Midwifery Profession Research Articles

Pioneering point-of-care obstetric ultrasound integration in midwifery education – the MEPOCUS study

BackgroundUltrasound technology is indispensable in perinatal care due to its non-invasive and painless nature, offering vital insights into foetal development and childbirth. With the academisation of midwifery in Germany, there is a growing necessity to incorporate ultrasound training into midwifery education. This paper discusses the development and implementation of an introductory obstetric ultrasound curriculum tailored for midwifery students, focusing on fundamental ultrasound techniques in obstetrics.Materials and methodsWe used Kern’s six-step approach of curricular development comprising [1] problem identification and general needs assessment [2], needs assessment of the targeted learners [3], goals and objectives [4], educational strategies [5], implementation, and [6] evaluation and feedback. The individual components of the curriculum were meticulously designed based on comprehensive literature reviews, thorough consultations with experienced ultrasound experts and evaluated needs of participants prior to the course instruction.ResultsTwenty-seven ultrasound-naive midwifery students participated in the newly developed obstetric ultrasound course. Structured as a modular and integrated framework, the course aimed to provide theoretical and practical instruction in basic obstetric ultrasound, with intrapartum sonography and focused assessment with abdominal sonography for trauma (FAST) as key supplementary specialisations. The results demonstrated a significant increase in the students’ overall knowledge and practical skills, as evidenced by the median post-course total score rising from 20 to 60 out of 75 (p < 0.001) in the objective structured clinical examination (OSCE) and from 9 to 19 out of 20 (p = 0.001) in the knowledge test. Additionally, students reported high satisfaction with the course and noted substantial personal benefits.ConclusionThe integration of basic obstetric ultrasound training within the midwifery curriculum is feasible and effective to teach fundamental knowledge and skills of obstetric ultrasound examinations to midwifery students. Expansion, standardisation and regulatory structures are critical components for a continued improvement and realistic integration into midwifery educational frameworks and thus the further development of the midwifery profession.

Developing and validating a self-assessment tool for assessing confidence of nurse-midwives against competency domains of the International Confederation of Midwives, in India.

While midwives are recognized as primary care-providers for maternal and new-born care in many parts of the world, India is transitioning to professional midwifery. The pathway to midwifery in India has been through integrated nursing and midwifery education. Since 2018, India has introduced an 18-month post nursing midwifery education programme. To establish a baseline for midwives' competence and measure progress, there is a need for a quick, easy-to-administer and low-cost tool that can be used at scale to guide programme efforts. This paper describes the process of validation and testing of a tool to assess the confidence of practicing nurse-midwives as a proxy indicator for competence against the seven competency domains of the International Confederation of Midwives (2013). A total of 2198 nurse-midwives, providing maternal and new-born services at the time of the study, from 442 public and private hospitals across six states in India, responded to a self-administered questionnaire. The tool is psychometrically sound and can potentially be used in low-middle-income countries to measure confidence of midwives and nurse-midwives against international competence standards. It is suitable for quick large-scale programmatic assessments within a short time period, providing evidence to inform midwifery strengthening initiatives. The tool can be contextualized to suit specific country contexts. Since it was tested in India, where a distinct cadre of midwives is not yet established and nurse-midwives provide maternity care, the tool can be easily adapted for use in other countries in the South East Asia Region with similar contexts.

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.

Midwifery in Turkey within the Framework of The Areas of Competence and Proficiency: A Qualitative Study

Objective: The objective of this study is to evaluate the proficiency and competence of the midwifery profession in Turkiye through the eyes of midwives, academic midwives, student midwives, and women receiving care from midwives. Methods: This research is qualitative research conducted using the phenomenological research design. The interviews were conducted on an online platform. The sample group was selected through purposive sampling and was completed using the individual in-depth interview technique with 20 participants. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Data saturation was reached because of interviewing 20 participants. The transcripts of the interviews were systematically examined, and the study results were gathered around the areas of competence and proficiency determined. Within the framework of these main themes, competence in midwifery is included under the headings of "Public Health," "Pregnancy," "Birth," "Postpartum," "Newborn," and "Women and Counseling." Proficiency in midwifery is included under the headings of "General Qualification," "Before Pregnancy," "Pregnancy and Antenatal," "Childbirth and Care During Childbirth," and "Continuous Care for Woman and Newborn." An intense/strong relationship was detected between the main themes. Conclusion: As a result, it was revealed that the most emphasis was placed on the proficiency and competence of midwives related to childbirth. It can be stated that the study results will shed light on the health policies in different areas to be developed for the midwifery profession in Türkiye.

The occupational roles of nurses and midwives in the UK: an analysis of the Nursing and Midwifery Council-census England and Wales 2021 data linkage study

ObjectiveThe nursing and midwifery professions are facing challenges to recruitment and retention. Understanding the occupational choices of people registered as nurses and midwives can inform policy as to the potential of initiatives to encourage registrants back to practice. This study thus aims to ascertain the occupational roles taken by nurses and midwives in the UK in 2021 and the drivers behind choosing to work outside of direct clinical practice. ApproachThe Nursing and Midwifery Council (NMC) register contains information on everyone meeting required standards to practice in those professions in England and Wales (currently around 800 thousand people). Registrants must not only complete a course of study for registration but must revalidated every three years. The register has been linked to the 2021 census for England and Wales. The census includes questions ascertaining occupation. Information provided is categorised to provide indication of individuals’ main occupation. These include codes for nursing and for midwifery which provides indication not only to occupation but also to engagement in clinical practice. Analysis uses logistic regression to ascertain how socio-demographics influence engagement in clinical practice or otherwise. Conclusions and ImplicationsData linkage for this study is now completed with the conference being the first time results will be shared. This will be the first time there has been concrete evidence as to nurses and midwives actual occupational roles. A stakeholder group supporting this work includes individuals from Chief Nurses’ Offices to enable findings to feed into policy.

P7 - Pushing spontaneously during labour: Moving the midwifery profession forward in the Chinese context

P7 - Pushing spontaneously during labour: Moving the midwifery profession forward in the Chinese context

National Nursing and Midwifery Commission Act, 2023 in India: Issues and the Way Forward.

With the recent enactment of the National Nursing and Midwifery Commission (NNMC) Act, 2023, significant changes are anticipated in the scope of practice and autonomy for registered nurses and midwives in India. However, alongside these anticipated advancements, concerns have emerged regarding various aspects of the Act, necessitating critical examination. In this article, we aim to explore expected changes in nursing education and service and concerns about the NNMC Act, providing insights into the implications of the NNMC Act on the regulation and advancement of the nursing and midwifery profession in India. The Act is anticipated to introduce uniform standards, implement entry and exit examinations, recognize midwifery as a distinct discipline, and determine the scope of practice for nurses and midwives. Moreover, the implementation of the Nurse Practitioner Program and guidelines for its limited prescribing authority is anticipated. Concerns exist regarding the composition of the commission and board members, adequate stakeholder representation, lacking provisions for ensuring continued competence, working conditions of nurses and midwives, nomenclature, integrating new terms, and clearly defining roles. These concerns emphasize the need for viable career pathways, uniform cadres, and a streamlined registration system, crucial for advancing nursing and midwifery profession in India. The coexistence of concerns and anticipation highlights the complexity of enacting regulatory reforms in nursing and midwifery. Policymakers can lay the foundation for a comprehensive, inclusive regulatory system that promotes excellence in nursing and midwifery practice, ultimately benefiting both healthcare providers and patients.

Bullying Behaviors and Stress (Acute and Perceived) among Undergraduate Nursing and Midwifery Students: The Moderating Role of Gender and Academic Majors.

Nursing and midwifery professionals' well-being may be affected by various factors, including the bullying of new nurses. To analyze the relationship between bullying behaviors, perceived stress, and acute stress among undergraduate nursing and midwifery students in Saudi Arabia, as well as the moderating role of gender and academic majors in this relationship. A cross-sectional correlation design was used, and data were collected from 322 undergraduate nursing and midwifery students enrolled in four major nursing universities in Saudi Arabia. Educational level, environment, and personal attacks had a significant negative impact on perceived and acute stress (social and non-social), while hostility toward academic achievement and direct negative behaviors had significant positive impacts on perceived and acute stress (social and non-social). Female nursing students reported a stronger impact of bullying behavior on their perceived stress, while male students reported a greater impact on social and non-social stress. Nursing students reported a stronger impact of bullying on perceived stress, while midwifery students reported a greater impact on social and non-social stress. Nursing educators should raise awareness about the harmful effects of bullying and emphasize the importance of creating a safe, supportive learning environment.

Determination of Professional Belonging Level and Affecting Factors in Student and Working Midwives

Objective: The research has been carried out to determine the professional belonging of the undergraduate senior students studying midwifery at universities in Turkey and the midwives with a bachelor’s degree who are actively working as midwives in the field. Methods: The descriptive and cross-sectional study was conducted with 174 midwifery senior undergraduate students studying at universities in Turkey and 171 midwives with a bachelor’s degree in the field between January 17 and April 29, 2022. The data were gathered through Google Survey Forms using introductory information form prepared by the researchers, including socio-demographic characteristics, views on the midwifery profession, professional activity information, and the Midwifery Belonging Scale. The number percent distribution, the chi-square analysis, the Mann Whitney U test, and the Kruskall Wallis test were used in the evaluation of the data, and the post-hoc Bonferonni test was used in the further analysis. Results: 50.43% of the participants in the research are senior undergraduate students, and 49.57% of them are working midwives. The total average score of the student midwives on the midwifery belonging scale is 93.18±10.01, and 90.21±13.18 for the working midwives. While a statistical difference was found between the student midwives and the working midwives in the emotional belonging sub-dimension mean scores of the scale, no difference was found in the other sub-dimension mean scores (p

How to promote midwives' recognition and professional autonomy? A document analysis study

ObjectiveTo identify challenges associated with midwives' professional autonomy in Belgium and develop recommendations to promote midwives’ recognition and professional autonomy. DesignThrough a document analysis study we identified challenges, categorized them into themes and linked them with Greenwood's sociological criteria for a profession. This involved an in-depth synthesis of findings from our published studies to comprehensively examine the challenges to optimizing midwifery autonomy and to develop corresponding recommendations. FindingsWe identified challenges related to midwife-led continuity care models, regulation of the midwifery profession, collaboration with stakeholders, professional esteem and professional culture. Based on them, our recommendations include prioritizing midwife-led continuity of care, fostering collaboration, tailoring continuous professional development, increasing public awareness and advocating for policy changes. The attribute of a profession which is lacking the most in midwifery in Belgium is recognized authority, which may result in midwives being undervalued, underutilized and underpaid. Key conclusionsIn this paper we identified challenges in Belgian midwives' recognition and professional autonomy and provided recommendations to address them, emphasizing the importance of recognized authority in midwifery. Implementing these recommendations can positively impact midwives' recognition and autonomy in Belgium and potentially in other countries. Implications for practiceIt is essential for policy makers to address the issue of the lack of recognized authority in midwifery, as it plays a critical role in facilitating decision-making, policy development, and the professionalization of the field. Implementing the outlined recommendations can drive positive changes in midwifery recognition and autonomy in Belgium and beyond.

Midwifery Students' Experiences of Bias in the Clinical Setting: Prevalence, Types, and Impact.

Exposure to bias in clinical learning environments may undermine students' confidence, cause emotional harm, impede learning, and potentially delay graduation. However, little is known about the prevalence of bias experienced by midwifery students in the United States. This cross-sectional, descriptive study aimed to quantify clinical midwifery students' experiences of bias based on 7 self-identified characteristics (gender identity, race or ethnicity, body size, age, sexual orientation, religion, and occupational background). Additionally, this research explored the impact of bias on student well-being, learning, and professional commitment. The survey consisted of 39 items addressing (1) prevalence and types of bias, (2) emotional impact and influence on clinical learning, (3) ways students coped, (4) whether anyone spoke up at the time bias occurred, (5) whether students reported bias to faculty, and (6) impact of bias on commitment to midwifery. The survey was distributed to midwifery students and recent graduates in 2022 via American College of Nurse-Midwives email discussion lists and social media. Participants were eligible if they were in a clinical rotation in an Accreditation Commission for Midwifery Education-accredited midwifery program between 2019 and 2022. Surveys were returned by 383 participants, with 301 meeting inclusion criteria. Most participants (66.5%) reported personally experiencing or witnessing bias against at least 1 of 7 personal characteristics. The most commonly reported biases were related to gender, occupational background, age, and race or ethnicity. Only half of the participants reported these occurrences to someone with academic authority, and nearly a third considered withdrawing from their educational programs. In this study bias was common and significantly impacted students. These results underscore the need for creative and bold interventions at personal, educational, and institutional levels to prevent and mitigate bias. Safeguarding clinical learning environments will enable students to thrive, graduate with confidence and competence, and thereby contribute to the diversification and strengthening of the midwifery profession.

Increasing the number of midwives is necessary but not sufficient: using global data to support the case for investment in both midwife availability and the enabling work environment in low- and middle-income countries

BackgroundMost countries are off-track to achieve global maternal and newborn health goals. Global stakeholders agree that investment in midwifery is an important element of the solution. During a global shortage of health workers, strategic decisions must be made about how to configure services to achieve the best possible outcomes with the available resources. This paper aims to assess the relationship between the strength of low- and middle-income countries’ (LMICs’) midwifery profession and key maternal and newborn health outcomes, and thus to prompt policy dialogue about service configuration.MethodsUsing the most recent available data from publicly available global databases for the period 2000–2020, we conducted an ecological study to examine the association between the number of midwives per 10,000 population and: (i) maternal mortality, (ii) neonatal mortality, and (iii) caesarean birth rate in LMICs. We developed a composite measure of the strength of the midwifery profession, and examined its relationship with maternal mortality.ResultsIn LMICs (especially low-income countries), higher availability of midwives is associated with lower maternal and neonatal mortality. In upper-middle-income countries, higher availability of midwives is associated with caesarean birth rates close to 10–15%. However, some countries achieved good outcomes without increasing midwife availability, and some have increased midwife availability and not achieved good outcomes. Similarly, while stronger midwifery service structures are associated with greater reductions in maternal mortality, this is not true in every country.ConclusionsA complex web of health system factors and social determinants contribute to maternal and newborn health outcomes, but there is enough evidence from this and other studies to indicate that midwives can be a highly cost-effective element of national strategies to improve these outcomes.

Employing a serious game intervention to promote adolescent school children’s perceptions of nursing and midwifery professions

AimTo test a serious game intervention about nursing and midwifery perceptions among adolescent school children.BackgroundNursing and midwifery professions face challenges in recruitment, with persistent gender stereotypes and a lack of clarity regarding the roles contributing to this issue. This study addresses the need for innovative approaches to reshape perceptions and encourage career exploration in adolescent school children.DesignEmploying a pre/post-test design, this study involved 137 post-primary students aged sixteen or seventeen in the United Kingdom.MethodsData collection occurred between November 2022 to April 2023, involving three post-primary schools. Participants engaged with a digital serious game designed to address misconceptions and promote a more accurate understanding of nursing and midwifery. Participants completed pre- and post-intervention questionnaires, including an adapted version of the Nursing as a Career Choice Questionnaire. Statistical analyses included descriptive statistics, paired t-tests, and independent groups t-tests.ResultsThe serious game intervention resulted in statistically significant improvements in students’ perceptions across multiple domains. Overall, participants showed higher mean post-test scores (M = 139.57, SD = 15.10) compared to their mean pre-test score (M = 131.06, SD = 14.73) on the questionnaire. The domains of self-efficacy (p < .001), job prospects (p < .001) and social influences (p < .001) exhibited the most substantial positive changes. Female participants showed higher perceptions than males in pre- and post-tests and students from all-girls schools consistently scored higher than those from all-boys and mixed-gender schools.ConclusionsA serious game about the nursing and midwifery professions appears to be capable of changing perceptions of self-efficacy and job prospects related to nursing and midwifery professions. The study suggests that a serious game intervention may have the potential to change adolescent perceptions of nursing and midwifery professions which may lead to their considering of these when making future career choices.

Gender-inclusive language in midwifery and perinatal services: A guide and argument for justice.

Effective communication in relation to pregnancy and birth is crucial to quality care. A recent focus in reproductive healthcare on "sexed language" reflects an ideology of unchangeable sex binary and fear of erasure, from both cisgender women and the profession of midwifery. In this paper, we highlight how privileging sexed language causes harm to all who birth-including pregnant trans, gender diverse, and non-binary people-and is, therefore, unethical and incompatible with the principles of midwifery. We show how this argument, which conflates midwifery with essentialist thinking, is unstable, and perpetuates and misappropriates midwifery's marginalized status. We also explore how sex and gender essentialism can be understood as colonialist, heteropatriarchal, and universalist, and therefore, reinforcing of these harmful principles. Midwifery has both the opportunity and duty to uphold reproductive justice. Midwifery can be a leader in the decolonization of childbirth and in defending the rights of all childbearing people, the majority of whom are cisgender women. As the systemwide use of inclusive language is central to this commitment, we offer guidance in relation to how inclusive language in perinatal and midwifery services may be realized.

“Here It Is Not Like at Home”: Cross-Cultural Competencies for Midwives

Cross-cultural competence in midwifery practice is an important skill when caring for childbearing women from different cultural backgrounds. Cross-cultural competence has many definitions and technical, professional, and personal skills vary by profession. In the midwifery profession it can be achieved through improved education curricula, greater faculty and student diversity, and the opportunity for students and faculty to participate in global placements. At the University of British Columbia (UBC), the Division of Midwifery has developed a 6-8 week Global Midwifery placement as an option during the end of the third year of the program. Students who experience a global placement face many challenges and a thorough orientation on local custom and expectations should occur. The benefits of an international placement experience are numerous, including increased cultural sensitivity and awareness of global health issues, skills to adapt to a low-resource environment and improved communication skills. Planning for an international placement program is discussed in this article from the perspective of an overseas placement coordinator and tutor.

The Professionalization of Midwifery in the Late Middle Ages

The concept of midwifery as an independent profession for women, one that gave them the opportunity for autonomyandeducation,isevidentinthehistoricalrecordofWesternEuropeinthelateMiddleAges. Thisstudy looks at several determinant factors that define the concept of professionalization in a medieval context – such as education, the establishment of standards of practice and the ability to earn income – concluding that midwifery should be considered by historians as a specialized profession, separate from other healers, physicians, and lay midwives. The study reflects on the work of early Greek medical scholars and the advancement of knowledge by Trotula of Salerno and St. Hildegard von Bingen, as well as the autonomy of practicing midwives and their relationship to the established Church, to illustrate the status of midwifery as a distinct profession during the established time period.

Midwives' and registered nurses' role and scope of practice in acute early pregnancy care services: a scoping review.

The objective of this scoping review was to investigate and describe what is reported on the role and scope of practice of midwives and registered nurses providing care for women with pregnancy complications under 20 weeks' gestation in acute clinical settings in Australia. In many high-income countries, women experiencing unexpected complications in early pregnancy attend an acute care service, such as an emergency department, rather than a maternity or obstetric unit. This service structure can impact the care women receive, and determine who provides it. Women and their partners, who are often experiencing emotional distress, have reported difficult experiences when accessing acute services, particularly emergency departments, which are not traditionally staffed by midwives. The role and scope of practice of both midwives and registered nurses providing acute early pregnancy care in most high-income countries, including Australia, is poorly reported. Documenting this area of practice is an important first step in facilitating ongoing research in this important aspect of pregnancy care. Published and gray literature that described the role and scope of practice of midwives and/or registered nurses providing care in acute early pregnancy settings in Australia were considered for this review. A scoping review of the literature was conducted following JBI methodological guidance and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. A 3-step search strategy was conducted to explore evidence from databases and search engines, gray literature sources, and selected reference lists. After screening, data were extracted from records selected for the final review, mapped, and analyzed using content analysis. The evidence reviewed (n=23) included primary research studies, conference abstracts, and gray literature, such as clinical guidance documents, academic theses, and websites from January 2008 to October 2023. The most common setting for care provision was the emergency department. Midwives' and registered nurses' roles and scope of practice in acute early pregnancy care in Australia can be summarized into 4 areas: physical care, psychosocial support, care co-ordination, and communication. Women's access to midwifery care at this time in pregnancy appears to be limited. Registered nurses, usually employed in emergency departments, have the most prominent role and scope in the provision of care for women with acute early pregnancy complications. Descriptions of midwives' practice focuses more on psychosocial support and follow-up care, particularly in early pregnancy assessment service models. This review highlights the inconsistency in midwives' and registered nurses' roles and scope in acute early pregnancy in Australia, a finding which is relevant to other international settings. Both professions could further fulfill role and scope capacity in the provision of supportive, individualized, and timely care for women and families accessing a range of acute early pregnancy services. Emergency departments are the usual practice domain of registered nurses who may be limited in terms of the scope of care they can provide to women with early pregnancy complications. Leaders of the midwifery profession should conduct further research into innovative service models that embed a role for midwives in all settings that provide care for pregnant women, regardless of gestation. Open Science Framework osf.io/7zchu.

The role of motivation in the initiation and maintening mentoring relationships among nurses and midwives.

To understand clinicians' motivations to engage in mentoring to support newly graduated nurses and midwives working in hospital settings. Nursing and midwifery literature has established the benefits of mentoring and challenges that affect the effectiveness of formal mentoring programmes. No studies have explored hospital nurses' and midwives' motivations to mentor in the absence of the obligatory status and associated rewards of institutionalised mentoring. A qualitative descriptive study with 35 nurses and midwives working in three public hospitals in the western, northern and northwestern parts of Uganda. Data were collected using semistructured interviews. Reflexive thematic analysis was applied to interpret the data. We have adhered to COREQ reporting guidelines. The study revealed three salient themes that capture nursing and midwifery professionals' mentoring perspectives. Participants expressed confidence in their inherent mentoring capacities and were often motivated by a desire to reciprocate prior mentoring experiences. Their mentoring approaches varied between self-focused and other-focused motivations, with some overlap in perspectives on hierarchical versus relational mentoring. Across the board, there was a strong consensus on the need of mentoring for individual clinicians, healthcare institutions and the broader profession. The study highlights five opportunities that can be harnessed to design future mentoring programmes. The findings delineate a complex interplay between self-centred and altruistic mentoring motivations, aligning with hierarchical or mutually beneficial mentoring paradigms. Nurse managers should tailor mentoring programmes to align with these intrinsic motivations, affirm the enduring need for mentoring, and leverage existing institutional resources to create both acceptable and efficient mentoring frameworks.

Making Midwifery Services Accessible to People of Low SES: A Qualitative Descriptive Study of the Barriers Faced by Midwives in Ontario

Midwifery care is associated with health benefits for disadvantaged groups but continues to be accessed less frequently in Ontario by people who are of lower socio-economic status (SES). We conducted a qualitative descriptive study investigating the work midwives do to make midwifery care accessible to people of low SES and explored the barriers they encounter in doing this work. We interviewed 13 Ontario midwives who serve people of low SES in a wide range of clinical settings. Participants faced multiple challenges in their work to make midwifery care more accessible. They described barriers that they had encountered which pertained to the nature of the work itself, to professional and organizational factors, and to systemic factors. Midwives engaged in this work are deeply committed to it and take on extra unpaid work. The barriers they face threaten the sustainability of their work, and as a result, many participants identified a high risk of burnout. Our findings provide new insight into ways in which gaps in the curriculum of undergraduate midwifery education, lack of opportunities for mentorship, and debate within the midwifery profession about who is suitable for midwifery care serve as barriers to midwives taking on a greater role in providing care to people of low SES and particularly to those who struggle to access primary maternity care services. Systemic changes are needed to overcome these barriers and to expand the work of making midwifery care more accessible while ensuring its sustainability. This article has been peer reviewed.

Racism in Ontario Midwifery: Indigenous, Black and Racialized Midwives and Midwifery Students Unsilenced

This article reports on findings from a 2019 online survey titled Experiences of Racism Among Ontario BIPOC Midwives and Students in Midwifery Education and Profession, completed by Ontario midwives and midwifery students who identify as Black, Indigenous, or People of Colour (BIPOC). The survey explored their experiences of racism in both midwifery education and profession. In total, 40 participants consented to participate in the survey, of which 36 completed some or all of the survey; 56% identified as midwives in varying stages of their career, and 45% as students. Of these participants, 86% reported experiencing racism in their work as a midwife, and 87% reported witnessing another midwife or midwifery student being a target of racism. In addition, 61% of participants reported not feeling supported by their practice group when confronted with racism. Over 85% of participants agreed or strongly agreed that racism or fear of racism impacts how they communicate or express themselves, their mental health, and their comfort in working in any community where work is available. To achieve racial equity in the profession, participants recommended raising awareness about racism in the profession, increasing diversity in midwifery, and holding accountable people who commit racist acts and perpetuate racist systems. This article has been peer reviewed.