Midwives Research Research Articles

Insights gained through exploring UK midwifery care by US midwifery graduate students in a short-term study abroad: A qualitative study.

Student midwives exposed to effective systems of midwifery care in other countries can consider how aspects of this knowledge can translate into their healthcare system to improve maternal and infant perinatal outcomes. An optional short-term study abroad (STSA) experience was developed for US midwifery graduate students to expose them to the UK healthcare system, where midwives are considered the primary professionals for the care of the childbearing family. This qualitative study explored the influence of an STSA experience on US midwifery graduate students' learning of midwifery in the UK. Ten midwife student participants wrote pre- and post-trip narratives in the US and daily diary entries during their week in the UK. A grounded theory approach guided the content analysis. The themes were derived from the NVivo software data by three midwife researchers who value global health learning experiences. Analysis was shared with participants to ensure its trustworthiness. Themes that emerged included: 'Another viewpoint', encapsulating curiosity and comparison of US and UK midwifery; 'Eye-opening', capturing surprise at noted differences between US and UK midwifery practice; and 'Goals met and influenced', expressing how their learning is anticipated to shape their professional identities and career trajectories going forward. US student midwives exposed to functional systems in countries where midwifery care is fully integrated, broadened their views of midwifery care and practice. They became inspired to make positive changes in the US. Educational opportunities for midwifery students, such as STSA experiences, can positively influence self-confidence and professional identity.

Transforming the Quality Maternal Newborn Care Framework into an index to measure the quality of maternity care.

The Quality Maternal and Newborn Care (QMNC) Framework describes the care that childbearing women and newborn infants need in all settings. It comprises five components and was designed for use in planning, workforce development, and resource allocation, aimed at improving the quality and cost effectiveness of maternal and newborn care globally. The purpose of this paper is to describe the first phase of a project designed to transform the Framework into a quantitative tool for service user assessment of the quality of maternity care. Each component of the original Framework content was developed into a draft service user questionnaire and distributed to an expert panel, drawn from a range of low-, middle-, and high-resource countries. The panel consisted of five Framework authors, nine midwife researchers, six midwives, and five service user (consumer) advocates. Two rounds of discussion and revision were undertaken with the expert panel who commented on the importance, relevance and clarity of questions, and then on their necessity, wording, and order. A third round involved two experts in survey design. Following 24 responses in the first round, the questions were refined and returned to the panel. After incorporating the second-round comments from 16 experts, the survey was then sent to two experts in questionnaire design and construction. Face validity was affirmed through this consultative process. Despite Covid-19 pandemic-related restrictions, this robust iterative consultative process with an international expert panel has resulted in the prototype QMNC Framework index (QMNCFi)-a questionnaire designed for use in diverse settings to assess the quality of maternity care. The QMNCFi's psychometric properties are now being tested in an international online survey.

Midwives speaking out on COVID-19: The international confederation of midwives global survey.

Maternity services around the world have been disrupted since the outbreak of the COVID-19 pandemic. The International Confederation of Midwives (ICM) representing one hundred and forty-three professional midwifery associations across the world sought to understand the impact of the pandemic on women and midwives. The aim of this study was to understand the global impact of COVID-19 from the point of view of midwives' associations. A descriptive cross-sectional survey using an on-line questionnaire was sent via email to every midwives' association member of ICM. The survey was developed and tested by a small global team of midwife researchers and clinicians. It consisted of 106 questions divided into seven discreet sections. Each member association was invited to make one response in either English, French or Spanish. Data were collected between July 2020 and April 2021. All respondents fulfilling the inclusion criteria irrespective of whether they completed all questions in the survey were eligible for analysis. All data collected was anonymous. There were 101 surveys returned from the 143 member associations across the world. Many countries reported being caught unaware of the severity of the infection and in some places, midwives were forced to make their own PPE, or reuse single use PPE. Disruption to maternity services meant women had to change their plans for place of birth; and in many countries maternity facilities were closed to become COVID-19 centres. Half of all respondents stated that women were afraid to give birth in hospitals during the pandemic resulting in increased demand for home birth and community midwifery. Midwifery students were denied access to practical or clinical placements and their registration as midwives has been delayed in many countries. More than 50% of the associations reported that governments did not consult them, and they have little or no say in policy at government levels. These poor outcomes were not exclusive to high-, middle- or low-income countries. Strong recommendations that stem from this research include the need to include midwifery representation on key government committees and a need to increase the support for planned out of hospital birth. Both these recommendations stand to enhance the effectiveness of midwives in a world that continues to face and may face future catastrophic pandemics.

The use of educational games in midwifery: an overview

This article provides an overview of the development, testing, and use of educational games in midwifery. It considers the educational advantages of this approach and draws on the authors' experience of using games to promote safer childbirth. Games designed for the World Health Organization Safe Motherhood midwifery education modules and also for the Lugina Africa Midwives Research Network are described, and the experiences of project participants of using and researching the effect of these games are discussed. Early evaluation has shown promise for the increasing use of more innovative educational approaches and considerable potential for having a positive effect on midwifery practice and consequently the quality of care.

Avoiding Induction of Labour for Prolonged Pregnancy

Current national guidelines in many countries recommend that otherwise healthy pregnant women be offered induction of labour if the pregnancy exceeds 10 days beyond term. Many women in this situation wish to avoid clinical or pharmacological induction techniques, and seek advice on alternatives from their midwives. The UK northwest midwives research group conducted a survey of midwives based on four sites. The formal evidence base for the most frequently recommended practices was then reviewed. The aim was to identify midwives’ knowledge of techniques to avoid clinical or pharmacological induction of labour for post-maturity in healthy women and babies; the related advice they would give to women; and the formal evidence base for those techniques most frequently recommended.

The Lugina Africa Midwives Research Network: Challenges and successes

The Lugina Africa Midwives Research Network: Challenges and successes

Honoring U.S. midwife researchers. Part I: theorists and historical influences.

Journal of Midwifery & Women's HealthVolume 60, Issue 1 p. 89-98 Honoring US Midwife Researchers Part I: Theorists and Historical Influences Mary Barger CNM, PhD, MPH, Mary Barger CNM, PhD, MPHSearch for more papers by this authorMary Ann Faucher CNM, PhD, MPH, Mary Ann Faucher CNM, PhD, MPHSearch for more papers by this authorPatricia Aikins Murphy CNM, DrPH, Patricia Aikins Murphy CNM, DrPHSearch for more papers by this author Mary Barger CNM, PhD, MPH, Mary Barger CNM, PhD, MPHSearch for more papers by this authorMary Ann Faucher CNM, PhD, MPH, Mary Ann Faucher CNM, PhD, MPHSearch for more papers by this authorPatricia Aikins Murphy CNM, DrPH, Patricia Aikins Murphy CNM, DrPHSearch for more papers by this author First published: 24 February 2015 https://doi.org/10.1111/jmwh.12288Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume60, Issue1January/February 2015Pages 89-98 ACNM Members ACNM Members: Click here to log in RelatedInformation

LOFIR: Introducing a framework for building midwifery-type questions

Midwifery is an evidence-based profession. Evidence is drawn from a wide range of disciplines and midwife researchers are increasingly generating a distinct body of knowledge to support high quality care for women and their babies. Every enquiry must begin with a good question. This is the first step in the evidence-based practice cycle but existing question-building tools have largely emerged from the paradigm of evidence-based medicine. The questions student midwives want to develop often relate to women's experiences, rather than a comparison of treatment options. A framework to support the development of midwifery-type questions has not previously been differentiated. The LOFIR (theoretical location, focus, intervention, result) tool offers an alternative framework to facilitate the development of effective midwifery-type questions.

Reflexivity in midwifery research: The insider/outsider debate

Objective to explore the challenges of conducting an observational study of postnatal interactions, between midwives and women, when the researcher was a midwife observing in familiar midwifery settings. Background participant observation conducted by researchers who are themselves midwives raises questions regarding the influence of ‘identity’ and ‘insider’ knowledge on the conduct of such projects. The insider/outsider status of researchers has been explored in other disciplines, yet this is an area which is underdeveloped in the midwifery literature where few attempts have been made to subject this issue to sustained analysis. Design a qualitative study (investigating the provision of breast-feeding support in the first week after birth) provided the opportunity for reflexive exploration of the tensions faced by midwife researchers. Setting two maternity units in New South Wales, Australia. Participants participants included 40 midwives and 78 breast-feeding women. Findings possessing ‘insider’ midwifery knowledge was advantageous in the ‘getting in’ and ‘fitting in’ phases of this research study however unanticipated role ambiguity, and moral and ethical challenges, arose as a result of this ‘insider’ knowledge and status. Prolonged periods of observation challenged the midwife researcher's preconceived ideas and early decisions about the advantages and disadvantages of being an ‘insider’ or an ‘outsider’ in the research setting. Key conclusions reflexive analysis of insider/outsider experiences revealed the middle ground which participant observers tend to navigate. Whilst professional insider knowledge and status offered many advantages, especially at the first study setting, some of the inherent embodied, and socially constructed features of the ‘midwife’ observer role, were unanticipated. Cultural competence, in these observational study settings, translated into role ambiguity, and at times, culturally entrenched role expectations. Implications for practice midwifery observation of clinical practice, for research, or practice development purposes, requires a degree of juggling of insider knowledge to facilitate observation and analysis. Prior to conducting observations midwives should consider how best to occupy the middle ground between insider and outsider. Within the middle ground the midwife can draw on those aspects of ‘self’ required to negotiate respectful relationships with colleagues, whilst also ensuring the maintenance of an analytical degree of distancing.

Team process in community‐based participatory research on maternity care in the Dominican Republic

A cross-cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community-based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal-newborn care. Community-based participatory research is one way forward to address the past and present inequities constitutive of global health disparities.

Strengthening health systems

On the 30th November 2009, we had the privilege of attending the 7th Biennial Scientific Conference of the Africa Midwives Research Network (AMRN). The theme of the conference was strengthening health systems to reduce maternal, neonatal and child morbidity and mortality. The conference is one of the many activities used by AMRN to share information on evidence-based practice. Dr Christina Rawdon, acting AMRN Regional Chairperson, gave a brief overview of AMRN activities, which included evidence-based practice workshops, information technology, writing workshops and conferences; all aimed at sharing information. During her welcome speech, she reiterated the importance of ‘knowledge translation from data to impact’. She concluded by thanking the audience for contributing to AMRN's activities ‘for the love of women and children’.

Improving maternal health through research

It has been two years since we launched the African Journal of Midwifery and Women's Health (AJM) at the Africa Midwives Research Network (AMRN) conference in Nairobi 2007. Since then we have had a number of valuable contributions from midwives and nurses in many different African countries, such as Nigeria, Kenya, Zambia and South Africa, to name only a few. We have also received contributions from midwives with a special interest in Africa from other countries, such as Sweden and the UK. Research by midwives and other health professionals in Africa is copious and the aim of the AJM since its inception has been to provide a forum for this knowledge to be shared, so that clinical practice can be influenced and improved.

An African success story: an external evaluation of the AMRN

The paper provides a conference report from the Africa Midwives Research Network sixth biennial scientific conference held in Nairobi, Kenya in November 2007. The presentation was made by one of the external evaluators who undertook an independent evaluation of the Network on behalf of the Swedish International Development Cooperation Agency (Sida). The evaluation identified the lessons learned during the fourteen years of the Network's existence and concluded that AMRN has achieved much, particularly in the seven core countries at the heart of the organization. Valuable lessons have been learned concerning midwifery education and practice that should make childbirth safer and contribute appreciably to the achievement of the Millennium Development Goals. Further efforts are needed to disseminate research findings, expand opportunities for promoting evidence based practice and utilise evidence based advocacy strategies in working with governments to facilitate the development of ‘enabling environments’ essential to the functioning of skilled midwives.

Strengthening a research based profession

The major aim of the African Journal of Midwifery and Women's Health is to enhance networking and communication and provide for sharing scientific evidence and professional experiences in midwifery and women's health. To enhance networking and communication, midwives in Africa established the Africa Midwives Research Network (AMRN) in 1992. The AMRN has grown steadily I would like to congratulate all network members for the hard work they put in to make the sixth biennial conference in November 2007 such a success. The conference attracted more than 350 participants from both Africa and Europe. The participants shared various research findings in areas which should bring about a positive effect in improving the health status of women and children.

Africa Midwives Research Network sixth biennial conference

A midwife from the developed world gives her impressions of the Africa Midwives Research Network conference and the important themes that were highlighted at this special event.

Enhancing clients' rights and quality of care

Midwives from Tanzania, Zambia, Zimbabwe, and Mozambique first conceived the African Midwives Research Network (AMRN) in Tanzania in 1992 (Lugina et al, 2002). The network provides a pathway for best evidence and information to be shared internationally, helping to create strategies and solutions for future practice. The aim of the network is to reduce maternal mortality and morbidity rates and improve the quality of care for women globally.

Science and midwifery: Paradigms and paradoxes

The everyday world of clinical practice is filled with paradigms and paradoxes that stem from the issues of who defines knowledge, how it is generated, and how the individual midwife applies it when providing care for women and families. Research useful for clinical practice should provide evidence to support scientific approaches (models) or strategies (interventions) in caring for women. In a clinical discipline, the answers to research questions should eventually inform clinical decision-making by providing practical clinical knowledge. This article presents an application of Stevenson’s research steps for the development of clinically applicable knowledge that the midwife can use to analyze and evaluate research findings as a basis for practice decisions. Specific examples of midwifery research are used to illustrate each stage in the process and the circular nature of knowledge development. The challenge is to prepare midwives who can apply research findings skillfully using the best evidence to support clinical practice, as well as to groom midwife researchers who will develop systematic programs of relevant research about midwifery practice and outcomes.

Becoming a mother — an analysis of women's experience of early motherhood

This paper presents the results of a qualitative study conducted by midwife researchers into women's experience of new motherhood. Data were collected using focus groups involving 55 first-time mothers and analysed using grounded theory method. The analysis produced six categories: 'realizing', 'unready', 'drained', 'aloneness', 'loss' and 'working it out'. The core category, 'becoming a mother', integrates all other categories and encapsulates the process of change experienced by women. Also explained are factors mediating the often distressing experience of becoming a mother. The analysis provides a conceptualization of early motherhood enabling the development of strategies for midwives, nurses and other helping women negotiate this challenge.

Midwife researchers need to get their work published

Midwives show a marked reluctance to publish findings of their research, which may be due to certain occupational characteristics. Dissemination is a crucial part of the research process and recommendations are made in this article to encourage midwives to publish their findings.

Rallying midwife researchers: how to increase output

It is widely recognized that midwifery research is critical in enhancing the quality of care, yet there is a limited research output. What are the reasons for this, and how can research initiatives be encouraged?