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PubMed2001

Graduates' perceptions of their midwifery training during the four year comprehensive nursing diploma.

Since its inception in 1986, the Comprehensive Nursing Diploma has received many criticisms from registered nurses, who graduated from the pre-existing programmes. This study attempts to examine the perceptions of graduates from this training programme, towards their midwifery education in terms of its adequacy in preparing them for midwifery practice. Twenty-nine graduates of the four year Comprehensive Nursing Programme completed self-administered questionnaires. Data was analysed by means of descriptive and inferential statistics, namely the paired t-test and the Wilcoxon test for matched pairs. Qualitative data was analysed to determine emerging themes and patterns. Differences in competence ratings on entry into midwifery units and those a year later, were significant at p = 0.0001. It was found that graduates appear to have a positive perception of the midwifery component of their training programme. They found the theory aspect to be more than adequate in preparing them for their professional roles. However, with regards to clinical exposure, it was felt that the time period was too short and needed to be extended in order for them to attain clinical proficiency.

Adult↗
PubMed1998

[Quality assurance in midwifery outside the hospital: reasoning and suggestions for its execution].

Childbirths outside the hospital make up a small but during the last years increasing part of births. At the same time a process of sorting out midwifery institutions outside the hospital is taking place. The quality of providing obstetric care outside the hospital is called in question by clinical obstetricians as a result of a supposed high risk. Meanwhile the results of a lot of studies, including also those from Germany, allow an evaluation of indication, quality and the limits of midwifery outside the hospital. Against this background quality assurance acquires a special importance. Currently there are no legal regulations for quality assurance in midwifery outside the hospital as they exist for clinical obstetrics and other fields of medical and nursing care. Establishing measures for quality assurance systematically is a necessary step towards acceptance and professionalization of midwifery outside the hospital. It should be possible to draw upon the experiences of medical and clinical quality assurance. This work presents a complete and differentiated model for organizing and implementing quality assurance and refers to its function in professional practice.

Female↗
PubMed1999

[History of gynecology and perinatology in Croatia. Midwifery. Clinics and hospitals in Zagreb].

The development of obstetrics in Croatia and the formation of unique discipline of obstetrics and gynecology in Croatia in first ten years of 20th century are presented. The midwifery is mentioned in Croatia for the first time in Dubrovnik in 14th century. The "protomedicus" from Varazdin Johan Baptist Lalangue in 1777 has published the booklet "Brevis institutio de re obstetritia". First public school of midwifery was founded in Zadar on 1820 and the second one in Zagreb in 1877. In Zadar, Ante Kuzmanić, "magister obstetritiae et chirurgiae" published a short textbook "Sixty lessons from midwifery for midwifes", thereafter in 1908 Nikola Lalich "Book for midwifes". In Zagreb, Antun Lobmayer published in 1877 "The midwifery". Gynecology was developing in the second half of 19th century as a part of surgery. On break-time from 19th to 20th century rose the unique medical profession obstetrics and gynecology. In Croatia the unique discipline established Dr Franjo Durst, since he was in 1905 installed for the first head of Royal Country Maternity Hospital in Ilica street and thereafter in 1921 for the first head and university professor of Royal University Clinic for Gynecology and Obstetrics in Petrova street. The evolution of gynecology and obstetrics, respective of perinatology, during last 30 years, in the Zagreb in departments of clinical hospitals "Clinical Hospital Center", "Sestre Milosrdnice", "Merkur" and "Sv. Duh" is presented.

Croatia↗
PubMed1999

Predicting style-of-care preferences of obstetric patients. Medical vs. midwifery model.

OBJECTIVE: To identify patient populations preferring more medically oriented vs. more midwifery-oriented medical care in order to provide an institutional resourcing model. STUDY DESIGN: Questionnaires were distributed to pregnant women regarding possible concerns related to style of care and length of hospitalization for obstetric delivery. Responses from the 135 usable surveys were analyzed by cluster analysis to search for common demographic or ideologic concerns that might distinguish two or more groups of patients according to style-of-care preferences. RESULTS: Four clusters were identified and categorized based on the initial hypothesis as midwifery preference, medical preference, passive and wanting both. Cluster membership could not be predicted by any demographic or historical variable studied, and the most significant style-of-care discriminator was related to preferred length of postpartum hospital stay, with 80% of the midwifery preference cluster desiring a short (< 24 hour) stay as compared to a single patient (2%) in the medical preference cluster. CONCLUSION: While obstetric care is often offered in distinctly stylized packages according to the training of the provider, our study suggests that patient preferences are much more complex and may contain many elements of both midwifery and medical styles of care. Broadening access to obstetric care will involve moving from our own preconceived notions of appropriate packaging into a patient-based and multi-option setting for delivery of these services.

Attitude to Health↗
PubMedDate not supplied

A preliminary survey of midwifery training in Edinburgh, 1844 to 1870.

A brief review of the teaching of midwifery in Edinburgh from the creation of the first chair of midwifery in 1723 to the introduction of mandatory teaching of midwifery to medical students in 1833 is given. The evidence that women continued to be taught after this date is examined and the hypothesis that the latter led to the reduction or termination of midwifery training for women is shown to be untrue by examination of the casebooks for the Edinburgh Royal Maternity Hospital (founded in 1844) and associated documents. The nature of the training offered to female pupils prior to 1871, and the contemporary confusion of the terms midwife and nurse, are also examined.

Education, Special↗
PubMedDate not supplied

[Development of midwifery in Vojvodina].

This paper deals with the beginnings and development of midwifery services as well as schooling modalities and professional education of midwives in Vojvodina after gaining freedom from Turkish rule. Obstetrical services in the Military Border Region of Vojvodina were much better organized than in the civil, so-called "provincial" part. In the second half of the 18th century, law regulations were brought and only midwives with certificates of universities and training courses of special midwifery schools in bigger towns could practice midwifery. At that time most trained midwives in Vojvodina were of German nationality, because Serbs knew neither German nor Hungarian and could not get education in Vienna and Budapest. A century later the situation was practically the same. Dr. Svetozar Maksimović, Master of Obstetrics and the first director of the Maternity Hospital and a city physician in Novi Sad, was well aware that this town had no midwifery service. That is why on July 27, 1879 he submitted a suggestion for foundation of a "Government Training Institute for Midwives and Pregnant Women". Although this suggestion was not realized, it was the first attempt to establish a school for midwives in Novi Sad in Serbian language and was of great importance fir history of medicine in Vojvodina, especially in Novi Sad. Furthermore, it points to the fact that physicians in Novi Sad, especially Dr. Svetozar Maksimović, were informed about current medicine in the world. In the frame of public health special attention was paid to Women's Care Services concerning especially pregnancy, delivery and puerperium. However, it was not possible to realize his vision in Vojvodina at that time, due to insufficient number of trained midwives.

Female↗
PubMed2006

Mapping the literature of nurse-midwifery.

OBJECTIVE: This article is part of a project for mapping the literature of nursing. The purpose is to identify the core journals in nurse-midwifery and to determine the extent to which these titles are covered by standard indexing sources. METHODS: Cited references from two source journals were analyzed to discover the most frequently cited publications, including their format, age, and amount of dispersion, as well as the indexes that offer the most complete coverage. RESULTS: A study of the literature of nurse-midwifery reveals that the field is diverse, including such topics as women's health, obstetrics, gynecology, and parent-child relations, in addition to the practice of nurse-midwifery itself. Journals were the most heavily cited format, and analysis revealed that ten journals provided one-third of all the references in the study. CONCLUSIONS: A combination of Science Citation Index and Social Sciences Citation Index or PubMed/MEDLINE provided the best overall coverage because of the field's reliance on medical journals. CINAHL had the most complete coverage for the nurse-midwifery journals as well as nursing journals in general.

Abstracting and Indexing↗
PubMed1985

Midwifery services in Madang Province, Papua New Guinea: a proposal.

This report describes socio-cultural similarities and differences which will affect the success of midwifery training programs in Karkar and Negiri, Madang Province, Papua New Guinea. The report acknowledges these communities' concerns about a midwifery project, notes problems in determining accurate perinatal data for these locales, and indicates the need for comprehensive maternal-child care which is commensurate with these peoples' customs and beliefs. While recognizing that in many nations training of midwifery specialists addresses needs in a practical manner, this report recommends training local women as midwifery teachers as a preferred approach for areas such as Karkar and Negiri.

Child Health Services↗
PubMed1994

[160th anniversary of the Chilean school of midwifery: in the path of Sifra and Pua].

Midwifery is one of the oldest professions. However, the first attempts to train midwives appeared only in the seventeenth century and the first maternities, that become training centers, arose in the eighteenth century. Legal Norms for training and practice of midwifery began to be dictated during nineteenth century in Holland, Scandinavia, Germany and France. It is thus noteworthy that a young country as Chile is celebrating the 160th anniversary of the School of Midwifery, one of the oldest in the world. After the Independence, Chile gave great impetus to education, numerous european professors were hired and the school of midwifery was founded in 1834 by Dr Lorenzo Sazie, a french surgeon and obstetrician. Due to its nature, midwife education must emphasize the ethical aspects of the profession. Since ancient times, midwives are committed with human life. Hebrew midwives Sifrá and Puá, disobeyed the Egyptian King's order to kill all male newborns, and were rewarded by god, as mentioned in the Old Testament. On the other hand, during the Obstetrics course opening in 1835, Dr Sazie underscored the ethical demands of the profession, exhorting students to be "mankind ministers".

Anniversaries and Special Events↗
PubMedDate not supplied

Assessment of the process and outcomes of the first 1,000 births of a nurse-midwifery service.

This article is a retrospective descriptive analysis of the first 1,000 births conducted by the Nurse-Midwifery Group of Fresno County, California, over the period from 1980 to 1985. The multiethnic patient population was of mixed obstetric risk. Nurse-midwifery care was offered within the context of a comprehensive maternity care program in close collaboration with a perinatal health care team. Patient care outcomes were quite favorable when compared with county and state statistics. A perinatal mortality rate of 7.0/1,000 was observed. The incidence of low birth weight infants (5.7%) and the cesarean section rate (7.7%) were also lower than county and state statistics. These data add to the growing body of literature that suggests that nurse-midwifery care, within the structure of collaborative practice, can be effective and advantageous. The nurse-midwifery service made a contribution to access to perinatal care for the residents of this community.

Adolescent↗
PubMedDate not supplied

Nurse-midwifery service model in an academic environment.

The Nurse-Midwifery Division, with the full support of the Department of Obstetrics and Gynecology, and with committed partners in the College of Nursing, is proceeding forward with a three-part mission: nurse-midwifery practice, teaching, and research. Our practice sites are likely to remain varied but stable, with half of our clients being either Hispanic or Native American. Our commitment to nurse-midwifery education is solid, and our participation in the process will continue to take several forms, including the central one of clinical preceptorships. Our research agenda will grow. We hope our experience with GRAVI-DATA will contribute to the development of a national nurse-midwifery data base. Other future goals of our research program include collaboration in multisite clinical research projects, obtaining substantial external funding and recruiting doctorally prepared investigators.

Databases, Factual↗
PubMedDate not supplied

The development of the Community-based Nurse-midwifery Education Program: An innovation in distance learning.

Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in which to educate enough nurse-midwives. The application of distance learning to nurse-midwifery education expanded opportunities for a greater number of students to have access to an education in nurse midwifery. The story of the Community-based Nurse-midwifery Education Program is presented as an exemplar.

Clinical Competence↗
PubMedDate not supplied

The historical relationship of nurse-midwifery with medicine.

This historical review of the literature highlights the struggles that American nurse-midwifery has undergone in defining itself to the medical profession. Because nurse-midwifery came into existence in this country close on the heels of the demise of traditional midwifery, it had many prejudices to overcome. For many years, nurse-midwifery allied itself with nursing to gain power and acceptance from physicians. Now, however, there is a move toward independence as nurse-midwives are more visible and the effectiveness and safety of their practice have been established.

History, 20th Century↗
PubMed1991

Introducing confident midwives: Midwifery Education--Action for Safe Motherhood.

The present crisis in midwifery and the seriousness of maternal mortality and morbidity demands a rethink about the background and training requirements of each level of midwifery worker. This paper describes the background of the present shortage and mal-distribution of midwives. The reduction of maternal mortality by 50% at the turn of this century requires the development of a maternal health care team in which the midwife functions as the linchpin. In order to equip the midwife for the leadership functions in this team, the present educational system needs to be fundamentally improved. The rationale for the acquisition of epidemiological, managerial specialised technical and teaching skills by midwives is discussed. Implications for further education are high-lighted. Collaborative actions taken by the WHO, ICM, UNICEF and other governmental and non-governmental agencies to address the issue of midwifery are outlined. This paper was given at the 1990 ICM, WHO, UNICEF Pre-Congress Workshop on Midwifery Education--Action for Safe Motherhood in Kobe, Japan.

Clinical Competence↗
PubMed1996

Eliciting the views of experienced midwives about the assessment of competence in midwifery.

OBJECTIVE: to investigate the views of the English National Board for Nursing, Midwifery and Health Visiting (ENB) Professional Midwifery Advisory Network (PMAN) members about the assessment of competence in midwifery. DESIGN: initial questionnaire followed by a group discussion of a summary of the data from the completed questionnaires. PARTICIPANTS: 54 PMAN midwives representing education, management, research, practice and supervision; plus six ENB Education Officers (midwifery). FINDINGS: the response rate to the questionnaires was 75%. In the group discussion the PMAN members commented particularly on: the large number of items identified as needing assessment in practice and by written work; lack of total agreement on the assessment in practice of normal delivery; differences in practitioners' perceptions of assessment; the number and range of areas to be assessed; differences in expectation of 'task' assessment versus 'holistic' assessment; lack of assessment in simulation; heavy reliance on written work in assessment. CONCLUSIONS: the group's discussion of the questionnaire data revealed further interesting data, which added considerably to the initial analysis and overview. Some participants had misinterpreted the instructions and found that what they had filled in did not accurately reflect their beliefs about assessment. General consensus was reached on the need for a national standard or framework for assessment and more emphasis to be placed on assessing students in the practice setting whilst ensuring this includes knowledge and understanding and not merely psycho-motor skills. The major implications include effective preparation of assessors and more teacher involvement in practice to support the midwife assessors.

Attitude of Health Personnel↗
PubMed1997

Midwifery education for safe motherhood.

OBJECTIVE: To determine the useability (relevance, clarity and quality of content), applicability (ease of use) and accessibility (structure and form) of a series of new safe motherhood midwifery education modules. DESIGN: Questionnaire survey and focus group discussions, preceded by a two week clinical skills course and an eight day orientation to using the modules. SETTING: Nursing and midwifery education institutions, regional training centres, acute-care hospital facilities and community settings in Ethiopia, Fiji, Lesotho, Mozambique and Nepal. PARTICIPANTS: Thirty-six teachers, 82 midwives, nurse-midwives and auxiliary nurse-midwives from practice settings, and 60 post basic midwifery students. KEY FINDINGS: Overall it was found that the introductory information and the technical content of the modules were easy to understand and use as were the instructions for both teachers and students. The presentation of the material was orderly and easy to follow; the language was comprehensible; and the illustrations were appropriate, clear and facilitated teaching. The teachers found that they were able to use most of the teaching/learning methods, teach most of the skills in the modules, and use the guidelines for assessing competence. The main difficulties encountered included adherence to the recommended time frame for some of the classroom sessions; the limited availability of clinical cases for teaching the specific skills in the modules and time limitations in the clinical area for practising the skills; and the provision of transport for community visits, data to complete community profiles, and time to complete other planned community activities. The students identified the need for a set of learning materials which they could take with them for future reference, and both teachers and students expressed concern about resources to support, and legislation to cover, the application of the skills taught/learned. KEY CONCLUSIONS: The modules have the potential to strengthen and support the education of midwives in developing countries, enabling them to make motherhood safer and contribute to a reduction in maternal mortality by providing better midwifery care.

Adult↗
PubMed1996

Midwifery--the turning point?

This paper endeavours to respond to suggestions about the 'fate' of midwifery in Australia and to provide stimulus for further discourse and analysis about where and how midwifery is going and growing, now and in the future. The tone is set as one of optimism and self-determination, as midwifery evolves within its history in Australia and finds and affirms, its own way from nursing and medico-obstetrics its own genre with women, and its own unique heritage. It is argued that only with a self-determined commitment to the integrity of midwifery and of women (seeing the two as inseparable if we truly are with women). Will we as midwives be able to transcend notions of dependence, control, submission, and competitiveness among others. The writer has specifically chosen to present this paper without references to make clear the content of the response without the camouflage of other writers. It is hoped this paper may provoke other midwives to examine and debate their perspectives and ideas.

Australia↗
PubMed1996

A theory of caring for midwifery.

It is time that Australian midwives developed and published their own theories and models for midwifery. This paper proposes a practical model for midwifery based on caring concepts. The needs of midwifery clients have been analysed and supported by various authors and four concepts of caring have been selected and applied to these needs to bring about a positive birth experience. Philosophical assumptions have been made to form the grounding for the theory, the core of which is a caring midwifery interaction.

Communication↗