Midwifery Knowledge Research Articles

Analysis of the Midwifery Profession According to the Fields of Philosophy: Qualitative Study

Objective: Philosophy contributes to the formation of new strategies by affecting the development of questioning ability. Philosophy should be utilized to question the current situation and develop new strategies in midwifery. The study analyzes the midwifery profession according to the fields of philosophy, ontology, epistemology, and axiology. Methods: The qualitative type of research is conducted between May 20, 2021, and August 30, 2021. The research is carried out with 12 participants who were selected by the maximum diversity sampling technique. The data are collected face-to-face with the participant information form and the semi-structured interview form. The data recorded during the interview is evaluated thematically through content analysis. Results: In the research, three themes are identified: professional health discipline from an ontological point of view; development of midwifery knowledge and practices from an epistemological point of view; and professional and individual values from an axiological point of view. Conclusion: In this study, it is stated that the midwifery profession is essential and sacred, that it should have professional knowledge and updated literature, and that women should be with them every period since birth.

You are Now a Midwife: What Next?

Congratulations if you have recently completed your midwifery programme. With assignments and assessments behind you are now ready to enjoy being a midwife. However, the end of your midwifery programme is not the end of your learning. Some of you will want to undertake further academic study and have an ambition of advancing your midwifery knowledge to move onto more specialised roles. You will all complete activities put on by your place of work, attend study days and the occasional conference.

Midwifery Insights Advancing Midwifery Knowledge Through Storytelling: A Birth Story

Midwifery as a profession and a vocation has historically been passed from generation to generation through narratives, practice and storytelling: wise women passing their skills down to the next generation, again and again.1 In this article, midwife Pia invites student midwives to take a moment for themselves while she tells the story of her 40th birth as a student midwife. Through this story, she explains how continuity of carer (CoC) and an experience of spontaneous labour was crucial for developing the direction of her career. *Names and details of the story shared with parents’ permission.

Pre-eclampsia training needs of midwives in a Ghanaian tertiary hospital: A cross-sectional study

AimThis study aimed to assess the specific clinical and non-clinical training needs of midwives and determine their preferred approach to enhancing performance. BackgroundPre-eclampsia remains one of the leading causes of maternal deaths in low and middle-income countries. Pre-eclampsia-related deaths may be due to reduced midwifery knowledge and inadequate management. Therefore, a training needs assessment is vital in identifying gaps in practice, especially, in poorly resourced settings for maximal use of training resources. DesignA hospital-based cross-sectional study. SettingThe largest tertiary hospital in Ghana. MethodsAn online version of the validated WHO Hennessy-Hicks Training Needs Analysis questionnaire was used to assess midwives’ training needs on the management of pre-eclampsia. The tool has good psychometric properties and was used to assess 1) midwives’ confidence in performing tasks, 2) the importance of the task to their role and 3) their preferred performance improvement approach. Data analysis adhered to the guidelines specified in the Hennessy-Hicks Training Needs Analysis Questionnaire and the priority training requirements of the midwives were assessed through descriptive statistics and a series of independent t-tests. ResultsAmong the 250 midwives who responded, most possessed 1–5 years of experience (74.7 %). All 28 tasks were viewed by midwives as essential responsibilities in pre-eclampsia management. Midwives had the greatest need for training in research/audit and clinical skills domains respectively (p < 0.001, 95 % confidence interval: 1.08–1.47, Cohen’s-D = 1.27; and p < 0.001, 95 % confidence interval: 0.69–1.06, Cohen’s-D = 0.87). The foremost primary training necessity, as recognised by midwives, was undertaking health promotion activities, including antenatal health education (MD= 0.43, 95 % confidence interval: 0.29–0.57). Training courses were identified as the preferred approach to address training needs and improve overall proficiency. ConclusionMidwives in Ghana require comprehensive training covering research and clinical-based competencies to improve pre-eclampsia management. Considering the pivotal role of Ghanaian midwives in safeguarding maternal well-being, there is a compelling need to enhance the calibre of midwifery services. These findings can guide stakeholders in countries with comparable healthcare contexts in creating effective, resource-efficient training programs that avoid counterproductivity, ultimately supporting national initiatives to enhance pre-eclampsia management and the quality of care.

THE EFFECTIVENESS OF BIRTHING BALL AS COMPLAINTS REDUCTION PHYSICAL ON PREGNANT MOTHERS TO PREPARATION FOR DELIVERY IN DEBY MATERNAL HOUSE IN MEDAN CITY

Labor is the process of the baby, placenta, amniotic membranes coming out of the mother's uterus, gestational age at term (37 weeks) without any complications, labor pain causes frustration, trauma that can occur to the mother. Labor pain can be treated in an effective way because pain accompanied by a stress reaction will have harmful side effects for the mother and fetus. This study aims to develop knowledge in the field of midwifery knowledge and can educate mothers in labor to reduce physical complaints and can speed up the delivery process. The research method used is a quasi-experimental pre-test and post-test research design, which is a research design to analyze the effectiveness of the Birthing Ball as a Reduction of Physical Complaints in Pregnant Women on Childbirth Preparation. Sampling using consecutive sampling technique, analysis using independent t test to compare the values ​​in the intervention group and control group. There is an effect of the implementation of the birthing ball as a reduction in physical complaints with a value of p = 0.001 meaning p &lt;0.05 and there is a difference in the process of labor taking place faster in the first stage of the active phase in the intervention group where birthing balls are carried out 2-3 times a day during the final trimester compared to the group. control. The birthing ball should be done every day during the third trimester of pregnancy to reduce the physical complaints of pregnancy and speed up the delivery process.

Midwives' views on the acceptability of a future trial of the Sims posture for fetal malposition in labor in the context of their knowledge and practice: A mixed-methods study.

INTRODUCTIONEvidence of safe and effective maternal interventions to improve fetal malposition in labor is inconclusive. A contemporary, randomized controlled trial of maternal posture would expand this evidence, however, collaboration with midwives will be critical. The aim of this study is to assess midwives’ views on the acceptability of a trial of the Sims posture for fetal malposition in labor and identify current midwifery knowledge and practice surrounding fetal malposition.METHODSA mixed-methods study incorporating a web-based survey and guided focus groups with midwives was conducted in New Zealand during 2020. Midwives serving Auckland Hospital and Māori and Pasifika midwives serving South Auckland (n=136) were invited to participate in the study. Data were descriptively analyzed using chi-squared and cross-tabulation. Collaboration with a trial was contextualized by thematic content from survey and focus-group data.RESULTSFifty (36%) midwives from primary and secondary/tertiary settings responded to the survey, and 19 participated in four focus groups. Most midwives thought maternal posture affects malposition, utilize changes of posture often with the peanut ball, would recommend a posture if cesareans were reduced by 20%, and would definitely or probably collaborate with a labor trial of posture. Fetal monitoring with women in the Sims posture was difficult for nearly one-fifth of midwives. Seven themes emerged regarding trial participation: trial design, relevance, practice, diagnosis, knowledge and skills, and trial compliance.CONCLUSIONSCurrent practice concerning malposition utilizes flexibility of posture. Provision of some free movement and reassurance surrounding trial equipoise may enhance trial collaboration.

Task shifting for maternal and neonatal care in low-resource settings: A mixed-methods evaluation of a midwifery training program in rural Papua New Guinea

In an effort to reduce maternal and neonatal mortality, a rural health system in Papua New Guinea implemented a two-week midwifery training program for 47 nurses and community health workers. We evaluated this program by administering pre- and post-training knowledge tests, focus group discussions, a clinical vignette task, and key informant interviews. Participants improved significantly in their midwifery knowledge and demonstrated effective care in the clinical vignettes. Participants described the training as novel and beneficial. Program leaders were motivated to scale up the program and assess community-level impact. This program has strong potential to improve local obstetric care capacity.

The quantification of midwifery research: Limiting midwifery knowledge.

As two academics researching in the area of maternal health, we are increasingly concerned with what we see as a positivist turn in midwifery research. In this paper, we examine this idea of the quantification of midwifery research, using as an example the current esteem given to the systematic literature review, and its creep into other methodologies. We argue that the current favor toward quantitative research and expertise in midwifery academia risks the future of midwifery research by the lack of equal development of qualitative experts, diluting qualitative research rigor within the profession, and limiting the kinds of questions asked. We identify the similarity between the current prominence of quantitative research and medical dominance in midwifery and maintain that it is of vital importance to the profession (research and practice) that the proper attention, contemplation, and merit are given to qualitative research methods.

Being Empowered to Reduced Unnecessary Medicalisation of the Latent Phase

Medical care saves lives, but the biomedic al model of care should not be the dominant model in maternity. By offering some insight into global definitions of the latent phase and associated outcomes of a prolonged latent phase, this article highlights how the unnecessary medic alisation of the latent phase occurs within the UK. Discussion surrounds how midwives as a group can claim empowerment and prevent unnecessary medicalisation through leadership, thinking beyond guidelines, constructing midwifery knowledge and listening to women. It acts as an introduction for midwives to suggest how they can change their practice as a professional group.

Strengthening midwifery education through clinical experience: Findings from a qualitative study in Indonesia

BackgroundOne of the Indonesian Government’s strategies to reduce maternal mortality rates has been to place a midwife in every village to provide midwifery care and facilitate essential primary healthcare services. To increase the numbers of midwives, the Indonesian Government began opening midwifery schools. However, Indonesia’s maternal mortality rates remained high. This raises the question of the quality of midwifery education in Indonesia and how this education could be strengthened so that midwifery plays a key role in reducing maternal mortality rates. Aim of the researchThe aim of this study was to identify the barriers and enablers to strengthening midwifery education in Indonesia. MethodsA qualitative descriptive approach and in-depth interviews was the method used with 37 participants from 12 midwifery schools in eight cities situated in six provinces in Indonesia. Indonesian midwives, midwifery lecturers, midwifery students, newly graduated midwives, and obstetricians were interviewed in Bahasa Indonesia. Interviews were transcribed, translated, and thematically analysed following Braun and Clark (2006). FindingsThis article focuses on findings on “midwifery clinical experience”, a theme which contained four sub-themes: “effective hands-on clinical experience”, “theory-practice gap”, “role of the mentor in practice”, and “the system in the clinical environment”. ConclusionThis study highlights barriers to preparing midwifery students for obtaining adequate midwifery knowledge and skills during clinical placement. Quality clinical experience would improve knowledge and skills for better preparedness for students to competently meet their role as midwives, contributing to the strengthening of midwifery education in Indonesia.

Midwifery knowledge of equitable and culturally safe maternity care for Aboriginal women.

The Birthing on Noongar Boodjar project (NHMRC Partnership Project #GNT1076873) investigated Australian Aboriginal women and midwives' views of culturally safe care during childbearing. This paper reports on midwifery knowledge of Aboriginal women's cultural needs, their perceptions of health systems issues, and their ability to provide equitable and culturally safe care. A qualitative study framed by an Indigenous methodology and methods which supported inductive, multilayered analyses and consensus-driven interpretations for two clinical midwife data groups (n=61) drawn from a larger project data set (n=145) comprising Aboriginal women and midwives. Midwives demonstrated limited knowledge of Aboriginal women's cultural childbearing requirements, reported inadequate access to cultural education, substituted references to women-centered care in the absence of culturally relevant knowledge and consistently expressed racialized assumptions. Factors identified by midwives as likely to influence the midwifery workforce enabling them to provide culturally safe care for Aboriginal women included more professional development focused on improving understandings of cultural birth practices and health system changes which create safer maternal health care environments for Aboriginal women. Individual, workforce, and health systems issues impact midwives' capability to meet Aboriginal women's cultural needs. An imperative exists for effective cultural education and improved professional accountability regarding Aboriginal women's perinatal requirements and significant changes in health systems to embed culturally safe woman-centered care models as a means of addressing racism in health care.

The regulation of midwives in England, c.1500–1902

Throughout the 19th century, midwives were depicted as incompetent slatterns in both popular imagery and medical literature. We examine how, between 1500 and 1800, midwifery was regulated by a combination of formal licensing by the Church and informal oversight within the community. We argue that episcopal licensing demanded that midwives demonstrate knowledge and competence in midwifery, not only that they were spiritually fit to baptise dying infants. Although episcopal licensing lacked statutory authority, the symbiosis of formal and informal systems of regulation ensured good midwifery practice and midwives were regarded as experts in all matters relating to childbirth. The Midwives Act 1902 introduced statutory regulation of midwives, restoring their ‘professional status’ if in a subordinate role. We show that the history of the regulation of midwives across four centuries casts light on the interplay between formal and informal regulation and matters of gender and professional status.

Writing a journal article from your thesis or research project

Background: Many midwives who have completed their thesis or dissertation have not subsequently published their findings in a peer reviewed journal. This means that the potential contribution of their research findings to midwifery knowledge does not reach a wider audience. Aim: The aim of this paper is to alert prospective midwife authors to useful tips and writing strategies and encourage them to write and submit an article to a peer reviewed journal. Discussion: Adapting a large manuscript to the size and shape required by a journal can be a daunting task, requiring trimming and rewriting. Some authors may also experience writer anxiety and a lack of practical support. These issues are addressed, and readers are alerted to steps and strategies for writing well and establishing a simple clear argument. We discuss the practical challenges and offer advice on making time to write, choosing a journal, enlisting the help of a co-author, preparing for submission, and responding to editor or reviewer comments. Conclusion: It is our intention to assist midwives to publish their research, while acknowledging that this work needs to fit around already busy lives. In this article we address the personal and practical issues which may inhibit some midwives from writing, plus discuss tips and strategies to manage the writing tasks.

“When spotted deaths ran arm’d through every street”: Women-Healers and the Great Plague in Geraldine Brooks’ Year of Wonders

In the late 1600s, England was reeling under the recurrence of the pandemic that had swept continent-wide in the 14th century. However, it was not the only disease lurking around. At the heels of the scarlet-ringed Black Death, came the scarlet letter of witchcraft accusations, mostly geared towards Wise Women in the margins of society- women who exhibited knowledge and skill in medicine, herbal remedies and midwifery. Set in the time when religious fanaticism and Puritanical fear-mongering was at its height, Year of Wonders presents before us an opportunity to delve into the web of lies and life-threatening allegations that formed the bedrock of the English witch trials continuing in full swing since the incursion of Continental lore ever since James I came to power. Furthermore, with midwives and female herbalists in the area falling prey to targeted sexual and physical violence in the wake of the pandemic in the story, what needs to be inspected is the inescapable link between Church-backed patriarchy’s delusional fear, jealousy and consequent scapegoating of the economically and socio-sexually marginalized woman-healers in the countryside and the failure of the male-dominated medical field in effectively containing the spread of the virus. The paper investigates further the generational flow of biomedical wisdom in a female-oriented domain which becomes significant in the presentation of the two female leads inheriting the function of the Wise Women from the original holders of the position, thus solidifying the sense of found family and sisterhood standing against the mounting social pressure to bend to the will of the Church and the men in their lives.

Experiences of a new cadre of midwives in Bangladesh: findings from a mixed method study

BackgroundBangladesh did not have dedicated professional midwives in public sector health facilities until recently, when the country started a nation-wide programme to educate and deploy diploma midwives. The objective of the findings presented in this paper, which is part of a larger study, was to better understand the experience of the midwives of their education programme and first posting as a qualified midwife and to assess their midwifery knowledge and skills.MethodsWe applied a mixed method approach, which included interviewing 329 midwives and conducting 6 focus group discussions with 43 midwives and midwifery students. Sampling weights were used to generate representative statistics for the entire cohort of the midwives deployed in the public sector health facilities.ResultsMost of the midwives were satisfied with different dimensions of their education programme, with the exception of the level of exposure they had to the rural communities during their programme. Out of 329 midwives, 50% received tuition fee waivers, while 46% received funding for educational materials and 40% received free accommodation. The satisfaction with the various aspects of the current posting was high and nearly all midwives reported that a desire to work in the public sector in the long run. However, a significant proportion of the midwives expressed concerns with equipment, accommodation, transport and prospect of transfers. The scores on the knowledge test and self-reported skill levels were varied but reasonably high.ConclusionWhile the midwives are highly motivated, satisfied with many aspects of their current jobs and have adequate knowledge and skills, there are some bottlenecks and concerns that, if unaddressed, may derail the success of this programme. To capture the career progress of these midwives, additional research, including a follow-up study with the same cohort of midwives, would be beneficial to this programme.

Shared learning on an international clinical placement: Promoting symbiotic midwifery practice knowledge

AimThe aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia. BackgroundCultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women’s individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs. MethodsThis study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n=9), a Balinese private midwifery school (n=4) and a Balinese public midwifery school (n=4). Thematic analysis was used to analyse the data. FindingsThe findings were categorised into major themes under the headings of “Learning together despite differences”; “Cultural differences”, “Communication, Resources”, and “Recommendations for future placements”. ConclusionThis study provides a valuable insight into how shared learning increases students’ midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students’ clinical midwifery practice.

Opinion survey on postpartum pelvic floor rehabilitation among Ivorian practitioners

Introductioncette étude visait à rapporter l´expérience des prestataires de soins dans les maternités d´Abidjan en matière de rééducation périnéale en évaluant leur niveau de connaissance et leurs attitudes pratiques.Méthodesune enquête a été menée auprès des obstétriciens et sages-femmes exerçant dans une maternité d´Abidjan depuis au moins deux ans. Les informations ont été recueillies sur un questionnaire à questions directes, ouvertes et semi-ouvertes.Résultatscent vingt praticiens ont été sélectionnés dont 66 sages-femmes et 54 obstétriciens. Un total de 79,6% des obstétriciens et 37,9% des sages-femmes officiaient dans un centre hospitalier universitaire. L´indice de connaissance des sages-femmes était bon ou moyen dans 25% (intervalle interquartile [IIQ] 16,8-48,3). Tandis que les obstétriciens avaient un niveau de connaissances bon ou moyen dans 65% (IIQ 41,1-48,3). La majorité des prestataires convoquaient les femmes dans le post partum, mais seulement 7 soignants sur dix contrôlaient le périnée et deux obstétriciens sur dix proposaient une rééducation périnéale.Conclusionle faible niveau de connaissances des sages-femmes et obstétriciens ivoiriens sur la rééducation périnéale du post-partum et le manque de pratique suggèrent la nécessité d´une mise à niveau perpétuelle de ceux-ci à travers des formations continues.

Knowledge and Attitudes of Ege University Midwifery, Nutrition-Dietetic, and Nursing Students About Natural Functional Foods

Objective: This study aimed to determine the knowledge and attitudes of midwifery, nutrition-dietetic, and nursing students at Ege University about natural functional foods. Materials and Methods: This descriptive study included all senior midwifery, nutrition-dietetics, and nursing students at Ege University in the 2019–2020 academic year. Of all 442 senior students in these departments, 384 86.9% could be reached. The dependent variables were knowledge and attitude regarding functional foods. Knowledge was defined as having heard of and giving at least five examples of functional foods. The attitude was evaluated through the Attitude Towards Functional Foods Scale. The sociodemographic characteristics, health behaviors, and the perceptions of health were independent variables. Data were collected through a questionnaire and the attitude scale. Chi-square test, Student’s t-test, and one-way analysis of variance were used for the data analyses. Results: More than half of the students stated that they had never heard of the term ‘functional food’ previously; 37.5% could not give an example for functional foods. Nutrition dietetics students were able to give more examples of functional foods than nursing and midwifery students p

Nurturing autonomy in student midwives within a student led antenatal clinic

BackgroundA clinical environment that provides meaningful and productive learning experiences is essential for students of all health care professions. To support the learning needs of undergraduate midwifery students and facilitate the continuity of care experiences a student led clinic was established in one South East Queensland maternity unit. AimThis study explored the experiences and learning processes of previous and current midwifery students undertaking clinical practice within a student led clinic. MethodQualitative descriptive. Ten students that elected to work in the midwifery student led clinic were invited to participate in a one off digitally recorded face to face or telephone interview. Thematic analysis was used to analyse the data set. University ethical approval was granted (NRS/17/15/HREC). FindingsFindings suggest the student led clinic positioned students in the ‘driver’s seat’. Overwhelmingly students described the clinic as providing them with an array of opportunities to ‘lead’ care rather than being forced to ‘sit and watch’. Students believed the experience of working in the clinic increased their midwifery knowledge, skills, confidence, critical thinking, and the ability to advocate for and empower women. ConclusionHigh quality and supportive clinical teaching and learning experiences are vital for ensuring the student midwife develops into a competent practitioner who is fit for registration. The evidence from this small study highlights the benefits afforded to students of working in partnership not only with pregnant women but also with their university midwifery lecturer. The student’s continuity of care learning experiences appeared to foster and cultivate their capability, identity, purpose, resourcefulness and connection; all the five senses of success.

Storytelling, Midwifery Knowledge and Physiological Birth

Midwifery has a long oral tradition, where knowledge has been generated via the sharing of stories and experience from practice, rather than via scientific research. Any midwife working in a team in the community, on a labour ward or in a birth centre will be familiar with the rich discussion and reflection on practice that is at the heart of what we do. In recent years, the move towards a more scientific and ‘evidence-based’ approach has undermined the value of this tradition as a form of knowledge. This article explores the nature of midwifery knowledge, proposing that storytelling is a valid method of sharing, reflecting on and developing midwifery knowledge and practice in relation to supporting physiological labour and birth.