Midwifery Perspective Research Articles

Polycystic Ovary Syndrome as a Key Risk Factor in Pregnancy Outcomes: A Midwifery Perspective from the International Guideline.

Polycystic Ovary Syndrome as a Key Risk Factor in Pregnancy Outcomes: A Midwifery Perspective from the International Guideline.

ICP: A midwifery perspective.

ICP is a liver condition specific to pregnancy affecting 0.5-0.6% of pregnancies in Australia. to review the SOMANZ guidelines and extrapolate information relevant to midwives proving care for women with ICP. Multidisciplinary input is essential in caring for women with ICP and their families. Non-fasting TSBA samples ≥19 µmol/L are diagnostic in the presence of pruritus. Peak TSBA denotes the severity of the disease. Increased risk of stillbirth is small when peak TSBA ≥100 µmol/L. Midwives play an essential role in supporting women with ICP helping them navigate complex appointments and manage the pruritus and concomitant issues.

Pregnancy experiences of transgender and gender-expansive individuals: A systematic scoping review from a critical midwifery perspective.

Evidence suggests that transgender and gender-expansive people are more likely to have suboptimal pregnancy outcomes compared with cisgender people. The aim of this study was to gain a deeper understanding of the role of midwifery in these inequities by analyzing the pregnancy experiences of transgender and gender-expansive people from a critical midwifery perspective. We conducted a systematic scoping review. We included 15 papers published since 2010 that reported on pregnancy experiences of people who had experienced gestational pregnancy at least once, and were transgender, nonbinary, or had other gender-expansive identities. Three themes emerged from our analysis: "Navigating identity during pregnancy," "Experiences with mental health and wellbeing," and "Encounters in the maternal and newborn care system." Although across studies respondents reported positive experiences, both within healthcare and social settings, access to gender-affirmative (midwifery) care and daily social realities were often shaped by trans-negativity and transphobia. To improve care outcomes of transgender and gender-expansive people, it is necessary to counter anti-trans ideologies by "fixing the knowledge" of midwifery curricula. This requires challenging dominant cultural norms and images around pregnancy, reconsidering the way in which the relationship among "sex," "gender," and "pregnancy" is understood and given meaning to in midwifery, and applying an intersectional lens to investigate the relationship between gender inequality and reproductive inequity of people with multiple, intersecting marginalized identities who may experience the accumulated impacts of racism, ageism, and classism. Future research should identify pedagogical frameworks that are suitable for guiding implementation efforts.

Healers and midwives accused of witchcraft (1563–1736) - What secondary analysis of the Scottish survey of witchcraft can contribute to the teaching of nursing and midwifery history

BackgroundNearly 4000 people were accused of witchcraft in Scotland between 1563 and 1736. Some of these were healers, midwives, and nurses. ObjectiveTo investigate Scotland's folk-healers and midwives accused of witchcraft and review their work from a nursing and midwifery perspective. DesignSecondary analysis of the Survey of Scottish Witchcraft. MethodsThose on the Survey with witchcraft accusations relating to folk-healing or midwifery were identified and their biographies were created from Survey data (2021). Individual biographical data were descriptively analysed. Healing/midwifery practice information was tabulated and thematically analysed. Results142 individuals were identified (85 % women), 51 % were found guilty, 90 % were executed. Most (98 %) were folk-healers with 10 accused for midwifery reasons. Mainly their work was accused of causing harm. Three themes emerged: their use of rituals; unorthodox religious practices and treatments. Rituals included actions carried out a certain number of times. Religious practices frequently referenced Catholicism. Many of their treatments for ingestion, application or bathing used items still recognised for their health properties. Approximately, 10 % of the 142, mainly in the 1500s/early 1600s, utilised expensive items and complex treatments which had more in common with ‘elite’ knowledge rather than simple folklore. ConclusionsAcross all 142 people, many aspects of their work are identifiable within more contemporary nursing and midwifery practice including their use of rituals, treatments, and holism. Mostly the accused were folk-practitioners, but a few (1500s/early 1600s) appear to have been healers working akin to physicians. Following the Protestant reformation (1560) their work, unlike that of physicians, was marginalised, considered unorthodox and harmful because they were women and/or their work reflected Catholicism. European hospital nursing originates in the monastic houses, but little is known about these early religious nurses. This study is novel in suggesting that whoever taught these accused witch/healers may have been connected to the monastic hospitals pre-Reformation.

A Midwifery Perspective on Trauma-Informed Care Clinical Recommendations.

Stephanie Tillman through her own organization, Feminist Midwife, LLC, offers trainings in trauma-informed care as well as consults on resource development and revision related to trauma-informed care. The other authors have no conflicts of interest to disclose.

A participatory action research study exploring midwives’ understandings of the concept of burnout in Ireland

IntroductionIn depth exploration of the burnout phenomenon among midwives is sparse. The concept has been extensively studied, but predominantly reports rates and evaluates interventions to reduce burnout. A definition has yet to be offered in the literature from a midwifery perspective. AimsTo explore midwives’ understandings of burnout, professionally and personally, in the context of contemporary maternity care in Ireland. MethodsThis was a Two-phase Participatory Action Research study. Five co-operative inquiry meetings were held with practising midwives (n=21) over a six-month period between October 2018 and March 2019, in a large, urban teaching maternity hospital in Dublin, Ireland. FindingsWe found that multiple factors contributed to midwives’ perceptions and understandings of the concept of burnout. Midwives defined burnout as persistent stress and exhaustion, with an associated reduction of their individual coping abilities, motivation, empathy and/or efficacy, is unique to the individual and is primarily, in the midwifery context, caused and inextricably linked to excessive workload. ConclusionBurnout is a complex concept with many entities and its significance and impact within the midwifery profession highlights the importance of its exploration and understanding. This study is the first of its kind to explore, with midwives, the concept of burnout. The elements of stress and exhaustion in the definition mirror existing definitions in the literature.

Telephone triage and midwifery: A scoping review.

Midwives use telephone triage to provide advice and support to childbearing women, and to manage access to maternity services. Telephone triage practises are important in the provision of accurate, timely and appropriate health care. Despite this, there has been very little research investigating this area of midwifery practice. To explore midwives and telephone triage practises; and to discuss the relevant findings for midwives managing telephone calls from women. A five-stage process for conducting scoping reviews was employed. Searches of relevant databases as well as grey literature, and reference lists from included studies were carried out. A total of 11 publications were included. Thematic analysis was used to identify key concepts. We grouped these key concepts into four emergent themes: purpose of telephone triage, expectations of the midwife, challenges of telephone triage, and achieving quality in telephone triage. Telephone triage from a midwifery perspective is a complex multi-faceted process influenced by many internal and external factors. Midwives face many challenges when balancing the needs of the woman, the health service, and their own workloads. Primary research in this area of practice is limited. Further research to explore midwives' perceptions of their role, investigate processes and tools midwives use, evaluate training programs, and examine outcomes of women triaged is needed.

Mind over Matter: Inside Hypnobirthing

In order to examine hypnotherapy, the psycho-physiological science underpinning the practice is an important issue and is significant for the use of hypnotherapy by women in labour and birth. Contemporary literature regarding hypnotherapy and its’ side effects and limitations focuses on the culture inherent in hypnotherapy ideology, whilst the pertinent ethical issues that arise and question its alignment with the contemporary midwifery perspective are an important factor within midwifery care. While it is possible for women to undertake hypnotherapy through self-taught measures, this paper will focus on women purchasing the CAM therapy, including the services of a supportive hypnotherapist who trains and partners with women antenatally and through their labour and birth.

Managing obesity in pregnancy – An obstetric and midwifery perspective

Overweight and obesity during pregnancy and childbirth represent a significant health burden, placing women and their infants at increased risk of almost all documented adverse outcomes. Research efforts have focused on strategies to limit gestational weight gain, including dietary and lifestyle interventions, as well as the use of adjuvant therapies such as metformin. However, there remain many barriers to behavioural change for women during pregnancy, and current care recommendations largely reflect good clinical practice, rather than being based on strong evidence.

Collaboration in Practice: Implementing Team-Based Practice: A Midwifery Perspective.

Collaboration in Practice: Implementing Team-Based Practice: A Midwifery Perspective.

Ethics Education in Midwifery Education Programs in the United States.

Familiarity with ethical concepts is a required competency for new graduates and a component of accreditation for midwifery education programs in the United States. While midwifery educators have acknowledged the importance of ethics education in midwifery programs, little is known about current methods, format, or evaluation of ethics education. A Web-based survey was developed for program directors of accredited midwifery education programs in the United States. Clock hours, formats, venues, content topics, barriers, and evaluation methods were evaluated by descriptive analysis. Fifty-one percent of programs completed the online survey (25/49). Of these, only 7 (28%) offer ethics as a stand-alone class, although all responding programs integrate some ethics education into other core classes. Programs show variation in format, venue, resources, and clock hours dedicated to ethics education. The most frequent barrier to ethics education is an already crowded curriculum (60%), although 32% of programs denied any barriers at all. The majority of programs include the ethical concepts of informed consent, shared decision making, and effective communication in curriculum content. This survey found that there is considerable variation in ethics education in terms of content, format, and evaluation among accredited midwifery education programs in the United States. Midwifery educators have an opportunity to explore the ethical dilemmas unique to maternity care from a midwifery perspective. There is also the opportunity to create a comprehensive and dynamic midwifery ethics curriculum, which incorporates both stand-alone ethics courses and ethics concepts that are woven throughout the core midwifery curriculum.

Constipation and haemorrhoids: A midwifery perspective for the childbearing continuum

Minor disorders of pregnancy and the puerperium can be debilitating, and have an impact on a woman's physical and emotional wellbeing during her transition into motherhood. Constipation and haemorrhoids are among the most common of these disorders and can arise or worsen during pregnancy and the puerperium. Due to the embarrassing nature of these disorders, women may be reluctant to seek midwifery or medical assistance and may perceive constipation and haemorrhoids as something normal to be tolerated. However, if left untreated these disorders could progress and worsen, becoming pathological and potentially leading to chronic lifelong impairment. As frontline practitioners, midwives are key in ensuring gastrointestinal wellbeing through enabling disclosure, educating women, swiftly referring when required and ensuring appropriate management. This review of relevant literature explores both constipation and haemorrhoids from the viewpoint of the midwife, including the importance of midwifery knowledge, recognition and management of the disorders in both pregnancy and the puerperium.

Perspective of midwives working at hospitals affiliated to the Isfahan University of Medical Sciences regarding medical errors

Background:Committing an error is part of the human nature. No health care provider, despite the mastery of their skills, is immune from committing it. Medical error in the labor and obstetrics wards as well as other health units is inevitable and reduces the quality of health care, leading to accident. Sometimes these events, like the death of mother, fetus, and newborn, would be beyond repair. The purpose of this study was to investigate the perspective of gynecological ward providers about medical errors.Materials and Methods:This was a descriptive–analytical study. Sample size was 94 participants selected using census sampling. The study population included all midwives of four hospitals (Al-Zahra, Beheshti, Isa Ben Maryam, and Amin). Data were collected by a self-administered questionnaire and analyzed using SPSS software.Results:This study shows that three factors (human, structural, and managerial) have affected medical errors in the labor and obstetrics wards. From the midwifery perspective, human factors were the most important factors with an average score of 73.26% and the lowest score was related to structural factors with an average score of 65.36%. Intervention strategies to reduce errors, service training program tailored to the needs of the service provider, distribution of the tasks at different levels, and attempts to reform the system instead of punishing the wrongdoer were set in priority list.Conclusions:Based on the results of this study on the perspectives of participants, among the three factors of medical errors (human factors, structural factors, and management factors), human factors are the biggest threat in committing medical errors. Modification in the pattern of teaching by the midwifery professors and their presence in the hospitals, creating a no-blame culture, and sharing of alerts in medical errors are among appropriate actions in the dimensions of human, structural, and managerial factors.

An exploration of the benefits and drawbacks of intrapartum pain management strategies

The advantages and disadvantages of pain management strategies in labour demand comprehensive midwifery exploration, with equal attention to psychological, physiological and pharmaceutical methods. This review of relevant literature discusses an array of options and their clinical sequelae from a midwifery perspective. Often intrapartum pain management is reductionist in approach, being cited around pharmacological options, negating the influential and holistic possibilities of a wider therapeutic perspective. In order to facilitate truly woman-centred care, midwives must endeavour to educate themselves and inform their practice to offer myriad of diverse coping strategies. An innate understanding of the ramifications that each strategy may have is fundamental, not only on women's perceptions and lived experience of their birth, but on the midwifery management implications which each strategy affords. Sharing this midwifery expertise enables women to self-direct their own individualised care plans in partnership with midwives, facilitating informed decisions regarding their journey through the unknown territory of labour.

Are we nearly there yet? A midwifery perspective on the Millennium Development Goals

Are we nearly there yet? A midwifery perspective on the Millennium Development Goals

The hardware and software implications of hospital birth room design: A midwifery perspective

Objectiveto explore the impacts of physical and aesthetic design of hospital birth rooms on midwives. Backgroundthe design of a workplace, including architecture, equipment, furnishings and aesthetics, can influence the experience and performance of staff. Some research has explored the effects of workplace design in health care environments but very little research has examined the impact of design on midwives working in hospital birth rooms. Methodsa video ethnographic study was undertaken and the labours of six women cared for by midwives were filmed. Filming took place in one birth centre and two labour wards within two Australian hospitals. Subsequently, eight midwives participated in video-reflexive interviews whilst viewing the filmed labour of the woman for whom they provided care. Thematic analysis of the midwife interviews was undertaken. Findingsmidwives were strongly affected by the design of the birth room. Four major themes were identified: finding a space amongst congestion and clutter; trying to work underwater; creating ambience in a clinical space and being equipped for flexible practice. Aesthetic features, room layout and the design of equipment and fixtures all impacted on the midwives and their practice in both birth centre and labour ward settings. Conclusion and implications for practicethe current design of many hospital birth rooms challenges the provision of effective midwifery practice. Changes to the design and aesthetics of the hospital birth room may engender safer, more comfortable and more effective midwifery practice.

Working and learning: Post-registration student midwives' experience of the competency assessment process

Aimto explore student midwives experiences of the Clinical Competency Assessment process utilised on the Higher Diploma in Midwifery (18 month) programme. Backgroundthe assessment of clinical skills and practice has traditionally been an integral part of midwifery educational programmes; however the method of clinical assessment has changed and developed. Similar to other countries, in Ireland assessment of clinical practice is achieved through the utilisation of a broad competency framework provided by the regulatory body, An Bord Altranais (2005) which is yet to be evaluated from a midwifery perspective. Methoda descriptive qualitative study was undertaken once ethical approval had been granted by the University's Ethics Committee. All student midwives (n=20) in one cohort were invited to participate and nine students were interviewed. Interviews were tape recorded. Data were analysed using Burnard's (2006) framework. Findingsthe process of competency assessment was perceived by many of the students to facilitate continuous assessment of clinical practice but there were issues in relation to the language and the number of competencies to be assessed. There were challenges also associated with the written evidence required as part of the assessment with many of the students questioning the usefulness of this in a clinical assessment. A variety of supports were identified and utilised by the students. Continuity and availability of preceptors were noted to be factors impacting on completion of the assessment as were the competing demands of clinical care. Recommendationsthe findings of this small study are congruent with much of the international literature focusing on clinical competency models. Consideration needs to be given to identifying and integrating into practice, a clearly defined process for competency assessment, by all the relevant stakeholders. An opportunity for feedback throughout the process is considered very significant and the mechanism for this needs to be made explicit in any competency assessment documentation Competency documentation currently in use needs to be reviewed in light of the findings of this study and the rationale for inclusion of a written evidence component needs to be carefully considered. Further research is warranted in relation to the effectiveness of the competency tool in assessing competency in practice.

Chiropractic care in women's health: A midwifery perspective

Introduction: Chiropractic care is one of the newer concepts and treatment modalities available to women in coping with the physical stresses of pregnancy, other than pharmacotherapy. Chiropractic care can help to increase the chances of a healthy pregnancy and can ease labour. Therefore midwives in clinical practice may find it useful to know the basic facts about chiropractic care in order to increase awareness of options in midwifery and inter-professional acceptance of chiropractors. Methods: An integrative review was conducted using a multimodal search of databases such as CINAHL, Science Direct, SCOPUS, PubMed and Cochrane. Results: Twelve studies met the inclusion criteria and findings suggest that chiropractic care is beneficial to pregnant women with back pain and mal-presentation during labour. Conclusion: Although there is still limited empirical research about chiropractic care in midwifery practice, the available studies showed that chiropractic treatment can offer women relief from musculoskeletal complaints. To this end, midwives should be educated and given opportunities to learn chiropractic skills to aid the comfort of mothers during pregnancy.

The Future of Nursing: A Midwifery Perspective

<i>The Future of Nursing</i>: A Midwifery Perspective

Advancing a midwifery perspective in health systems and human resources

African Journal of Midwifery and Women's HealthVol. 5, No. 4 Guest EditorialAdvancing a midwifery perspective in health systems and human resourcesPatricia L. RileyPatricia L. RileySearch for more papers by this authorPatricia L. RileyPublished Online:23 Sep 2013https://doi.org/10.12968/ajmw.2011.5.4.162AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Eccles M, Mittman B (2006) Welcome to Implementation Science. Implement Sci 1(1): 1 Crossref, Google ScholarHill P, Mansoor GF, Claudio F (2010) Conflict in least-developed countries: challenging the Millennium Development Goals. Bull World Health Organ 88(8): 562–3 Crossref, Google ScholarInstitute of Medicine (2010a) A summary of the February 2010 Forum on the Future of Nursing. IOM, Washington DC Google ScholarInstitute of Medicine (2010b) Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility. IOM, Washington DC Google ScholarJoint Learning Initiative (2004) Human Resources for Health: Overcoming the Crisis. JLI and Harvard University Press, Cambridge MA Google ScholarLugina H (2011) Closing the gap between research and action. AJM 5(2): 57 Google ScholarReich M, Takeni K, Roberts M, Hsiao W (2008) Global action on health systems: a proposal for the Toyako G8 summit. Lancet 371(9628): 865–9 Crossref, Google ScholarWorld Health Organization Maximizing Positive Synergies Collaborative Group (2009) An assessment of interactions between global health initiatives and country health systems. Lancet 373(9681): 2137–69 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byWhat Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective2 May 2016 | PLOS ONE, Vol. 11, No. 5 1 October 2011Volume 5Issue 4ISSN (online): 2052-4293 Metrics History Published online 23 September 2013 Published in print 1 October 2011 Information© MA Healthcare LimitedPDF download