medical practices, and the healer’s role within the community as an accepted medical authority. Cushman’s portrayals illuminate the different locations and situations in which women practiced medicine during the Middle Ages, thus she presents more historically accurate portrayals of female healers.
The significance of this project is that Cushman challenges the stereotype of the isolated and disfigured old crone that has been, perhaps inadvertently, perpetuated by authors and focuses on the historical accuracies of female healers. Many young readers learn about history through novels and it is important that authors present accurate historical representations of the past they are trying to describe to their audiences. In addition, this project will bring multiple disciplines together such as medieval studies, young adult literature, medical history, and folklore in order to illuminate the historical accuracies and representations of female healers.
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Ross-Davie, Mary C. "Measuring the quantity and quality of midwifery support of women during labour and childbirth : the development and testing of the 'Supportive Midwifery in Labour Instrument'". Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/9796.
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The thesis describes the development and testing of a new computer based systematic observation instrument designed to facilitate the recording and measurement of the quantity and quality of midwifery intrapartum support. The content of the systematic observation instrument, the ‘SMILI’ (Supportive Midwifery in Labour Instrument), was based on a comprehensive review of the literature. The instrument was found to be valid and reliable in a series of studies. The feasibility and usability of the SMILI was extensively tested in the clinical setting in four maternity units in Scotland, UK. One hundred and five hours of direct observation of forty nine labour episodes were undertaken by four trained midwife observers. The clinical study demonstrated that the study and the instrument were feasible, usable and successful in measuring the quantity and quality of midwifery intrapartum support. The data collected has provided significant new information about the support given by midwives in the National Health Service of Scotland, UK. Continuous one to one support was the norm, with 92% of the observed midwives in the room for more than 80% of the observation period. Emotional support, including rapport building, encouragement and praise, was the most frequently recorded category of support.
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Sundholm, Anna, i Akar Jalal. "Transkulturella möten inom mödravården : Barnmorskors egna erfarenheter". Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104446.
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The purpose of this study was to look at the experiences of midwives in maternalhealth care encounters with non-european-born women and men, and to determine ifmidwives deem any special competence necessary to handle these encounters well.We gathered information by means of qualitative interviews and semi structuredquestions with eight midwives all of whom matched the inclusion criterias and gavetheir personal consent. Midwives from four district health care centers in Uppsalawere included. The interviews were transcribed and analyzed by means of qualitativecontent analysis.The results reveal the experiences from encounters with non-european patients to betwofold. On one hand the encounter is a positive, exiting experience with anopportunity to learn more about a foreign culture and exchange experiences. On theother hand complications can occur as patients may have unexpected expectationsregarding the health care, have great difficulties with the language or haveexperienced traumatizing incidents, all on top of coming to Sweden alone withoutrelatives.In the encounter with non-european-born patients the midwives consider it importantto have special competence in form of knowledge of other cultures and religions asthis provides a greater understanding of the reasoning behind the patients’ decisions.Cultural competence is also important as it helps avoid inadvertently insulting thepatient during the encounter.The special competence held by the midwives has been attained from their basic andspecialist education as well as from self acquired experiences and interests. A lifelongeducation is required to uphold this competence as well as a dialog betweenmidwives at the health care clinic.
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Hall, Valerie. "'Wise women' : students' use of experience in developing midwifery knowledge". Thesis, University of Sussex, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341067.
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Philomène, Uwimana. "Handwashing compliance among nurses and midwives caring for newborn babies in Rwamagana health facilities, Rwanda". Thesis, University of the Western Cape, 2014. http://hdl.handle.net/11394/4145.
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Magister Curationis - MCurInfections (including healthcare-associated infections) are one of the leading causes of neonatal morbidity and mortality, yet these deaths could be prevented by cost-effective interventions. Handwashing (HW) is crucial to preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs). However, healthcare workers' compliance with optimal practices remains low in most settings.The purpose of this study was to determine the compliance with HW among nurses and midwives caring for newborn babies at Rwamagana Health Facilities, and the extent to which demographic and cognitive characteristics predict nurses' HW compliance. The study’s methodology involved a cross-sectional approach encompassing descriptive and quantitative methods. The data was collected over a period of 3 weeks from a total sample of 139 nursemidwives. An anonymous self-administered questionnaire was used to collect data; out of 139 questionnaires distributed 134 were returned back completed, giving a rate of 96.4%. The data analysis was done using SPSS software version 21.The results demonstrate that a mean self-reported HW compliance rate was 82.00% (SD= 13.60). A compliance rate of 80% or greater was confirmed by most of the participants in the study (79.1%). The highest reported rate of hand washing was HW after exposure to the newborn's body fluids (M= 89.33%; SD= 14.878),while results revealed that nurses tend to perform less HW after touching an object in the vicinity of the patient(73.43%; SD=22.81). A multiple regression analysis revealed that attitudes, subjective norms and intentions were unique independent predictors of HW compliance. However, results did not show any relationship between HW and nurses' demographic characteristics.This study recommends that, strategies aiming to improve HW compliance must be focused on concepts that predict HW. Further research ought to be conducted using observational approach.
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Dumisani-Ndlovu, Sidumisile Charity, Balandeli S. I. Sonti i S. James. "Knowledge of midwives at Community Health Centres and Midwife Obstetrics Units in the Nelson Mandela Bay regarding the use of the Road-to-Health Chart". Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/21692.
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The challenge of child mortality between the ages of 0 and 5 years has extensively increased over the past few years. Furthermore, the ever-evolving and complex consequences of ineffective monitoring of children’s growth and development have been identified as one of the reasons for this increase in child mortality. The Road-to-Health Chart was developed and redesigned for use by child nurses and midwives to monitor children’s growth and development. The purpose of this study was to investigate whether the midwives at community healthcare centres in the Nelson Mandela Bay area had the necessary knowledge to utilise the Road-to-Health Chart effectively. Permission to conduct the study was sought from the Nelson Mandela Metropolitan University, the Department of Health and the participants. A quantitative, non-experimental descriptive survey was used in this research. The population consisted of all the midwives working in the Midwife Obstetric Unit and community healthcare centres within the Nelson Mandela Bay Municipal area. The sample was extracted from the targeted population but from willing participants that met the inclusion criteria. The research data-collection method was a self-developed questionnaire with closed-ended statements to measure the knowledge of how effectively the midwives in the Nelson Mandela Bay area were using the RTHC. The researcher ensured the validity of the questionnaire by focusing on the instrument’s validity, construct validity, content validity and face validity. Ethical considerations, including permission, informed consent, confidentiality and anonymity, were adhered to. The most significant findings showed that midwives at CHCs and MOUs in the Nelson Mandel Bay area were knowledgeable about the importance of the RTHC to the mother and child and the use of the RTHC. These findings may assist in the identification of measures to enhance the knowledge of midwives about the use of the RTHC thus ultimately facilitating the use of the RTHC by mothers as intended.
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Bluff, Rosalind. "Learning and teaching in the context of clinical practice : the midwife as role model". Thesis, Bournemouth University, 2001. http://eprints.bournemouth.ac.uk/339/.
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The purpose of this study was to develop a theory in order to explain the meaning and process of learning the role of the midwife from midwives in the clinical setting. To achieve the depth and detail required in the absence of literature on this topic, the grounded theory approach was adopted. The sample consisted of twenty student midwives and seventeen midwives. Data were collected by means of unstructured interviews which were tape-recorded. Each participant was interviewed on a minimum of two separate occasions. The constant comparative method was used to analyse the data. The findings of the research contribute to knowledge by making explicit how the role of the midwife is interpreted and enacted, the effect this has on what role students learn, how it is learned and hence how the role is transmitted from one generation of midwives to the next. The `emic' perspective facilitated the emergence of a number of theoretical ideas. Central to these are the rules of practice. When midwives rigidly follow written and unwritten rules they prescribe midwifery care which corresponds to the medical model. In doing so they act as obstetric nurses or handmaidens to the doctor. When everything is interpreted as rules to be followed prescriptive midwives appear to be uncaring and detached from the experience of childbirth. The individual needs of women are not met and the relationship between midwife and client is superficial. Midwives who rigidly follow the rules inhibit the growth and development of students providing them with few opportunities to achieve beyond the level of their role model. Midwives are flexible when they interpret the rules for the benefit of women and provide a woman-centred model of care. These midwives therefore act as autonomous practitioners. When rules are interpreted and adapted to meet the needs of women, flexible midwives demonstrate involvement in women's experiences and are empathic, supportive and caring. Midwives who use professional judgement to interpret the rules provide an environment in which senior students can become autonomous practitioners. When midwives demonstrate the role of autonomous practitioner, practise a woman-centred model of care and meet the learning needs of students, they are appropriate role models and teachers. There is conflict in the clinical setting when practitioners who hold opposing attitudes, values and beliefs practice together. Conflict can be avoided when flexible midwives adopt strategies that involve becoming prescriptive or practising by subterfuge. In accordance with Bandura's social learning theory students learn by observing and emulating the example of their role models. Learning is vicarious when students observe the consequences of their role models' actions. When learning the role from a role model is interpreted as a passive process, a behaviourist and pedagogical approach to learning and teaching ensures perpetuation of the obstetric nurse role that is no longer considered acceptable. Role modelling serves as a vehicle for transmitting new behaviour when learning is perceived to be an active process. In this case a humanistic, andragogical and cognitive approach to learning and teaching is adopted giving students the freedom to determine their own role. Practice from a number of role models is emulated. In this way each midwife acquires a unique identity which is derived from an abstract role model rather than a particular person. Students are prepared for the autonomous role of the midwife, and it is this role they wish to emulate.
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Toohill, Jocelyn. "Effects of a Midwife-Led Psycho-Education Intervention on Birth Fear in Childbearing Women". Thesis, Griffith University, 2014. http://hdl.handle.net/10072/366668.
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Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body’s ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies to address women’s childbirth fear, support normal birth, and diminish the possibility of a negative birth experience.
Purpose of Study
The program of work aimed to determine the prevalence of childbirth fear in a large population based sample and identify factors associated with, and possible antenatal predictors of, childbirth fear (Study 1). Study 2 aimed to test the efficacy of a midwife-led psycho-education counselling intervention (known as BELIEF – Birth Emotions and Looking to Improve Expectant Fear) in reducing women’s antenatal childbirth fear.
Method
A total of 2,311 eligible women in their second trimester of pregnancy were approached while attending antenatal clinics at one of three hospitals in South East Queensland. Sixty one percent of women (n = 1,410) agreed to participate and completed the first questionnaire package which included a measure to screen for childbirth fear. Women reporting high childbirth fear (≥66 on the Wijma Delivery Expectancy / Experience Questionnaire - WDEQ) were randomly allocated to study groups. Women who were expected to have returned data by June 2013 within the ongoing BELIEF study were included in Study 2 (intervention n = 118 or control group n = 132).Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
Full Text
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Bäck, Lena. "Confidence in Midwifery : Midwifery students and midwives’ perspectives". Licentiate thesis, Mittuniversitetet, Avdelningen för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-33560.
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A confident midwife has an impact on a pregnant woman’s clinical outcome and birth experience. Knowledge acquisition, competence, and confidence develops over a lifetime and is of great importance in developing and forming personal skills and allowing the personal traits to grow and mature. Previous international studies have shown that midwifery students do not feel confident in many areas in which they are supposed to practice independently. The aim of this thesis was to investigate confidence levels in basic midwifery skills in Swedish midwifery students in their final semester just before entering the midwifery profession. An additional aim was to describe clinical midwives’ reflections about learning and what factors that developes professional competence, and confidence. Study I was a cross-sectional survey with Swedish midwifery students (n=238). They assessed their own confidence in all competencies that a midwife should have and could practice independently. The results of study I confirmed that Swedish midwifery students feel confident in dealing with the most common procedures during normal pregnancy, childbirth, and postpartum and newborn care. However, they do not feel fully confident in cases in which there are deviations from the normal procedures and obstetric emergencies. When comparing groups of midwifery students, the younger group of midwifery students felt more confident in general compared to the older group. Students at a university with a medical faculty were also more confident than the students at a university without a medical faculty. In study II, focus group discussions were held with 14 midwives emphasizing the way in which midwives reflect on learning and the development of competence and confidence. Content analysis was used to analyze the focus group discussions. Four categories were identified as a result of study II: 1.) feelings of professional safety evolve over time; 2.) personal qualities affect professional development; 3.) methods for knowledge and competence expansion; and 4.) competence as developing and demanding. The conclusion of this thesis is that more practical and clinical training during education is desirable. Midwifery students need to have access and the opportunity to practice obstetrical emergencies within a team of obstetricians and pediatricians. Learning takes time, and one improvement is to extend midwifery education to include and increase in clinical training. This would strengthen the students theoretical, scientific, and clinical confidence. Clinical midwives claim that it takes time to feel confident and that there is a need to develop professionalism.En trygg barnmorska har en positiv inverkan för förlossningsutfall samt förlossningsupplevelse. Kunskap, kompetens och trygghet är ett livslångt lärande och har stor betydelse för att utveckla och forma personliga färdigheter, att låta de personliga egenskaperna växa och mogna. Tidigare internationella studier har påvisat att barnmorskestudenter känner sig otrygga inom områden där förväntas vara självständiga. Syftet med denna avhandling var att undersöka graden av trygghet hos svenska barnmorskstudenter strax innan de var färdigutbildade. Ett annat syfte var att utforska hur kliniskt verksamma barnmorskor reflekterar över lärande och vilka faktorer som bidrar till att utveckla yrkesmässig kompetens och trygghet. Studie I var en tvärsnittsundersökning med svenska barnmorskestudenter (n = 238). De bedömde egen trygghet inom alla kompetenser som en barnmorska förväntas kunna samt utföra självständigt. Resultaten av studie I bekräftade att svenska barnmorskestudenter känner sig trygga att hantera de vanligaste rutinerna vid normal graviditet, förlossning, eftervård samt nyföddhets vård. De känner sig emellertid inte fullt så trygga när något avviker från det normala samt vid obstetriska nödsituationer. Vid jämförelse mellan yngre och äldre barnmorskestudenter samt grad av trygghet, var det den yngre gruppen av barnmorskestudenter som kände sig tryggare i allmänhet jämfört med den äldre gruppen. Studenter vid ett universitet med en medicinsk fakultet var också mer trygga än studenterna vid ett universitet utan en medicinsk fakultet. I studie II hölls fokusgrupper med 14 barnmorskor, de diskuterade och reflekterade över hur barnmorskor utvecklar kompetens. Metod för att analysera var innehållsanalys, i resultatet framkom fyra kategorier 1.) känslor av professionell trygghet utvecklas över tid ; 2.) Personliga kvaliteter påverkar yrkesutveckling. 3.) metoder för kunskap och kompetensutveckling; och 4.) Kompetens som utveckling och krävande. Slutsatsen av denna avhandling är att mer klinisk träning under utbildning är önskvärt. Barnmorskestudenter behöver tillgång och möjlighet att öva obstetriska nödsituationer tillsammans i team bestående av förlossningspersonal och barnläkare. Det tar tid att lära samt att känna trygghet, en möjlighet att underlätta för studenter vore att utöka samt förlänga barnmorskeutbildningen, att inkludera mer klinisk träning. Detta skulle innebära att stärka studenters möjligheter till en utökad klinisk trygghet. Kliniska barnmorskor hävdar att det tar tid att känna sig trygg och att det ett finns behov av att utveckla professionalism.
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Nilsson, Linnéa. "Antikens barnmorskor : Männens berättelser om kvinnan". Thesis, Uppsala universitet, Institutionen för arkeologi och antik historia, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-353593.
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Ramahlo, Tebogo. "The self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa". University of the Western Cape, 2020. http://hdl.handle.net/11394/8158.
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Magister CurationisBackground: Globally, nurses and midwives are the most important healthcare providers. In most countries, nurses and midwives are often the first point of contact to healthcare, and in many rural areas, they are the only point of contact for patients. Skilled midwives are essential for the care of pregnant women and the safe delivery of their infants. Midwives play an important role in promoting the health and wellbeing of women, newborns and their families. In South Africa, slow progress in reducing maternal mortality can be partially attributed to a lack of appropriately trained health professionals to render some basic maternal care services. Aim & objectives: The aim of this study was to investigate the self-perception of preparedness for midwifery practice of final-year nursing students at a university in the Western Cape, South Africa. The objectives of the study were to: identify midwifery skills final-year nursing students found challenging to perform independently, determine the level of confidence of final-year nursing students for managing patients in the maternity unit, determine the level of comfort/confidence of final-year nursing students in key practice skills performance, and collect baseline evidence of nursing students’ perceptions of self-preparedness to inform the higher education institution of gaps and needs identified by nursing students. Methodology: A quantitative research approach using a descriptive survey design was implemented to gather information. A self-administered questionnaire using the Casey-Fink Readiness for Practice Survey was used. Due to the limited size of the population, an all-inclusive sampling strategy was utilised, with a sample size of N=217. At the time of the survey, only 164 nursing students attended class. Only 112 questionnaires were returned, yielding a response rate of 70.88%. All returned questionnaires had no missing data. SPSS Statistics version 25 was utilised for data analysis. Descriptive statistics, frequencies and tests for association were utilised.