Role Of Midwife Research Articles

Beyond Clinical Care: The Role of Midwives in Providing Holistic Support through Continuity of Care - A Case Study

Continuity of care (COC) in midwifery is a model that emphasizes a continuous and trusting relationship between a midwife and a woman throughout her pregnancy, childbirth, postpartum period, and beyond. This approach fosters holistic support, encompassing not only clinical care but also emotional, psychological, and social well-being. This case study explores the role of midwives in providing such comprehensive care within the COC framework. This study presents the case of Mrs. A, a 22-year-old primiparous woman who received COC midwifery care at TPMB Delima Winda Maolinda in Banjarmasin City, Indonesia. The care spanned her pregnancy, childbirth, postpartum period, newborn care, and family planning counseling. Data were collected through direct observation and interviews during midwifery care encounters. The study highlights the various dimensions of care provided, including antenatal check-ups, childbirth assistance, postpartum monitoring, newborn care education, and family planning guidance. It also explores the challenges and benefits of implementing COC in this particular context. In conclusion, this study demonstrates the positive impact of COC midwifery care on maternal and neonatal outcomes. The continuous support and personalized guidance provided by the midwife contributed to Mrs. A's emotional well-being, facilitated informed decision-making, and promoted healthy behaviors. This study underscores the importance of COC in midwifery practice and its potential to enhance the overall quality of care for women and their newborns.

Service evaluation of an early pregnancy loss support clinic in an inner London early pregnancy unit

BackgroundEarly pregnancy loss (EPL) can have profound implications for physical and psychological health. In the UK, significant variation in service provision exists for women affected by EPL. There is very little guidance on what hospital-based follow-up support services should entail, and how these can be implemented and integrated into current care provision to meet the needs of women who experience EPL. This service evaluation (SE) reports on an Early Pregnancy Loss Support Clinic (EPLSC) in an inner-city Hospital Trust.MethodsThis SE gathered both quantitative and qualitative feedback from women to assess the value of a locally implemented Early Pregnancy Loss Support Clinic (EPLSC). Quantitative feedback was collected using the Short Assessment of Patient Satisfaction (SAPS) questionnaire and the Visual Anxiety Scale (VAS-A), both administered to women attending the EPLSC. Qualitative feedback was collected through semi-structured interviews and focused on four pre-determined themes based on EPL literature - physical health, mental health, role of the bereavement midwife and overall service user experience. Quantitative feedback was summarised using descriptive statistics, while qualitative feedback was analysed using framework analysis.ResultsA total of 127 women were invited to the EPLSC, with 110 (87%) attending, and 17 (13%) not attending their appointment. SAPS scores ranged from 21 to 28, indicating that women were either satisfied or very satisfied with the care they received at the EPLSC. Results from VAS-A scores showed that 76 (69%) women reported a decrease in anxiety immediately after attending the EPLSC, compared to 8 (7%) who reported no change or a small increase in anxiety. Qualitative findings highlighted women’s concerns around future fertility, the importance of emotional support and the value of connecting with the bereavement midwife.ConclusionAn EPLSC that focuses on providing emotional support and reassurance, particularly regarding future fertility, is important to women. Further rigorous evaluation of national disparities in EPL follow-up is urgently needed to assess the gaps in clinical care delivery.

Compassionate and Safe Home Birth Transfer

This article aims to develop a recommendation by the National Institute for Health and Care Excellence (NICE), alluding to a more compassionate approach to home birth transfer. It overviews solutions towards this through operational planning and suggestions for core skills to enhance effective and compassionate homebirth transfer planning and preparation. It underscores the crucial role of midwives in planning and executing a transfer from home to hospital, making them feel valued and integral to the process.

A socially interactive communication skills training for competent health educators

Abstract Background Every contact with expectant and new parents can be a “teachable moment” for promoting the health of mother-baby-family; yet, healthcare providers may not effectively perform their educational role. Previous studies have described various setting-specific challenges. Procedural knowledge, resulting in lack of confidence and avoidance, is a universal theme, challenging current communications skills training. Given the evolving role of midwives under the new Cyprus National Healthcare System, there is need for innovative practices. Objectives “Baby Buddy Communicators” designed, implemented and piloted tested a socially interactive digital environment on the Edubreak platform, where practicing (N = 8) and in-training (N = 7) Midwives completed an 8-week iterative hybrid communication skills course along with service-users. Results Four situational-based scenarios were co-created with ‘holders of the experience’ tapping on key priorities (elective caesarean, breastfeeding challenges, baby in NICU, postnatal depression). Participants produced video artefacts of role-play consultations and engaged in peer-to-peer and service-user feedback via the in-built video annotations and blog writing tools. Deductive content analysis of the rich material using the 18-item Health Professionals Communications Skills (HPCS) scale identified recurrent patterns tapping on both informational aspects (e.g. incomplete information gathering, overload without assessing comprehension) as well as social skills (e.g. agenda setting, early reassurance, assertiveness). Conclusions This cross-sectoral transfer of social video from sports training to healthcare is a “proof of concept”. Inverted (i.e. making current practices visible) and experiential learning (e.g. feedforward) with cross-sectoral (service-user involvement) and cross-module dimensions (i.e. communication skills and evidence-based practice) provided the basis for evaluation and a source of shared learning and reflection. Key messages • Several areas of improvement in communication skills of maternal healthcare providers were identified while peer-to-peer and service-user feedback was a source of reflection. • The use of digital technology and social video allowed immersive role-playing, observation and constructive feedback loops providing a new paradigm in health communication skills training.

Door de ogen van de patiënt: tele- en zelfmonitoring voor zwangere vrouwen met een verhoogd risico op hypertensie

Through the patient’s eyes: remote monitoring and patient self-measurement for women at risk of gestational hypertensive disorders Remote monitoring (RM) and patient self-measurement (PSM) are new technologies that enable blood pressure monitoring at home for pregnant women at risk of gestational hypertensive disorders (GHD). As patient satisfaction is increasingly considered as an indicator of the quality of care, this study aimed to compare patients’ perceptions on RM and PSM with those on conventional care for women at risk of GHD. The data collection was part of a multicentric RCT with 2 intervention groups (RM and PSM) and 1 control group. 254 participants completed the survey, determining the patients’ perceptions regarding the care they received at 4 measurement points. Linear probability models were used to assess the impact of RM and PSM on patients’ perceptions. Women at risk of GHD were significantly more likely to be satisfied with the care outcomes, to feel confident about their role as a mother and to be satisfied with their delivery after a follow-up by RM than after a follow-up by conventional care. In addition, they were significantly less likely to be concerned about their general health. The perceptions of women in the PSM group were not significantly better than those of the control group. The positive perceptions of patients regarding RM may be partly explained by the reduction in complications and the role of the study midwife as ‘advanced midwifery practitioner’.

Opinions and Knowledge of Midwives Regarding Physical Exercise During Pregnancy: Insights and Implications for Midwifery Practice.

Background Physical exercise during pregnancy offers significant benefits for maternal and fetal health, improving cardiovascular fitness, managing weight, and reducing risks of gestational diabetes and hypertension. Despite these benefits, the role of midwives in promoting exercise is critical but often underexplored. Materials and methods This cross-sectional quantitative study surveyed 172 midwivesusing a structured questionnaire to assess their knowledge and attitudes towards physical exercise during pregnancy. Descriptive and inferential statistics, including chi-square tests, were used to analyze the data. Data collected through the questionnaires were analyzed using IBM SPSS Statistics v. 29 (IBM Corp., Armonk, NY). Results Among the 172 participants, 97.7% were female with a median age of 36 years. While 65.1% engaged in physical exercise themselves, only 26.7% recommended exercise during pregnancy to their patients. The knowledge level of midwives about the benefits of exercise was high, with 95.3% recognizing its role in maintaining hormonal balance and 88.4% understanding its benefits in reducing gestational diabetes. However, 32.6% of midwives reported not feeling confident in guiding pregnant women on how to exercise. Statistically significant correlations were found between midwives' opinion level and their knowledge of exercise benefits, including proper weight gain (rho = 0.263, p = 0.01) and reduced likelihood of gestational diabetes (rho = 0.492, p = 0.01). Conclusions Midwives recognize the importance of exercise during pregnancy but require more training to provide effective guidance. Enhancing midwives' education on exercise can improve maternal and fetal health outcomes by promoting physical activity during pregnancy.

Early Initiation of Breastfeeding (EIBF) Practices in Bener Meriah Regency, Aceh, Indonesia: A Cross-Sectional Study on the Role of Midwives in Reducing Infant Mortality

Early initiation of breastfeeding (EIBF) is critical for reducing infant mortality and improving child health outcomes. Midwives play a crucial role in promoting and supporting EIBF. This study investigated EIBF practices in Bener Meriah Regency, Aceh, Indonesia, focusing on the factors associated with midwives' knowledge, attitudes, and practices regarding EIBF. A cross-sectional study was conducted among 150 midwives in Bener Meriah Regency. Data were collected using a structured questionnaire that included items on sociodemographic characteristics, knowledge, attitudes, and practices related to EIBF. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. The majority of midwives (87.3%) had good knowledge about EIBF. However, only 62.7% of midwives reported always assisting mothers with EIBF within one hour of birth. Factors significantly associated with midwives' EIBF practices included their age, years of experience, and place of work (urban vs. rural). While midwives in Bener Meriah Regency generally possess adequate knowledge about EIBF, there is a need to improve their practices in assisting mothers with EIBF, especially in rural areas. Targeted interventions, such as training programs and supportive supervision, are necessary to enhance midwives' skills and confidence in promoting and supporting EIBF.

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.

HUBUNGAN PERAN BIDAN DAN DUKUNGAN SUAMI TERHADAP PENGGUNAAN IUD DI WILAYAH KERJA PUSKESMAS SRANDAKAN

Indonesia prioritizes the Family Planning (KB) program, especially Long Term Contraceptive Methods (MKJP) such as the Intrauterine Device (IUD). The use of IUDs in DI Yogyakarta is more popular even though injectable hormonal contraceptives are still dominant in Indonesia, the Srandakan Community Health Center in Bantul recorded the highest use of IUDs (44.5%). National development targets in the strategic plan and target setting for the 2020-2024 BKKBN program, as well as international agreements in the SDGs development goals to increase participation rates in the use of MKJP, this makes it an important issue for participation in the use of MKJP, especially the IUD, which is a contraceptive device that is considered effective. The availability of information and social support from midwives and husbands is key in increasing the acceptance and continued use of IUD contraception by WUS. This study aims to determine the relationship between the role of midwives and husband's support on the use of IUDs by WUS in the Srandakan Community Health Center Work Area, Bantul Yogyakarta. This research is a quantitative study with a correlational analytical design and a cross-sectional approach. The sampling technique used accidental sampling with a total population of 1,034 WUS and a sample of 92 respondents. The research instrument used a questionnaire. The research results were obtained from the Fisher's Exact Test which showed a significant relationship between the role of the midwife (p=0.019) and husband's support (p= <0.001) on IUD use. Based on these results, it can be concluded that the role of the midwife and the husband's support influence the decision to use IUD contraception.

O35 - Whose lane is this? The role of the caseload midwife in complex care

O35 - Whose lane is this? The role of the caseload midwife in complex care

Development of Local Wisdom in Preventing Stunting in Village Communities

Background: Child stunting refers to a child who is too short for his or her age and is the result of chronic or recurrent malnutrition, based on the height-for-age index (HAZ). The results of weighing and measurements at the Posyandu, or community health post, show an increase in the prevalence of stunting from 7% in 2019 to 10.41% in 2020. A preliminary survey at the Ceper Community Health Centre in Klaten Regency showed that out of 1,922 children under five, 187 were stunted. Local wisdom is considered highly valuable and has its own benefits for the lives of the community. Thanks to local wisdom, they can sustain their lives and even develop sustainably. The role of midwives in developing local wisdom for stunting prevention is crucial, as they are the frontline health workers in the prevention of stunting. Methods: The research design is an analytical observational study with a cross-sectional approach. Data analysis was conducted using regression. The research sample was taken using cluster random sampling techniques involving 60 respondents. Results: The data analysis results showed a relationship between the role of educators and motivators in the intervention of developing local wisdom for stunting prevention. Conclusion: The role of village midwives in providing information, encouragement, facilities, and empowering health cadres is crucial in developing local wisdom for stunting prevention.

Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives’ intentions to leave the profession and the role of retention midwives

Problem/Background: Midwifery retention is a global issue, but less is known regarding what motivates midwives’ intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. Aim: To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. Methods: An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. Findings: The three themes included ‘Values-based tensions: The eroding role of the midwife’; ‘Discerning differences: Intentions to leave or stay’; ‘Retention midwives: Activities and impact’. Discussion: We found that there was a clear link between midwives’ intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives’ experience of the workplace. Conclusion: Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required.

R v Noor: a landmark case in female genital mutilation prosecution

This article on the case of R v Noor (2024) discusses the second successful UK prosecution under the Female Genital Mutilation Act 2003, marking a significant legal precedent in addressing female genital mutilation. It underscores the critical role of midwives in detecting, reporting and caring for victims, highlighting the intersection of healthcare, law and ethics in combating this practice. By examining the case of Amina Noor, who took a child abroad for female genital mutilation, the article elucidates the legal ramifications of such acts. It stresses the importance of midwifery awareness, education and collaboration with legal entities to protect women and girls. The article advocates for continuous professional development, the use of legal tools such as female genital mutilation protection orders and a Commissioner to prevent female genital mutilation, emphasising the collective responsibility of healthcare professionals in eradicating this harmful practice and safeguarding vulnerable individuals.

Professional identity: Students’ learning from the attributes and behaviours of midwives on clinical placement

BackgroundMidwifery practice experience is an important component of education to develop an understanding of professional identity in midwifery students. The responsibility of supporting student development in the clinical setting is predominantly undertaken by clinical midwives. There is minimal literature relating to the professional identity development of midwifery students. AimTo explore midwifery student experiences of the positive attributes of clinical midwives who supported the professional identity development of midwifery students in the clinical practice setting. MethodsAn Appreciative Inquiry approach guided this study. The setting was a university in Sydney, Australia. Participants comprised thirteen students from a postgraduate midwifery course. Data were collected via individual interviews and analysed thematically. Students had two to six months of placement in the clinical setting. FindingsData analysis identified three themes, Putting the woman at the centre of care; Supporting a woman-centred environment and Focusing on student success. DiscussionFindings from this study revealed that extended time spent with a midwife enabled the student to observe and reflect on the nuances of midwifery practice that are not overtly shared with students. Students were able to observe a midwife’s tacit way of being. This paper reveals the positive attributes and behaviours of midwives whose practice the students want to emulate. ConclusionsMidwifery students’ exposure to positive clinical midwife role models on clinical placement enables them to develop a greater understanding of professional identity.

The Role of Midwives in US Perinatal Palliative Care: A Scoping Review.

Perinatal palliative care (PPC) is a rapidly growing and essential reproductive health care option for pregnant persons with a diagnosed life-limiting fetal condition who continue their pregnancy. The provision of PPC is within the scope of basic midwifery competencies, and midwives are well-positioned to make unique and valuable contributions to interprofessional PPC teams. However, little is known about midwives' past or current involvement in PPC in the United States. This scoping review of the literature investigated what is known about the role of midwives in PPC in the United States. Multiple databases of published literature were used for this review: PubMed, CINAHL, Embase, Web of Science, ProQuest, Google Scholar, and relevant citations from identified studies. All types of English language publications addressing midwives' involvement in PPC in the United States were included, without any limitations on publication date. The role and contributions of midwives in PPC is not well represented in existing literature. Of the 259 results identified, 7 publications met criteria for inclusion. These included 5 case reports, one quantitative research article, and one conference abstract. Midwives are involved in PPC through the provision of direct clinical care (including antepartum, intrapartum, postpartum, neonatal, bereavement, postmortem, and follow-up care) and care planning and coordination as part of an interprofessional team. Despite midwives being uniquely positioned to provide holistic, family-centered, and person-centered care in situations of pregnancy with life-limiting fetal conditions, there is limited literature about their involvement in PPC in the United States. PPC should be incorporated into midwifery education and training programs. Midwives should play a central role in shaping future research and policies to ensure the accessibility and quality of PPC.

Complexities of midwifery care delivered to perinatal women in prison: A qualitative study

PurposeTo provide insight into the challenges faced by imprisoned perinatal women in accessing appropriate information, support, and care and the importance of the midwife's role in this context. MethodThis paper draws on two studies conducted in one United Kingdom (UK) women's prison over two separate time points (2019, 2021). In both qualitative evaluative studies that were descriptive in nature, semi-structured interviews were conducted with perinatal women and professionals involved in their care. Participants17 women participated across the two qualitative studies, six were pregnant, nine were on the Mother and Baby Unit (MBU) and two had given birth in the last 12 months but were not on the MBU. 12 professionals participated across the two studies. ResultsThe studies highlight the specific challenges that perinatal women in prison face compared to their community counterparts in being able to access reliable information on pregnancy, birth, and parenting; having access to appropriate and reliable peer support and mental health support not only in terms of provision but also in terms of accessibility; and in being able to advocate for themselves or having people that can advocate for them. ConclusionThese challenges arguably heighten the importance of, as well as the pressure on the midwife in this context. The authors therefore highlight the need for consideration of three factors for midwifery in this context: (1) Resourcing (2) Information provision to, and information sharing between, midwives to increase awareness of challenges faced by this cohort, and (3) Strengthening the midwife's position to support and advocate for women's perinatal mental health in prison.

Hubungan Dukungan Suami, Peran Bidan Dan Pengetahuan Ibu Terhadap Kejadian Baby Blues Pada Ibu Nifas Di BPM Bidan Lena Jakarta

Introduction: Based on a preliminary study on secondary data at BPM Midwife Lena Jakarta in 2021 112 post-partum mothers gave birth at the BPM. From 112 post-partum mothers; based on secondary data from Lena's BPM in 2021, 15 post-partum mothers did not receive the support of their husbands, such as husbands never helping mothers with homework and husbands sometimes getting angry when the baby cries. Of the 112 post-partum mothers; 19 post-partum mothers felt anxious and worried that their babies would cry a lot and mothers felt that their sleep time was reduced. Of 112 post-partum mothers; 3 post-partum mothers felt uncomfortable with their current physical condition. Methods: This study aims to determine the relationship between the husband's support, the midwife's role, and the mother's knowledge of post-partum mother's baby blues. This type of research is Analytical and Descriptive with a cross-sectional approach. Results: there is a significant relationship between the husband's support and the incidence of baby blues in post-partum mothers with a p-value of 0,029 which is smaller than the alpha value of 0,029 <0,05. there is a significant relationship between the role of the midwife and the incidence of baby blues in post-partum mothers with a p-value of 0,030; the p-value is smaller than the alpha value 0,030 < 0,05. there is a significant relationship between mothers' knowledge of the incidence of baby blues in post-partum mothers with a p-value of 0,023; the p-value is smaller than the alpha value 0,023 < 0,05. Discussion: It is known that from a total of 37 respondents; the number of post-partum mothers who experienced symptoms of baby blues was 24 respondents (64,9%) which means that the variables of husband's support, the midwife's role, and a mother's knowledge played a big role in triggering the occurrence of baby blues in post-partum mothers.

Maternal Mortality in Pakistan: The Potential Role of Community Midwives

Maternal Mortality in Pakistan: The Potential Role of Community Midwives

Separation at birth due to safeguarding concerns: Using reproductive justice theory to re-think the role of midwives.

Separation at birth due to safeguarding concerns is a deeply distressing and impactful event, with numbers rising across the world, and has devastating outcomes for birth mothers and their children. It is one of the most challenging aspects of contemporary midwifery practice in high-income countries, although rarely discussed and reflected on during pre- and post-registration midwifery training. Ethnic and racial disparities are prevalent both in child protection and maternity services and can be explained through an intersectional lens, accounting for biases based on race, gender, class, and societal beliefs around motherhood. With this paper, we aim to contribute to the growing body of critical midwifery studies and re-think the role of midwives in this context. Building on principles of reproductive justice theory, Intersectionality, and Standpoint Midwifery, we argue that midwives play a unique role when supporting women who go through child protection processes and should pursue a shift from passive bystander to active upstander to improve care for this group of mothers.

UK midwives delivering physical activity advice; what are the challenges and possible solutions?

Despite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions. Ten UK midwives (mean work experience ± SD: 15.5 years ± 10.2) participated in semi-structured interviews between May and July 2023. Data were analysed using a deductive thematic approach following Braun and Clarke's six steps. Demographic data were collected by Microsoft Forms then summarised using Microsoft Excel. Six themes with 25 subthemes were identified as barriers and solutions in delivering PA advice. The role of midwives in providing PA advice during pregnancy; the role of midwives in providing PA advice postpartum; intrinsic barriers that limit PA advice provision (confidence, safety concerns, knowledge, and midwife's personal body habitus); extrinsic barriers that limit PA advice provision (lack of time, education, PA not a priority in care); solutions to allow midwives to promote PA (including formal PA education, and dissemination of resources); and optimising delivery of PA advice (personalized approach, interprofessional collaboration, and linking to mental health benefits). Midwives consider themselves ideally placed to provide PA advice to pregnant women, with many aware of the benefits PA provides. Despite this, there is a lack of PA advice provision and knowledge of PA guidelines. Postpartum PA advice appeared to be considered outside the remit of midwives, due to limited contact. Further research is needed to determine the current level of PA advice provision for pregnant and postpartum women and explore the role of other healthcare professionals involved in maternity care.