Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MIDWIFERY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1995

Changes in midwives' attitudes to their professional role following the implementation of the midwifery development unit.

OBJECTIVE: to examine changes in midwives' attitudes to their professional role following the implementation of the midwifery development unit (MDU). DESIGN: prospective cohort study. SETTING: the MDU is based at a major teaching hospital in Glasgow, UK. The MDU midwives provide care via a new self-rostering system which is intended to improve continuity of care. Midwives aim to provide total care for each woman from the antenatal period through delivery and the postnatal period. PARTICIPANTS: 21 midwives who joined the MDU were compared with a group of 64 midwives at the hospital who were also eligible and who continued in their usual pattern of work (non-MDU midwives). MEASUREMENTS: an audit questionnaire was distributed to MDU and non-MDU midwives prior to the implementation of the unit and about 15 months afterwards. In addition, the MDU midwives were sent the questionnaire every three months. Extra questions were added at each time period in order to identify specific problems. This information was then fed back to the midwifery management team to aid in the planning and implementation of the care programme. FINDINGS: the MDU midwives experienced a significant positive change in attitudes; no significant change was evident for the non-MDU group. There was no evidence of increased stress in the MDU midwives. In general, both groups of midwives had positive attitudes towards the unit and felt that MDU-style care had a role to play in the future provision of maternity care. A number of areas of concern were also highlighted, such as the system of liaison with colleagues. CONCLUSIONS: innovative models of midwifery care such as an MDU can have a positive impact on midwives' attitudes towards their professional role. IMPLICATIONS FOR PRACTICE: if change is managed in a systematic manner which involves the midwives, it may be possible to increase midwives' professional satisfaction, while at the same time minimising any negative effects such as increased stress.

Adult↗
PubMedDate not supplied

The evolution of midwifery faculty practice: impact and outcomes of care.

The Yale School of Nursing Nurse-Midwifery program was started in 1956 and is the second oldest existing master's degree program in the country. With an increase in student enrollment and a decrease in available clinical sites in the late 1990s, 2 initiatives for faculty practices were begun. Since then, the faculty practices have significantly strengthened the clinical teaching component of the educational program. The development and growth of the nurse-midwifery faculty practices has not been without its challenges. There are 3 lessons learned: The importance of a good business infrastructure, the importance of a positive relationship with physician colleagues, and the value of uncertainty. Two benefits of the practices are the modeling of evidence-based practice and the potential for research on nurse-midwifery care and outcomes.

Connecticut↗
PubMedDate not supplied

Computer-mediated distributed learning. An innovative program design in midwifery education.

The State University of New York, Stony Brook (SUNY-SB) Pathways to Midwifery Program offers a distributed learning curriculum that is unique among American nurse-midwifery education programs. The Pathways to Midwifery Program provides asynchronic, computer-mediated instruction. Community-based faculty coordinate, supervise, and evaluate the clinical education of students. The SUNY-SB model offers an opportunity to increase dramatically the number of students who can receive the curriculum. It also provides distinct advantages in maintaining a curriculum database that reflects rapidly changing clinical science and that takes advantage of vast educational resources available through related computer networks. By creating a classroom without walls, the program is cost-effective.

Computer Communication Networks↗
PubMed1996

NVQs in nursing, midwifery and health visiting: a question of assessment and learning?

The nursing, midwifery and health visiting professions are faced with the question of whether there should be development of higher level NVQs within these professions. However, an examination of the assessment process in NVQs finds it to be bureaucratic, reductionist and fragmented in nature and unlikely to engender analysis and synthesis. Educational research has revealed that assessment has a powerful effect on learning. When applying the findings of this research to NVQs, the assessment in NVQs is found to have the potential to fragment and damage the learning striven for. It is unlikely to promote learning or maximize candidates potential capabilities in terms of development. The professions in Australia have developed an holistic approach to competence. The assessment process used there is in keeping with the assessment process in professional nursing, midwifery and health visiting education in England. It is important that the statutory bodies and the nursing, midwifery and health visiting professions consider the assessment process in NVQs, its potential effect on learning and the development of the professional practitioner within the context of future collaboration regarding the development of higher level NVQs.

Australia↗
PubMed1996

An investigation of the components used to calculate staff:student ratios in nursing and midwifery education.

This article describes the results of a census questionnaire sent to all colleges of nursing and midwifery and institutions of further and higher education undertaking English National Board for Nursing, Midwifery and Health Visiting (ENB) validated pre- and post-registration nursing and midwifery courses. The questionnaire was designed to identify the range of components, incorporated into formulae, used by the colleges and institutions to calculate staff:student ratios (SSRs), for each type of course. The results indicate that the majority of colleges and institutions use: [formula: see text] The definitions of staff and student within the formulae were either assumed or variously defined. A total of 17 different formulae for calculating SSRs were identified and 10 different formulae for calculating whole time equivalents. Each of these formulae are given in the article. The advantages and disadvantages for resourcing nurse education arising from the lack of definition surrounding the standardisation of formulae and the components within formulae are discussed. The discussion reflects both the responses given in the open-ended questions in the questionnaire and the debates surrounding the use of SSRs highlighted in the literature.

Education, Nursing, Baccalaureate↗
PubMed1992

Systems of midwifery care in use in Scotland.

A survey was undertaken to identify the different systems of midwifery care in use in hospital and community settings in Scotland. The 53 units which responded provided 90% of the maternity care in Scotland. Of the 53 units, the 28 integrated units undertook 83% of Scottish births and were more likely than the non-integrated units to have implemented systems designed to reduce fragmentation of care. Nearly a fifth of units had five different systems of care in operation. More than half the units had at least one of the following systems of care in operation or under planning: individualised care plans; 'patient allocation'; DOMINO schemes; nursing/midwifery process or model; and team midwifery. The most frequently used system was planning individualised care (88% of the units). 'Patient allocation', nursing/midwifery process or model and the DOMINO scheme were in over 60% of the units. The least used system was team midwifery, which was in operation in 21% of the units and being planned for a further 30%. The use of the different systems in combination within a number of units demonstrates that approaches to the objective of continuity of care are complex. There is a need for further research into continuity of care as this is a commonly cited advantage of all five systems of care.

Data Collection↗
PubMed1996

Antenatal 'booking' interviews at midwifery clinics in Sweden: a qualitative analysis of five video-recorded interviews.

OBJECTIVE: To describe antenatal 'booking' interviews as regards content and illuminate the meaning of the ways midwives and expectant parents relate to each other. DESIGN: Content analysis and phenomenological hermeneutic analysis of transcribed texts from five video-recorded antenatal booking interviews. SETTING: Midwifery clinics at five health centres in the context of Swedish primary care. PARTICIPANTS: Five midwives, five pregnant women (less than 14 weeks pregnant) and two expectant fathers. FINDINGS: A variety of content themes and ways of relating were found. Combined themes of biomedical and obstetric content occurred as frequently as the sum of social, emotional, antenatal care and life-style themes. The midwives' ways of relating formed two main themes; considering and disregarding the uniqueness of the expectant parents. The midwives directed the interview through their choice of content themes and the way they related to the expectant parents. The expectant parents mainly shadowed the midwives' content themes and ways of relating. The expectant fathers seemed like strange visitors in the women's world. Two perspectives of antenatal midwifery care, obstetric and parental, operated alternately and in competition within the interviews. KEY CONCLUSIONS: The content and the ways of relating within the interviews seem to be connected and could be understood in the light of Buber's writings on dialogue. IMPLICATIONS FOR PRACTICE: The findings provide a basis for reflection on the education of midwives and the planning, training and implementation of midwifery care at antenatal 'booking' interviews.

Adult↗
PubMed1998

The development of a problem-based curriculum in midwifery.

Making use of best available evidence has clearly become an important part of midwifery practice. As educational programmes are preparing the practitioners of the future, it is believed that midwifery education should also be informed by evidence. At Thames Valley University, a BSc Midwifery curriculum, using the principles of problem-based learning, has been implemented following a review of both appropriate research and evaluation. This article explains the process undertaken in preparation for the course as well as the proposed means of ongoing evaluation.

Curriculum↗
PubMed1990

Methodological problems in the assessment of nurse-midwifery practice.

Through a review of the past 30 years' literature that addresses the structure, process, and outcomes of nurse-midwifery care, the limitations inherent to the study of nurse-midwifery are identified. The need for a prospective study that represents the diversity of nurse-midwifery practice patterns and incorporates an appropriate control group is acknowledged. Difficulties inherent in the design and statistical analysis of such a study are discussed.

Humans↗
PubMed1997

Midwifery negligence: a case study.

A professional health practitioner can be found in law to be liable to compensate clients when the practitioner causes harm to the client through a negligent act or omission. To date, most health-related litigation has been directed toward the medical profession. A minority of cases are taken against health institutions with respect to nursing and midwifery practice. In recent years there have been a few cases in England in which midwifery practice has been an issue. The purpose of this article is to report on one such case. It is important for all midwifery practitioners to be aware of the facts and circumstances in which midwives have been found to be negligent, and the way in which the courts have dealt with the matters in dispute.

Humans↗
PubMedDate not supplied

Midwifery management of first trimester bleeding and early pregnancy loss.

As many as 25% of women experience bleeding in the first and early second trimester of pregnancy; about half of these will have a miscarriage or, more rarely, ectopic or molar pregnancy loss. This can be a difficult time for women because of the uncertainty of the outcome, lack of preventative measures, and emotional significance of early pregnancy loss. The qualities that characterize midwifery care, including providing complete information, encouraging self-determination, and being sensitive to the emotional state, are particularly important at this time. This article reviews the epidemiology; physiologic process; signs and symptoms of first trimester bleeding; miscarriage and other early pregnancy losses; and methods of clinical, biochemical, and sonographic evaluation. A framework to guide midwifery evaluation and management, based on confirmation of an intrauterine pregnancy followed by the determination of viability, is presented. Surgical, medical, and expectant management of nonviable pregnancy, management of viable pregnancy when bleeding persists, and follow-up care, including screening for psychological sequelae, are discussed. Case studies and specific clinical guidelines for midwifery care, consultation, collaboration, and referral are included. Understanding the emotional significance of first trimester bleeding and loss as a basis for sensitive care throughout the management process is addressed.

Abortion, Spontaneous↗
PubMedDate not supplied

Midwifery co-management of hyperemesis gravidarum.

Hyperemesis gravidarum is an infrequent, yet significant, maternal complication of pregnancy. Beginning with the frequently experienced nausea and vomiting of pregnancy, symptoms can progress to hyperemesis, a debilitating condition affecting maternal and fetal well-being. A basic understanding of the pathophysiology of the disease process and an awareness of the therapeutic interventions that are available will facilitate midwifery planning for either the collaborative care or the potential referral to medical management, both of which may be required with this clinical entity. The diagnosis and initial management of hyperemesis is within the purview of midwifery care. As certain critical features of duration and severity evolve, medical collaboration and ultimate hospitalization may be required. For those few individuals requiring the most intense level of care, the critical support and encouragement afforded by midwifery participation will contribute to timely resolution of this debilitating condition. This article discusses the continuum from differential diagnosis to ultimate care of the woman who has excessive nausea and vomiting of pregnancy. Collaboration among health care providers will allow all to exercise their respective skills in achieving the optimum in safe therapy and support for their patients.

Adult↗
PubMed2002

The practice of nurse-midwifery in the era of managed care: reports from the field.

OBJECTIVE: The purpose of this paper is to describe the reports of certified nurse-midwives (CNMs) about how changes in the financing and organization of health care in the late 1990s influenced their ability to serve vulnerable populations and provide a woman-centered, prevention-oriented midwifery model of care. METHODS: A 13-page survey was mailed to all CNMs ever certified by the American College of Nurse-Midwives (N = 6365) in July 1998. The survey included closed- and open-ended questions. A total of 2405 CNMs responded: of these, 2089 were in clinical practice during the study period (1997-98) and 82% of the 2089 (N = 1704) wrote responses to the open-ended questions and were included in the qualitative database. We present responses to the closed-ended questions about seven domains of practice and elaborate on three major themes identified through content analysis of the qualitative data. RESULTS: The majority (57%) reported that the changes in the larger health care environment had influenced their practices during 1997-98. The effects most frequently reported were 1) increased client loads (31%); 2) altered style of practice (30%): 3) inability to serve the same populations; (20%); 4) decreased client loads (20%); and 5) increased administrative duties (17%). Three major themes were identified and elaborated upon in the qualitative data: 1) challenges to the style of midwifery practice related to the managed care environment; 2) the loss of socially and economically at-risk women from CNMs' client base; and 3) barriers to high quality and comprehensive services for women. CONCLUSIONS: During the late 1990s as managed care was expanding and health systems were merging, a significant number of CNMs in the field described threats to their ability to sustain economically viable practices and a style of care consistent with the woman-centered, prevention-oriented midwifery model.

Attitude of Health Personnel↗
PubMed2001

The lived experiences of autonomous Angolan midwives working in midwifery-led, maternity units.

OBJECTIVE: to describe the lived experiences of autonomous midwives working in Angolan midwifery-led maternity units. DESIGN: a qualitative approach using semi-structured, audiotaped interviews, in Portugese. Data were analysed in a six-step process. SETTING: three midwifery-led maternity units in the most densely populated suburbs in the capital of Angola, Luanda. The average number of deliveries per unit was 2500 per year. PARTICIPANTS: 11 midwives from the three maternity units. FINDINGS: four main areas emerged: society/culture, significant others, personal self and professional self. Sub-areas, concepts and supporting statements were defined in each area. KEY CONCLUSIONS: the midwives served within a population living in rough circumstances but which maintained strong traditional roots. The midwives did not support homebirths, but did assist when needed. The midwives described their professional role as a 'calling', which was very independent. Cure, was considered more important than care, and strong emotions were expressed when discussing cases of failure. The partograph was viewed as an important instrument and continuous learning as crucial in their role as autonomous midwives. IMPLICATIONS FOR PRACTICE: the model of a midwifery-led delivery unit described in this study may be used in other countries facing the same problems as Angola. Difficulties concerning transfer should be seriously considered as well as adequate education for the midwives. A pre-requisite in order for peripheral maternity units to have any impact on maternal morbidity and mortality, is a well-organised first-referral level.

Adaptation, Psychological↗
PubMed1994

Image of nurse-midwifery: a barrier to practice.

The image of nurse-midwifery forms a barrier to utilization that is just as, if not more, formidable as laws restricting practice. In this paper, the issue of image for its impact on the practice of nurse-midwifery is analyzed. Historical, technological, consumer-oriented, and nursing-oriented factors that have affected midwifery's image and the profession's current status are explored. Recommendations to clarify the role and image, including political involvement, networking strategies, and research, are discussed. Although nurse-midwives, who emphasize cost-effective, quality, primary care, should be in the forefront of health care delivery, they are still widely misperceived, underutilized, and unrecognized as mainstream health care providers. In this era of health care reform, it is essential that the role and image of the nurse-midwife be clearly defined to the general public, maternity care consumer, fellow health care providers, and legislators.

Health Policy↗
PubMed1991

The developments and trends in relation to men practising midwifery: a review of the literature.

The literature shows that throughout history the duties and responsibilities of the female midwife have been eroded and impinged upon by better-educated and better-equipped male medical men. Although several of these early 'men midwives' greatly improved midwifery practice, they tended to commandeer not only the best methods and the kudos but also the most interesting cases. The midwives of the past failed to stop the growth of obstetrics, and their contemporaries through the intercession of the 1951 Midwifery Act attempted to block entry into the profession by male nurses. Prior to the mid 1970s, it was assumed by the leadership of the Royal College of Midwives (RCM) that the introduction of male midwives would be unpopular not only with the expectant mothers but also with their husbands. Subsequent research demonstrated that this was not necessarily the case. Rather it was female midwives themselves who did not welcome the invasion of male practitioners into their domain. A review of the research literature suggests that the fears expressed by the RCM were unfounded and, by the late 1970s through to the Equal Opportunities Commission, the Sex Discrimination Act and several political machinations, male nurses were undertaking midwifery training.

Attitude of Health Personnel↗
PubMed1992

Research and the practice of midwifery.

During the past decade, the professional journals have contained numerous papers authored by nurses and nurse-researchers describing the gap which persists between research and clinical practice. Problems have been highlighted and challenges explored in the quest to discover ways of encouraging practitioners to become more aware of research evidence as a knowledge base for practice. Many of the identified issues may be transposed into a midwifery setting but other factors may be recognized which are specific to the practice of midwifery. This paper considers both conceptual and pragmatic issues in an attempt to explore the complexity of the influences which may affect the integration of research into midwifery practice.

Attitude of Health Personnel↗
PubMed2004

Journeying to professionalism: the case of Irish nursing and midwifery research.

This paper gives a 'discursive' account of the contemporary development of nursing and midwifery research in the Republic of Ireland in the context of advancing professionalism. Initially, the paper views the landscape by placing research in the current framework of Irish nursing and midwifery. It then examines the map of our present location by documenting a baseline. It ascertains the signposts that are in place by exploring the strategic direction for development. Finally, it uses the compass to orienteer the route through the various obstacles by examining the challenges of the role of the joint appointee leading the implementation of the national Research Strategy for Nursing and Midwifery in Ireland.

Documentation↗