Abstract
Background: This article is the third in a series reporting on original research exploring the sustainability of Lead Maternity Carer (LMC) midwifery. Previous publications have described sustainable practice arrangements and the way that partnership and reciprocity with women sustain LMC midwives. Research about sustainable caseload practice is important because lessons can be learnt that ensure this model of care, with its excellent outcomes and high levels of maternal satisfaction, continues. Aim: The aim of this paper is to provide stand-alone data in relation to what sustains LMC midwives in midwifery practice over time. The final theme to emerge from our original research arose from data which support the strong relationship between the midwives' generosity of spirit alongside professional boundaries that is critical to sustaining caseloading practice. Method: A qualitative descriptive study was conducted in New Zealand. Eleven LMC midwives with between 8-20 years of practice experience were interviewed. Interviews were transcribed and the data thematically analysed. The researchers within the group undertook the analysis together in a reciprocal fashion between the individual interviews and all the data as a whole. Themes were clustered into groups and excerpts from the data used to illustrate the agreed themes. Ethics approval was obtained from Auckland University of Technology Ethics Committee. Conclusion: This paper draws attention to the significance of generosity of spirit in LMC practice and how this acts synergistically with personal and professional boundaries. Reciprocity and partnership work well when generosity of spirt is enabled to flourish, and this, in turn, supports joy of practice. This paper provides further insight into how LMC practice is sustained over time and provides direction for midwives in LMC practice, and those planning to enter LMC practice, in New Zealand and elsewhere.
Highlights
This article is the third in the series and follows two previously published papers (Gilkison et al, 2015; McAra-Couper et al, 2014)
This paper provides further insight into how Lead Maternity Carer (LMC) practice is sustained over time and provides direction for midwives in LMC practice, and those planning to enter LMC practice, in New Zealand and elsewhere
Our research found that generosity of spirit is part of the history and culture of New Zealand midwifery and is integral to the sustainability of LMC midwifery practice (Guilliland & Pairman, 1995, 2010)
Summary
This article is the third in the series and follows two previously published papers (Gilkison et al, 2015; McAra-Couper et al, 2014). The themes that were identified in the research and explored in those previous papers were: working in partnership, reciprocal supportive relationships, like-minded midwifery partners, realising one is not indispensable, practice arrangements and managing the unpredictability of being on call. The final theme "generosity of spirit", describing the relationship between generosity of spirit and professional boundaries that sustain caseloading practice for Lead Maternity Carer (LMC) midwives, is explored. LMC midwives care for 93.4% of women, with the remainder choosing a general medical practitioner (0.5%) or an obstetrician (6%) (Ministry of Health, 2015). This article is the third in a series reporting on original research exploring the sustainability of Lead Maternity Carer (LMC) midwifery. Previous publications have described sustainable practice arrangements and the way that partnership and reciprocity with women sustain LMC midwives. Research about sustainable caseload practice is important because lessons can be learnt that ensure this model of care, with its excellent outcomes and high levels of maternal satisfaction, continues
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