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PubMedDate not supplied

Perceptions of team midwifery.

This small study was conducted in a maternity unit which had implemented team midwifery one year previously. A period of non-participant observation of activities on a labour ward over ten shifts was followed by nine semi-structured interviews with midwives of various grades. While the initial aim of the study was to investigate the interpersonal aspects of collegial activity among midwives, the respondents gave many valuable comments on team midwifery. The general view was that team midwifery allowed them greater opportunities to develop a rapport with mothers and also provided more chances for personal and career development.

Community Health Services↗
PubMedDate not supplied

Alternative healing in nurse-midwifery practice.

This Clinical Practice Exchange focuses on alternative healing in nurse-midwifery practice. It features interviews with six certified nurse-midwives (CNMs) who practice complementary therapies (CTs). The healing modalities they use include homeopathy, Healing Touch, hypnosis, herbal healing, mindfulness meditation, and water healing. The CNMs discuss their training to practice CTs, how they use alternative healing with clients, and how they integrate this with midwifery practice. The interviews are followed by an Alternative Healing Directory composed of 37 CNMs who responded to a Call, which appeared several times in Quickening and JNM. Each midwife's listing includes contact information, CTs practices, and special interests in networking with other CNMs about alternative healing. The JNM hopes that this Directory will be a catalyst for networking and communication that will move forward the discussion, practice, and research of alternative healing within the midwifery community.

Complementary Therapies↗
PubMed2000

General practitioners' views of working with team midwifery.

This report presents the results of a survey of general practitioners (GPs) working alongside a midwifery team in south-east England. Sixty-nine per cent of the GPs thought team midwifery was a good idea in theory. However, just 37% thought it was working well locally and 56% reported that they would like to go back to working in the way they did before. Of greatest concern was the decline in interprofessional communications and the loss of continuity for patients. Therefore, team midwifery, as implemented in this locality, may not attain the goals aimed at by the organisation of care in this way.

Attitude of Health Personnel↗
PubMed2002

Randomised controlled trials in nursing and midwifery: an interview with Maralyn Foureur. Interview by Pamela J. Wood.

Randomised controlled trials are considered to be one of the best research designs for determining effective care in the clinical setting. Relatively few randomised controlled trials, however, have been carried out in nursing or midwifery practice, so few examples of the practical realities of this research methodology are readily accessible. This is the sixth article in a series based on interviews with nursing and midwifery researchers, designed to offer the beginning researcher a first-hand account of the experience of using particular methodologies. This article focuses on the randomised controlled trial as experienced by Maralyn Foureur (RGON, RM, BA, Grad Dip Clin Epidem, PhD) who used this methodology to demonstrate the effectiveness of a continuity of care model in midwifery practice.

Continuity of Patient Care↗
PubMed2002

Midwifery research: the past, present and future.

This paper examines midwifery research in light of the Research Assessment Exercise and explores the research undertaken in the UK during the last ten years. It compares midwifery and general practice research, as well as a transatlantic comparison as to the research output in the UK and US. It also presents an assessment of the impact of midwifery research.

Databases, Bibliographic↗
PubMed2003

Midwifery in Gibraltar: the lived experience.

This article is based on personal and clinical experiences and observations during a two-week elective placement at a small, local maternity unit in Gibraltar. Training in a large multicultural and ethnically diverse hospital proved very different to the environment of St Bernard's Hospital in Gibraltar. The positive, almost idealistic midwifery care observed instilled hope about a midwifery career and the future of midwifery in the UK. It is hoped that this article will inspire other students.

Adult↗
PubMed1992

[A survey on the graduates of the baccalaureate program who elected the midwifery course at St. Luke's College of Nursing].

A survey was conducted on the Midwifery Graduates (MG) at the college. 244 students completed midwifery course from 1968 to 1990. The questionnaire was sent to 229 whose address were known, and 133 were responded. The questionnaire consists of demographic data, engagement status with job, expectation to the job, attitude toward the job, and comment on the midwifery course. The results of this study were compared with the study done on the all graduates from 1968 to 1984 at the same school in 1984. As a result, among MG it was shown high rate of higher degree holders and higher in engagement with job. Rate of job holders decreased in the period of childbearing and childrearing, which was similar to the '84 study. But higher in MG who kept their job after marriage. MG who are working in the area of maternal-infant nursing at the time of study, the highest number were being in the clinical nursing, and in the teaching next. The shorter the period from graduation, more number in clinical area, and those who staying in job longer, they were more in either teaching or community nursing area. Among all the subjects worked maternal-infant nursing area, the length of experience as a clinical nurse was approximately 4 years, and it as a teacher was approximately 3 to 4 years. 30 percent of clinical nurse in the maternal-infant nursing, later moved to teaching area. Those who have left their job for personal reasons or earning higher degree, most of them took the job in the area of maternal-infant nursing again. Among MG who were out of job, the rate of willing to return to job were similar to the '84 study.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Nursing, Baccalaureate↗
PubMedDate not supplied

A comparison of the outcomes of partnership caseload midwifery and standard hospital care in low risk mothers.

BACKGROUND: Maternal and infant clinical outcomes were compared for low risk mothers receiving a partnership caseload model of midwifery care, known as Primary Health Midwifery Care (PHMC), and standard hospital care (SHC). METHODS: Using secondary analysis of data from the Obstet Data System routine collection (PHMC n=976, SHC n=976) from a large metropolitan hospital, maternal and infant clinical outcomes were examined. RESULTS: Odds ratios (OR) demonstrated reduced rates of interventions for multiparous women (OR 0.62 [CI 0.49-0.80]), with multiparous women receiving PHMC being more likely to have a normal delivery (OR 1.75 [CI 1.22-2.5]). A higher proportion of both primiparous and multiparous women receiving PHMC received pethidine during labour (OR 1.78 [1.33-2.39], OR 1.55 [1.19-2.01] respectively). Primiparous women receiving PHMC underwent fewer episiotomies with an associated increase in the proportion of women experiencing perineal tears (OR 1.93, CI 2.35-2.78), although perineum trauma rates were similar for both care models. Similar and very small numbers of infants in both parity groups and care models had an Apgar of less than seven at five minutes or were admitted to the neonatal intensive care unit or special care unit. CONCLUSION: This study, within the limitations of its design, supports the safety of the partnership caseload midwifery care model, in addition to reduced rates of interventions experienced by multiparous women and fewer episiotomies in primiparous low risk English-speaking women receiving caseload care.

Adult↗
PubMed1989

"The best laid schemes...": an evaluation of the extension of midwifery training in Scotland.

A research project was undertaken to evaluate the extension of midwifery training in Scotland. The evaluative criterion used was the new midwives' employment decisions. The data on students' valuation of their training suggest that they regard their time as having been well spent and other data show that socialization into midwifery increased with the longer training. Confidence in midwifery skills did not change markedly in association with the extension of training. Certain benefits of the longer course anticipated among midwives, are shown by these data not to have happened.

Decision Making↗
PubMedDate not supplied

Criterion-referenced competency assessment and the national certification examination in nurse-midwifery.

The paper presents an overview of the recent change from norm-referenced to criterion-referenced score interpretation for the ACNM certification examination for entry level practice in nurse-midwifery. The advantages of criterion-referenced interpretation are presented. A successful adaptation of the Nedelsky method for the calculation of the minimum pass index, based on the identification of acceptable error, is discussed. Implications for the nurse-midwifery profession and for the national certification examination in nurse-midwifery are considered.

Certification↗
PubMedDate not supplied

Implementation of the mastery learning/modular curriculum in nurse-midwifery education.

A survey of all nurse-midwifery programs in operation during 1987 was designed to answer the questions: (1) to what extent were elements of mastery learning being implemented in nurse-midwifery programs, and (2) were there patterns of implementation associated with particular organizational characteristics of the programs. Mastery learning was introduced in nurse-midwifery education in 1972; in this study elements of mastery learning were found to be widely implemented in both mastery and non-mastery learning programs. Data about organizational characteristics of the programs revealed them to be homogeneous in several respects. There were no important differences in implementation of elements of mastery learning associated with the organizational characteristics studied.

Curriculum↗
PubMedDate not supplied

Speaking up and talking out. Barriers and obstacles to nurse-midwifery practice.

There are internal as well as external barriers to nurse-midwifery practice. We have let others define us. It is time to articulate a new vision for nurse-midwifery that speaks to what midwifery does better than obstetrics. We need to claim our "partnership" model and argue for its integration into health policy for all childbearing women.

Attitude of Health Personnel↗
PubMedDate not supplied

Are we losing the art of midwifery?

There has been an increasing emphasis on the use of technology for the assessment and evaluation of women during the antepartum and intrapartum periods. As a result, "hands-on" skills, such as abdominal palpation and clinical pelvimetry, receive less emphasis in educational programs and practice. Are nurse-midwifery educational programs turning the focus of their curriculum too frequently toward high-risk pregnancy and away from the normal pregnancy? There is a need to balance nurse-midwifery education, to consider the needs of all pregnant women while incorporating advances in technology appropriately. Some recent graduates are not adequately trained in the use of assessment skills that are not dependent upon technology; thus, their capability as practitioners is compromised. Integration of new content into nurse-midwifery curricula should always reflect the philosophy of each program. Renewed attention to teaching, using, and assessing these skills should be encouraged.

Clinical Competence↗
PubMedDate not supplied

1994 task analysis of American certified nurse-midwifery.

The ACNM Certification Council is responsible to the American College of Nurse-Midwives for the development, administration, and evaluation of a psychometrically sound and legally defensible certification examination in nurse-midwifery. A task analysis study was conducted to investigate the knowledge, skills, and abilities that define American nurse-midwifery practice. A stratified sample of 825 American College of Nurse-Midwives members was asked to rate the frequency of performance and the criticality of 189 nurse-midwifery activities and 109 discrete diagnoses that the nurse-midwife might encounter while providing clinical care. The frequency and critically ratings were combined to generate an importance weight for each activity. Study data will be used as the basis of the examination blueprint in order to ensure job-related content validity. Aggregate data can also be used for curriculum development, self-assessment, and evaluation research purposes.

Adult↗
PubMedDate not supplied

Guidelines for client selection in the home birth midwifery practice.

Numerous studies have documented the safety of planned home birth; yet, few have identified specific criteria for selection of the home birth candidate. Home birth midwifery practice achieves successful outcomes by appropriate evaluation of medical and obstetric risk factors, as well as an ongoing evaluation and development of the client's psychosocial resources and the midwife-client relationship. Relevant medical and obstetric factors include significant medical illnesses, antenatal course, smoking history, commitment to breastfeeding, and the woman's nutritional profile. Social and environmental factors include the need for a stable birthing environment, practical means for hospital transfer, and the presence of loving support for the client during and after delivery. The client's psychological preparedness is a critical variable that may affect the ability to deliver in the home setting without analgesia or labor augmentation. Active participation in prenatal care, preparation of the home and family members, and a realistic attitude regarding the risks, benefits, and potential complications of planned home delivery are all components of this preparedness. Because midwifery practice promotes midwife-client rapport by careful attention to both medical and psychosocial issues during prenatal care, this relationship is itself an important predictor of the client's suitability for home birth. The quality of midwife-client interactions may influence not only the decision to plan a home birth but the indications for hospital transfer should problems arise. In this article, existing literature is reviewed and criteria are proposed for selecting home birth candidates within the American midwifery practice setting.

Female↗
PubMedDate not supplied

Recent developments in professional midwifery education and credentialing.

The American College of Nurse-Midwives, (ACNM), as a membership organization, and the ACNM Certification Council (ACC), as a credentialing agency, pursue independent but allied missions of expanding access to education for the practice of midwifery, while adhering to established standard of quality for education and clinical practice. The following recent actions taken by these agencies are presented for the information of the membership. 1) The Assured Equivalency Option, a mechanism through which nurse-midwives educated in countries other than the United States can demonstrate their competency and, as needed, acquire additional requisite didactic knowledge or clinical skills, leading to eligibility for national certification examination, is detailed. 2) The rationale for adoption of the multiple-choice format for the criterion-referenced national certification examination in nurse-midwifery and the methods used to determine the validity and reliability of the examination are described. 3) The award of a time-limited credential to those newly certified is offered as a policy statement of the ACC. 4) Deliberations and decisions leading to development of guidelines for the accreditation of non-nurse-midwifery education programs and credentialing as a professional midwife are recounted.

Clinical Competence↗
PubMed1991

Towards an epistemological basis for andragogy in midwifery education.

In designing the curriculum for pre and post registration midwifery courses, the author has utilised an andragogical model. This term refers to the art and science of teaching adults (Knowles 1978). The ideas that Knowles (1978) put forward about andragogy while not new, have been implemented in adult education and are certainly relevant to the modern practice of midwifery education. The aim of this paper is to examine the two extreme philosophical views about the nature of man and to provide an epistemological basis for andragogy in midwifery education.

Adult↗
PubMed1994

Towards an integrated model of competence in midwifery.

Currently in the UK, there is no consensus as to what constitutes an adequate definition of a competent midwife. Yet, given the rapidly changing midwifery needs of childbearing women and society, such clarification has never been more important. In this paper some concepts of competence taken from a review of midwifery, nursing, educational and industrial literature are reviewed, and it is hoped that discussion leading to conceptualisation of an integrated model of competence in midwifery will be stimulated. Questions raised include--What is it that makes midwives competent? Can competence be inferred from performance? How can capability be recognised? Can competence be broken into elements for assessment without losing meaning?

Clinical Competence↗