Professional Midwives Research Articles

”Varför vi är där vi är idag”

This article explores if conversations about literary texts that thematize abortion can provide new knowledge about the clinical everyday practice of midwives. The empirical material consists of conversations with seven clinical midwives after shared reading of a sample of fictional and biographical Swedish texts from the 1930s, 1950s, 1990s, and 2010s. Drawing on theories of power relations, gendered knowledge, and narrative medicine, the article investigates the relationship between the texts and the midwives’ professional experiences. The study demonstrates that the participants agreed on the positive effects of reading and discussing literary texts related to their professional work. The study cannot establish that it has provided new knowledge about the midwives’ clinical practice; it concludes, however, that the shared reading and conversations generated an exchange about experiences of abortion care that subsequently could deepen knowledge about treatment and practice within the profession. The study demonstrates that the reading experience generated discussions about the clinical practice that otherwise would never have taken place, for the participants asserted that the conversations had given time for reflection about medical, social, and emotional issues that did not occur in clinic. The texts brought specific professional experiences to the fore and offered new perspectives on norms, practices, and the professional role. One distinct impression conveyed by the participants was that shame is still a salient feeling among the patients, signaling that abortion is still a sensitive subject. The article concludes that similar elements of reading and discussing literary texts could prove an important part of (continuous) training for professional midwives.

Kepatuhan Bidan dalam Penerapan SOP Pemotongan Tali Pusat Pada Bayi Baru Lahir

<p>Pinning and cutting the umbilical cord is a standard procedure that is always done when the baby is born. The benefits of delaying cord clamping for infants include the opportunity for red blood, stem cells, and immune cells to be transmitted to the baby's body outside the uterus. As for mothers, delaying cord clamping can reduce the complications of bleeding. This study aims to determine the Midwife's Compliance Level in the Implementation of SOP Cutting the Cord in Newborns in Bandar Lampung City. This type of research is correlation analytic with a cross-sectional approach. The research subjects are midwives who provide birth assistance services in the city of Bandar Lampung with a total of 131 people, the sample in this study was the total population. Data collection uses primary data. Univariate data analysis uses percentages and bivariate analysis uses chi-square. The results showed that midwives' level of compliance in implementing SOP of umbilical cord-cutting in newborns in the category of non-compliance was 83 respondents (63.4%), midwife knowledge was categorized as good as 102 respondents (77.9%) and the attitude of midwives in the category of no support as many as 76 respondents (58.02%). There is a significant relationship between midwives 'attitudes and midwives' compliance in the adoption of umbilical cord cutting SOPs in newborns and there is no relationship between midwives 'knowledge and midwives' level of compliance in implementing umbilical cord cutting SOPs. Professional organizations (IBI Bandar Lampung City) and midwives coordinator of the local health center need to program supervision to midwives who provide delivery assistance to always implement the SOP cutting the umbilical cord on newborns. </p>

Pengaruh Locus of Control Dan Stres Kerja Terhadap Kinerja Dosen Akademi Kebidanan

Professional midwives are produced from a good midwives education. Good midwives ' education requires a good mentor or lecturer. Some data were found that the lecturers ' performance in obstetrics academy in indonesia is still a challenge especially in general performance or special performance in conducting high school tridarma. The study wanted to know the effects of locus of control and work stress on performance. This research is a quantitative study with analysis survey method of 108 obstetrician academy lecturers in dki jakarta area. respondents are randomly selected. inferential statistics are used to test hypotheses about the influence between variables using pathway analysis techniques. The results showed that locus of control was a direct positive effect on performance; occupational stress is a direct negative effect on performance, and locus of control directly negatively affects the stress of work. research results can help in improving performance through improved locus control and lower working stress on obstetrics lecturers.

Midwives\u2019 perceptions of being \u2018with woman\u2019: a phenomenological study

BackgroundBeing ‘with woman’ is a central construct of the midwifery profession however, minimal research has been undertaken to explore the phenomenon from the perspective of midwives. The aim of this study was to describe Western Australian midwives’ perceptions of the phenomenon of being ‘with woman’ during the intrapartum period.MethodsDescriptive phenomenology was selected as the methodology for this study. Thirty one midwives working across a variety of care models participated in individual interviews. Giorgi’s four stage phenomenological approach was employed to analyse data.ResultsThree themes were extracted 1) Essential to professional identity; 2) Partnership with women; and 3) Woman-Centred Practice. Midwives described the importance of being ‘with woman’ to the work and identification of midwifery practice. Developing a connection with the woman and providing woman-centred care inclusive of the woman’s support people was highlighted.ConclusionsFor the first time, we are able to offer evidence of how midwives understand and perceive the phenomenon of being ‘with woman’ which has theoretical and practical utility. Findings from this study provide evidence that supports expert commentary and confirms that midwives conceptualise the phenomenon of being ‘with woman’ as essential to the identity and practice of the profession. Some previously identified ‘good midwifery practices’ were revealed as practical manifestations of the phenomenon. This new knowledge facilitates clarity and provides evidence to support statements of professional identity, which is useful for the development of educational curricula as well as supporting graduate and professional midwives. The findings emphasise the importance of the development of language around this important philosophical construct which permeates midwifery practice, enhances professional agency and supports the continued emphasis of being ‘with woman’ with new understanding of its applied practices in a variety of care models.

Knowledge of US Midwifery Credentials Among Members of the American College of Nurse-Midwives.

Three midwifery credentials are granted in the United States: certified nurse-midwife (CNM), certified midwife (CM), and certified professional midwife (CPM). Confusion about US midwifery credentials may restrict growth of the midwifery profession. This survey assessed American College of Nurse-Midwives (ACNM) members' knowledge of US midwifery credentials. ACNM members (N = 7551) were surveyed via email in 2017. The survey asked respondents to report demographic information and to identify correct statements about the education, certification, and scope of practice of CNMs, CMs, and CPMs. Responses to 17 items about all midwives certified in the United States, a 5-item subset specific to CNMs/CMs, and one item related to location of midwifery practice by credential were analyzed. Nearly a quarter of the membership (22.1%) responded to the survey. Higher scores on the survey indicated greater identification of correct statements about the education, certification, scope, and location of practice of CNMs, CMs, and CPMs. Significant differences in scores were found among ACNM members based on their level of education, degree of professional involvement in midwifery, and prior practice as a nurse. ACNM members with higher scores on the survey held a doctorate, worked in Region I, and had greater professional leadership involvement in midwifery organizations. Participants with less nursing experience prior to their midwifery education also scored significantly higher on the survey. Although two-thirds of respondents correctly answered items on the preparation, credentialing, and scope of practice of CNMs, CMs, and CPMs, a significant minority had gaps in knowledge. Results of this survey suggest the need for outreach about US midwifery credentials. Future research to replicate and expand upon this survey may benefit the profession of midwifery in the United States.

Peer group supervision is an efficient method to assist midwives to solve complicated cases: A case-study in the Women's Clinic, East-Tallinn Central Hospital, Estonia.

INTRODUCTIONMidwives have a remarkable influence on various outcomes in healthcare, of which the activities related to the management during the childbirth are emphasised the most. Midwives like all healthcare workers encounter many different stressors in clinical practice, including time pressure, excessive workload, different roles, and emotional issues. The profession of the midwife requires much knowledge, competence, good attitude and self-confidence in order to cope with many different complicated situations and dilemmas. This study has been conducted under the project: ‘Increasing midwives’ ethical competence: a European educational and practice development project (INEC)’.METHODSThis is a qualitative case study. The current case study involved 7 midwives of the Women’s Clinic, East-Tallinn Central Hospital, Estonia; the midwives expressed their willingness and agreed to take part in the activities of the peer group supervisors. The aim of the case study was to find how peer group supervision as a method helps midwives to solve complicated cases and dilemmas, helping them to maintain self-confidence and therefore to manage stress at work more effectively.RESULTSAll the participating midwives shared the opinion that peer group supervision helps midwives to cope with complicated situations and dilemmas more effectively, it empowers professional skills and self-confidence, and so contributes to more effective stress management at work. Also, the midwives expressed hope that this topic would be useful for the professional midwives and to other employees working in the field of healthcare, that encounter complicated cases in their daily work, and so will form an active team of peer group supervision.CONCLUSIONSPeer group supervision is an efficient method that helps midwives solve complicated cases in the Women’s Clinic, East-Tallinn Central Hospital, Estonia.

Is it possible to incorporate evidence-based professional midwifery practices into public health services in Mexico?

Problem and backgroundDuring the past two decades, Mexico has launched innovative maternal health initiatives to improve maternal and neonatal outcomes, placing emphasis on the incorporation of professional midwifery practices into the healthcare system. This study explored the perceptions of healthcare providers and women using public birth care services regarding professional midwifery practices and how can the inclusion of evidence-based midwifery techniques improve the quality of service. MethodologyWe conducted a qualitative, cross-sectional study of three healthcare networks in Mexico. A content analysis was performed of data collected through 109 semi-structured interviews: 72 with healthcare providers and 37 with women. ResultsHealthcare providers and women had minimal knowledge of the competencies and skills of professional midwives. Medical personnel accepted the incorporation of some evidence-based midwifery practices. Women had experienced fear and anguish during childbirth so they considered that incorporating professional midwifery practices into maternal health services would be favourable in that it would render birth care more respectful. Discussion and conclusionsHealthcare providers are willing to consider the inclusion of some evidence-based midwifery practices in health services and regard assistance from professional midwives. They believe that structural conditions will complicate their incorporation. Although the women interviewed had experienced fear, anxiety and loneliness during childbirth, most of them admitted to feeling “safer” in a hospital (secondary-care health centre) setting where possible complications could be resolved. This perception of safety served to justify the delivery of healthcare in a manner that is inattentive to women’s needs, which go beyond biomedical issues and include emotions and the positive experience of childbirth.

Legislative Gaps in Addressing Rural Women’s Access to Obstetric Care in the United States: A Case Study of the North Carolina Home Birth Freedom Act

Rural women in the United States face numerous barriers to accessing obstetric care. Hospitals and obstetric wards in rural areas are closing, and there is a shortage of rurally-located obstetric care providers. Recent experience in North Carolina provides insight into current legislative barriers to improving rural women’s access to obstetric care. In 2015, legislators in the North Carolina General Assembly unsuccessfully advocated for the Home Birth Freedom Act, which would have allowed certified professional midwives to practice in the state.While the Home Birth Freedom Act would have helped to address rural women’s access to care, it would not have been sufficient. This analysis describes why rural women’s access to obstetric care is limited and offers recommendations to expand access to care by providing certified nurse-midwives with more autonomy, appropriating funds to place obstetric care providers in rural areas, and improving Medicaid reimbursement rates.

A Review of the Forces Influencing Maternal Health Policies in Post‐War Guatemala

Guatemala's 1996 Peace Accord ending the 36‐year civil war included the goal to lower its maternal mortality ratio (MMR). Yet, Guatemala still has one of Latin America's highest MMRs, especially among Mayan women. To improve maternal health, the professional midwife is being reintroduced in Guatemala. Meier's Linear Model of the Public Policy Process states that policymakers respond to international and society‐centered forces when making policy decisions. How have such forces influenced the creation of birth attendance policies in Guatemala from 1996 to today? Using a process tracing approach, we analyzed 132 policy documents, peer‐reviewed journal articles, and gray literature noting international and national maternal health recommendations and all birth attendance legislation passed in Guatemala from 1996 to present. International forces advocated for skilled birth attendance (SBA) to address maternal mortality. Society‐centered forces promoted intercultural care with traditional birth attendants (TBAs). Both—sometimes conflicting—forces have influenced policymakers in the creation of maternal health policies in post‐war Guatemala. Policymakers must constantly reconcile tensions between society‐centered realities and international agendas when making policies. The reintroduction of professional midwifery in Guatemala presents a means of addressing both agendas: Increasing SBA and improving intercultural care.

Optimizing smoking cessation guideline implementation using text-messages and summary-sheets: A mixed-method evaluation

ObjectivesImplementation of smoking cessation care (SCC) guidelines is suboptimal. This mixed-method study evaluated a two-component implementation strategy for the revised Dutch multidisciplinary tobacco dependence treatment guideline, which consisted of the provision of text-messages and summary-sheets tailored to specific healthcare professional (HCP) groups, i.e., gynecologists, midwives, pediatricians, practice nurses and respiratory nurses. DesignObservational study with baseline (T1), intermediate (2-months, T2) and follow-up (8-months, T3) survey measurements, and interviews between T2 and T3. MethodData were collected December 2016–January 2018. Three hundred-ten, 228, and 174 HCPs completed T1, T1/T2, and T1/T2/T3, respectively, and 32 HCPs were interviewed. We examined reach, feasibility and acceptability of the implementation strategy; whether baseline factors related to HCP’s strategy evaluation; change in implementation outcomes over time (i.e., knowledge, intentions to use the guideline, satisfaction with own SCC delivery, and provision of quit-advice); and whether baseline factors related to change in implementation outcomes. ResultsText-messages had good reach, and text-messages and summary-sheets were evaluated positively on feasibility and acceptability. Results showed improvements over time in tested knowledge (assessed through false/true statements) and self-reported knowledge about SCC, as well as satisfaction with own SCC delivery. Provision of quit advice showed an improvement among pediatricians only. Improvements in knowledge were stronger among non-smoking HCPs, and HCPs with lower skills and self-efficacy at baseline. ConclusionsGuideline implementation often does not occur spontaneously. Guideline implementation may be facilitated by providing text-messages and summary-sheets to HCPs. Text-messages may be more beneficial if tailored to the individual HCP.

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa.

BackgroundCommunity service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions.AimThe study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition.SettingThe study was conducted at the training hospitals of the five districts in Limpopo province.MethodThe researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch’s eight-step process was used to analyse data.ResultsResults revealed that newly graduated midwives failed to meet the perceived expectations by experienced midwives; this was reflected in sub-themes: limited sense of independence, limited participation in task sharing and commitment and competence versus incompetence to patient care.ConclusionThe experienced midwives expected newly graduated midwives to function as professionals; unfortunately, they expressed disappointment as graduates did not meet their expectations. Newly graduated midwives lacked sense of independence, commitment to patient care and did not display ability in task sharing.

Recommendations for Sustainable Midwifery in Guatemala

Guatemala plans to open its first government-sponsored professional midwifery school since 1960. During the new program's design stages, it is imperative to consider possible impediments to the program's sustainability. Schell's Sustainability Framework assesses internal and external domains to consider a program's capacity for sustainability. We conducted in-depth interviews with Guatemalan key decision makers and professional midwives (n = 7) and matched pertinent open codes from these interviews with Schell's Sustainability Framework's a priori domains. We analyzed the content of the coded segments, triangulating the findings with policy documents, peer-reviewed journal articles, and gray literature to identify facilitators and impediments to midwifery's sustainability. Recommendations follow. Our study revealed the following internal facilitators for sustainability: strategic planning, program adaptation, organizational capacity, and funding stability. External facilitators such as political support and funding sustainability were also present. The program's poor internal communications and weak external partnerships pose significant impediments to the program's sustainability. Program evaluation and public health impact were not discussed in the interviews, which merits further consideration. At the launch of this important midwifery program, program designers must heed recommendations informed by identified facilitators and impediments to increase midwifery's likelihood of success in Guatemala.

Providers' Reports of Environmental Conditions and Resources at Births in the United States.

Environmental conditions and resources that may influence provider's behaviors have been investigated in birth environments focusing on location rather than conditions and available resources. Using a descriptive, cross sectional design, we surveyed a random sample of certified nurse-midwives (CNMs), obstetricians, family practice physicians, and certified professional midwives (CPMs) to describe conditions, resources, and workforce present during U.S. births. In all, 1,243 midwives and physicians reported most environmental resources were present at almost 100% of births they attended. Conditions varied: room noise acceptability restriction of phone calls/texts from any source and lighting kept to a minimum. Trainees were present at most births regardless of setting and provider type. The impact of room noise, phone calls/texting, and lighting on outcomes should be determined. The roles and impact of personnel, including trainees, should be described. The extent to which clusters of resources are associated with outcomes might provide new directions for interventions that improve care.

What prevents midwifery quality care in Bangladesh? A focus group enquiry with midwifery students

BackgroundWith professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives’ realities in Bangladesh, based on their own experiences.MethodData were collected through 14 focus group discussions that included a total of 67 third-year diploma midwifery students at public nursing institutes/colleges in different parts of Bangladesh. Data were analyzed deductively using an analytical framework identifying social, professional and economical barriers to the provision of quality care by midwifery personnel.ResultsThe social barriers preventing midwifery quality care falls outside the parameters of Bangladeshi cultural norms that have been shaped by beliefs associated with religion, society, and gender norms. This puts midwives in a vulnerable position due to cultural prejudice. Professional barriers include heavy workloads with a shortage of staff who were not utilized to their full capacity within the health system. The reason for this was a lack of recognition in the medical hierarchy, leaving midwives with low levels of autonomy. Economical barriers were reflected by lack of supplies and hospital beds, midwives earning only low and/or irregular salaries, a lack of opportunities for recreation, and personal insecurity related to lack of housing and transportation.ConclusionWithout adequate support for midwives, to strengthen their self-confidence through education and through continuous professional and economic development, little can be achieved in terms of improving quality care of women during the period around early and late pregnancy including childbirth.The findings can be used for discussions aimed to mobilize a midwifery workforce across the continuum of care to deliver quality reproductive health care services. No matter how much adequate support is provided to midwives, to strengthen their self-confidence through education, continuous professional and economic development, addressing the social barriers is a prerequisite for provision of quality care.

Understanding health systems to improve community and facility level newborn care among displaced populations in South Sudan: a mixed methods case study

BackgroundTargeted clinical interventions have been associated with a decreased risk of neonatal morbidity and mortality. In conflict-affected countries such as South Sudan, however, implementation of lifesaving interventions face barriers and facilitators that are not well understood. We aimed to describe the factors that influence implementation of a package of facility- and community-based neonatal interventions in four displaced person camps in South Sudan using a health systems framework.MethodsWe used a mixed method case study design to document the implementation of neonatal interventions from June to November 2016 in one hospital, four primary health facilities, and four community health programs operated by International Medical Corps. We collected primary data using focus group discussions among health workers, in-depth interviews among program managers, and observations of health facility readiness. Secondary data were gathered from documents that were associated with the implementation of the intervention during our study period.ResultsKey bottlenecks for implementing interventions in our study sites were leadership and governance for comprehensive neonatal services, health workforce for skilled care, and service delivery for small and sick newborns. Program managers felt national policies failed to promote integration of key newborn interventions in donor funding and clinical training institutions, resulting in deprioritizing newborn health during humanitarian response. Participants confirmed that severe shortage of skilled care at birth was the main bottleneck for implementing quality newborn care. Solutions to this included authorizing the task-shifting of emergency newborn care to mid-level cadre, transitioning facility-based traditional birth attendants to community health workers, and scaling up institutions to upgrade community midwives into professional midwives. Additionally, ongoing supportive supervision, educational materials, and community acceptance of practices enabled community health workers to identify and refer small and sick newborns.ConclusionsImproving integration of newborn interventions into national policies, training institutions, health referral systems, and humanitarian supply chain can expand emergency care provided to women and their newborns in these contexts.

IMPROVEMENT OF SOFT SKILLS THROUGH COOPERATIVE LEARNING METHOD (JIGSAW) IN COURSES OF MIDWIFERY CARE EMERGENCY ON MATERNAL AND NEONATAL

Being a professional midwife in the future is not enough to have good hard skills, but also a good soft skill, and for students to have good soft skills, a proper learning method is required, and the lecturer has an important role in determining the learning method. The purpose of this research is to know the method of learning that can improve students’ soft skills on Maternal and Neonatal Emergency Care. The method in this research is Classroom Action Research which measure soft skills of students DIII midwifery. The attributed used soft skills consisted of 15 items. The population of this research is the students of DIII Midwifery of PEMKAB Jombang Institute of Health Science semester IV who follow the Subject of care of Midwifery Emergency Maternal and Neonatal care, which are number 43 respondents. Sampling used is total sampling Method of data collection in this research is lecturers apply three kinds of learning method in 3 times meeting: conventional method, Case Based learning and Cooperative Learning (Jigsaw).The results of this study shows that the case-based learning method is better than the conventional method in improving the soft skills of DIII Midwifery students., cooperative learning (jigsaw) is better than conventional methods in improving the soft skills of DIII midwifery students. There is no significant difference between case based learning method and cooperative learning method (jigsaw).Thus cooperative learning is an appropriate method for midwives students because it is proven to improve students’ soft skills.

Perineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor.

Perineal trauma is a negative outcome during labor, and until now it is unclear if the maternal position during the second stage of labor may influence the risk of acquiring severe perineal trauma. We have aimed to determine the prevalence of perineal trauma and its risk factors in a low-risk maternity with a high incidence of upright position during the second stage of labor. A retrospective cohort study of 264 singleton pregnancies during labor was performed at a low-risk pregnancy maternity during a 6-month period. Perineal trauma was classified according to the Royal College of Obstetricians and Gynecologists (RCOG), and perineal integrity was divided into three categories: no tears; first/second-degree tears + episiotomy; and third and fourth-degree tears. A multinomial analysis was performed to search for associated factors of perineal trauma. From a total of 264 women, there were 2 cases (0.75%) of severe perineal trauma, which occurred in nulliparous women younger than 25 years old. Approximately 46% (121) of the women had no tears, and 7.95% (21) performed mediolateral episiotomies. Perineal trauma was not associated with maternal position (p = 0.285), health professional (obstetricians or midwives; p = 0.231), newborns with 4 kilos or more (p = 0.672), and labor analgesia (p = 0.319). The multinomial analysis showed that white and nulliparous presented, respectively, 3.90 and 2.90 times more risk of presenting perineal tears. The incidence of severe perineal trauma was low. The prevalence of upright position during the second stage of labor was 42%. White and nulliparous women were more prone to develop perineal tears.

Process is insufficient: a reply to Cote Hampson and McNulty

This reply explores the implications raised by a scholarly conversation among the pieces by Cramer, Cote Hampson, and McNulty in this special issue of Global Discourse. Cramer's piece argues that midwives and women living in states where home births are legally attended by Certified Professional Midwives continue to experience confusion about legal status, and chilling social approbation that constrains access to reproductive choice. Cote Hampson argues that women in hierarchical professions in the United States, as typified by academia and the military, often refuse to avail themselves of policies meant to facilitate work-life balance, in large part because they understand accessing maternity leave to be a stereotyped behavior that weakens employers’ perception of them as ideal workers. And, McNulty's research shows that procedural changes meant to facilitate – indeed mandate – women's participation in participatory-budgeting regimes in Peru may increase the presence of women in these meetings, but do not increase their actual, meaningful participation. In light of the findings of all three pieces, that women's access to rights is not meaningfully expanded by procedural changes, this comment asks whether legal venues and procedural changes are the best ways by which women can assert claims to equality, equity, and justice.

Midwives’ perceptions of vaccines and their role as vaccinators: The emergence of a new immunization corps

BackgroundIn France, midwives have recently been authorized to administer various vaccines to women (including pregnant women), newborns, and their family members. This is expected to enhance vaccine coverage. However, the French high level of vaccine hesitancy is also observed in some healthcare workers. We thus aimed to determine the perceptions of French midwives concerning vaccines. MethodsWe distributed an anonymous online questionnaire between September and December 2017, targeting midwives who were still in training or working in the public or private sector. ResultsA total of 917 questionnaires were analyzed (median age 26 years). Almost half of participants (44.5%) were students. On a scale of 0–100, the median perception of the usefulness, safety, and trust of vaccinations were 92, 80, and 85, respectively. The mean scores of students were significantly higher for each perception, whereas in professional midwives, age and perceptions were negatively correlated. When asked whether there were scientific, philosophical, or religious arguments not to vaccinate, 83.2%, 69.8%, and 77.8% of participants disagreed, respectively. The vast majority (91.6%) was very or mostly favorable to the pertussis vaccine after delivery, but only around half (51.5%) to the influenza vaccine during pregnancy; those favorable to the pertussis vaccine were younger. A high proportion of participants (88.3%) considered that midwives were in a good position to vaccinate, with this proportion being even higher among students. ConclusionsThese results suggest that the recent authorization regarding vaccine administration will result in better vaccine coverage of pregnant women and their families by midwives. The better perceptions of younger participants are also encouraging. However, the level of trust in vaccinations (only 80.1%) and the low number of participants favorable to the influenza vaccine during pregnancy suggest that initial and continuous training should be reinforced.

Educating student midwives about compassion: A critical reflection

This article provides a critical reflection upon the author's experiences regarding the development of the ‘Compassionate and Professional Midwife’ module within the undergraduate curriculum at Nottingham University. Traditional definitions of compassion that describe alleviation of suffering do not fully resonate with the philosophy of midwifery, which is to support women through a normal physiological life experience. While the Francis report and the Department of Health and Social Care have stated that healthcare must be compassionate, there is little literature to support how this should be taught in midwifery education.