Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Midwives”

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 109 records · Page 6Linked to original sources
PubMed2000

The hour of birth: comparisons of circadian pattern between women cared for by midwives and obstetricians.

OBJECTIVE: To examine the difference, if any, between midwives' care and obstetricians' care in the circadian pattern of the hour of birth in spontaneous labour and delivery. DESIGN: A descriptive study comparing the circadian pattern of the hour of birth between women cared for by a midwife or an obstetrician. SETTING: Data were derived from the Perinatal Database of the Netherlands (LVR), comprising 83% of all births under midwives' care and 75% of all births under obstetricians' care. SUBJECTS: 57,871 women receiving midwives' care and 31,999 women receiving obstetricians' care with spontaneous labour and spontaneous delivery. MAIN OUTCOME MEASURES: Differences in the circadian rhythms between women receiving midwives' care and obstetricians' care. FINDINGS: There was a difference in the circadian pattern of the hour of birth between midwives' and obstetricians' care. Peak times differed 5.43 hours (CI 4.23-7.03) for primiparous and 3.34 hours (CI 3.00-4.08) for multiparous women between the midwives' group and the obstetricians' group. CONCLUSION: This study demonstrates a remarkable difference in circadian pattern of the hour of birth between midwives' care and obstetricians' care. In obstetricians' care the duration of normal labour appears to be prolonged, presumably by an increased level of stress. In normal birth the care of midwives is preferable.

Circadian Rhythm↗
PubMed2002

A study of Swedish midwives' encounters with infibulated African women in Sweden.

OBJECTIVES: to investigate Swedish midwives' perceptions and attitudes towards infibulation and infibulated women, midwives' experiences of providing care for them and the training the midwives describe having received to enable them to care for and deliver infibulated women. DESIGN: a multi-stage sampling procedure was used. Open-ended questionnaires were distributed to midwives in labour wards with the purpose of identifying midwives to contact for interviews and focus group discussions. SETTING AND PARTICIPANTS: twenty-six midwives from three labour wards and two antenatal clinics situated in two towns in central Sweden participated in eight focus group discussions and three individual interviews. FINDINGS: there were three major themes: (a) emotions and communicational challenges entailed in the care of infibulated women, (b) knowledge and skills needed for caring and (c) the midwives' reliance on the Swedish law when dealing with the dilemmas they face in their interactions with the women and their families. The data indicate communication problems on different levels between midwives and the women and their families. There appear to be few or no guidelines in the units on how to provide good care for infibulated women and little or no co-ordination between antenatal care and the maternity wards. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the care of infibulated women during pregnancy and childbirth seems to be a marginalised issue in the areas where this study was performed. Early acknowledgement of female genital mutilation during pregnancy as well as improved communication between health care units may help professionals to offer culturally sensitive professional care to the women and their families.

Adult↗
PubMed1998

Traditional birth attendants in South Africa: professional midwives' beliefs and myths.

It is necessary to establish in a scientific way what the knowledge of midwives regarding TBAs are, because misconceptions can very often lead to a negative attitude. The objective of the research was to determine what the practices of traditional birth attendants are regarding antenatal, intrapartum, and postnatal care according to professional midwives. An exploratory research design was used, where qualitative research methods were used to explore the above-mentioned aspects about the traditional birth attendant in certain communities in South Africa. Open-ended questionnaires were used to determine how midwives see the role of the TBA. Content analysis has been used to analyse the responses of the professional midwives. The role of the TBA according to the midwives can be summarised as follows, she is a middle aged or elderly lady with no formal training, who acquired her skills through experience. She attends to women during pregnancy, labour and the postnatal period in different ways that have been used by the TBA are mainly herbs that facilitate a quick delivery, or others that cause bleeding of the uterus postnatally. Other TBAs use no medicine. All the functions identified by the midwives were compared with literature about the role of TBAs in Africa. The majority of functions identified by midwives were found in the literature. The majority of professional midwives thought it a good idea to have TBAs who have undergone some form of training in order to improve their standard of practice and to teach them the early symptoms of complications. Implications for future practice will therefore be, amongst others, to start with training programmes for TBAs. An assessment in each community of the best way to do so, should first be done.

Attitude of Health Personnel↗
PubMed1994

Midwifery defined by physicians, nurses and midwives: the birth of a consensus?

OBJECTIVE: To describe the form of midwifery practice preferred by physicians practising obstetrics, nurses providing maternity care and midwives. DESIGN: Mail survey conducted in 1991. SETTING: Province of Quebec. PARTICIPANTS: A systematic random sample of 844 physicians, 808 nurses and 92 midwives; 597, 723 and 92 respectively completed the questionnaire, for an overall response rate of 80%. MAIN OUTCOME MEASURES: Midwife training options, range of responsibilities, location of midwifery care, relationship to other maternity care providers and degree of autonomy. RESULTS: Most of the physicians, nurses and midwives surveyed agreed that if midwifery was legalized, midwives should have a university degree, provide basic care to women with normal pregnancy and delivery, provide prenatal and postnatal care in hospitals and community health centres, perform delivery in hospitals and work in close collaboration with the other maternity care professionals. Disagreement existed concerning the level of university training required, the need for training in nursing first, the scope of medical intervention performed by midwives, out-of-hospital delivery, the autonomy of midwives and control over their practice. CONCLUSION: Some consensus on midwifery practice exists between physicians, nurses and midwives. In jurisdictions where opposition to midwives is strong, such consensus could serve as the starting point for the introduction of midwifery.

Attitude of Health Personnel↗
PubMed1995

A study exploring midwives' education in, knowledge of and attitudes to nutrition in pregnancy.

OBJECTIVE: to explore midwives' education in, knowledge of and attitudes to nutrition in pregnancy. DESIGN: survey using questionnaire and interview schedule. PARTICIPANTS: a randomly selected sample of 77 Registered Midwives. SETTING: one English regional health authority. MEASUREMENTS AND FINDINGS: qualitative and quantitative data collection methods. Midwife teachers were responsible for 95% of teaching in nutrition. 86% of midwives had received no education in nutrition following qualification. 46% of midwives achieved a poor score in nutrition knowledge. Considerable numbers of midwives felt unprepared to offer dietary advice to women from ethnic minority groups (36%), vegetarians (66%) and to women with pre-existing medical conditions (41%). KEY CONCLUSION: midwives require more education in nutrition both during basic education and following qualification. IMPLICATIONS FOR EDUCATION PRACTICE: nutritional issues should be included in continuing education programmes available to qualified midwives.

Female↗
PubMedDate not supplied

Opportunities and burdens for nurse-midwives working in primary health care. An example from population-based cervical cancer screening in urban Sweden.

In Sweden, nurse-midwives in primary health care are responsible for taking Papanicolaou smears in population-based cervical cancer screening programs. This article discusses the manner in which a group of nurse-midwives, working with the cervical cancer screening program, view both opportunities and burdens inherent in their work. Semistructured interviews were conducted with 21 nurse-midwives engaged in screening at seven antenatal health care centers in demographically different parts of Stockholm, using a team approach to collect and inductively analyze the interviews. Results indicate discrepancies between ideals guiding the midwives and their practice. Positive aspects described by the midwives appear to be related to an ideology of care, whereas perceived burdens include the midwives' sense of powerlessness, lack of congruence between midwives' ideology and screening organization, and lack of professional familiarity with cancer. Several of these features can be related to issues that are challenges for many health care practitioners today, even in other settings. Our conclusion is that the screening program has latent potential for further development of the role of the nurse-midwife as an advocate for women throughout the lifespan and in a variety of situations.

Female↗
PubMed1999

Improved cognitive knowledge of midwives practising in the eastern Cape Province of the Republic of South Africa through the study of a self-education manual.

OBJECTIVES: To determine whether the Maternal Care manual of the Perinatal Education Programme (PEP) is effective in improving the cognitive knowledge of midwives. DESIGN: A prospective controlled trial in a region where PEP was not previously used. The midwifery knowledge of all midwives caring for pregnant women in the three towns was tested before the commencement of the study. The Maternal Care manual was then introduced to the midwives in he study town and they worked through the programme. Following the completion of the manual, all midwives were tested again with the same test. The time interval between the pre and post testing was 12 months. SETTING: Three towns on the Eastern Cape Province of South Africa. PARTICIPANTS: All Midwives caring for pregnant women in three towns. INTERVENTIONS: The Maternal Care manual of PEP was studied by the midwives in the study town. MEASUREMENTS AND FINDINGS: Changes in cognitive knowledge were tested with multiple choice questions. A significant improvement (p < 0.0001) was achieved in the study town. The mean score (maximum 70) improved by 22.4 (32%) marks, from 35.9 (51%) to 58.3 (83%). KEY CONCLUSIONS: The cognitive knowledge of midwives who completed the Maternal Care manual improved significantly. IMPLICATIONS FOR PRACTICE: These findings are to particular importance as the method by which the Maternal Care manual of PEP was applied conforms to the method suggested for the its national use.

Adult↗
PubMedDate not supplied

Improved practical skills of midwives practicing in the Eastern Cape Province of the Republic of South Africa through the study of a self-education manual.

OBJECTIVE: Changes in the ability of midwives to perform practical skills, after completion of the Maternal Care Manual of the Perinatal Education Program, were determined. STUDY DESIGN: A prospective, controlled trial in a study town and two control towns. The practical skills of midwives caring for pregnant women in the towns were determined. Subsequently the Maternal Care Manual was studied by midwives in the study town, and the skills of all midwives were subsequently evaluated. RESULTS: A total of 34 midwives in the study town and 39 midwives in the two control towns were studied. The marks showed a significant (p < or = 0.000) improvement in the study town when comparing the pre- and postintervention marks. The mean improvement in the study town was 36.6%. DISCUSSION: The practical skills of midwives improved significantly. The Perinatal Education Program can be implemented with confidence as a distance learning program that is especially suited to the needs of health workers in remote regions.

Adult↗
PubMed1998

Labour ward midwives' perceptions of stress.

This exploratory study set out to examine labour ward midwives' perceptions of stress. It utilized a combination of two self-report questionnaires, one devised by McGrath et al. and the GHQ12. Additional qualitative data were collected by asking midwives to produce narratives about recent stressful events. A convenience sample of the 43 midwives formed the study population and a response rate of 77% was achieved. Quantitative data were analysed using descriptive statistics and qualitative narratives were explored for content analysis. Midwives in this study demonstrated their awareness of stress in their working and personal lives and many took active steps to redress the negative effects with exercise, hobbies and talking with colleagues. However, the study revealed that 78% of the midwives indicated that having insufficient time to perform their duties was very stressful, paralleled by their perceived inability to influence work-based decisions. The study revealed that both medical and midwifery colleagues frustrated their endeavours to change an unsatisfactory condition. The GHQ12 revealed 30% of the midwives had scores above the threshold level of 2 indicating psychiatric morbidity and this is of major concern. The narratives revealed that lack of communication between the professionals about decision making was a major source of stress and as a result of this study efforts to improve multidisciplinary communication through the development of journal clubs and planned social activities is under consideration by the unit. Overall, the findings from this study highlight stress as a potential, occupational health problem in the working lives of some labour ward midwives.

Adult↗
PubMed1999

Midwives in Victoria, Australia: a survey of current issues and job satisfaction.

OBJECTIVE: To describe demographic and work profiles of registered practising midwives, to assess their job satisfaction and their knowledge of and attitudes to the 1990 Victorian Birthing Services review. DESIGN: A questionnaire posted in 1995 to a population-based random sample of registered midwives. PARTICIPANTS: Two hundred and forty midwives currently using their midwifery skills in their work. SETTING: One thousand names and addresses were randomly selected from a database of midwives registered to practise in Victoria, Australia in 1993. FINDINGS: There was a 72% response rate to the postal questionnaire. Two hundred and forty practising midwives returned completed questionnaires. Seventy-three per cent were in full time employment, 49% lived in rural Victoria, 80% were born in Australia, more than half were aged 40 or more years and 72% had at least one child. Twenty-six per cent worked in postnatal wards, 9% in each the labour ward and the neonatal nursery, 2% in birthing centres and 12% in out of hospital settings. Eighty per cent were satisfied with their work and interactions with women were the most important aspect. Satisfaction was associated with working in a labour ward, feeling adequately prepared by midwifery education and training, nursing for more than 15 years and having continuing education. Neonatal and rotating positions were significantly associated with dissatisfaction. Less than one-half of the midwives had read some of the Birthing Services Review, and of these only one-half had changed their attitudes or practice. One-third knew little of the imminent changes to the Midwifery Regulations. CONCLUSION: Although most midwives enjoyed their work there was little evidence of increasing autonomy or involvement in change.

Adult↗
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↗
PubMed2003

Medicine as discursive resource: legitimation in the work narratives of midwives.

This article examines the work narratives of midwives practicing in the United States, specifically in the State of Florida. We focus analytic attention on how the discourse of medicine is used as a resource in constructing a sense of legitimation for midwifery. Data are drawn from in-depth interviews with 26 direct-entry, licensed midwives and certified nurse-midwives. Historically, social scientific literature on midwifery has placed a midwifery, or a holistic, model of childbirth in polar opposition to a technocratic or medical model. In practical work, however, midwives demonstrate knowledge of, and make use of, a discourse of medicine to serve their purpose-at-hand. In these 'narratives of legitimation', the medical model does not emerge as an entity definable as separate and necessarily at odds with the midwifery model. Rather, the medical model is a resource through which midwives work narratively to construct the validity of their profession. The midwives interviewed use the discourse of medicine in three specific ways. First, they draw upon it as a contrast device, setting themselves and their work apart from the medical establishment. Second, midwives use the medical model to communicate necessary daily aspects of their work. Finally, they construct a story of medical collaboration to equate their work with that of physicians.

Female↗
PubMed2006

Making the diagnosis of labour: midwives' diagnostic judgement and management decisions.

AIM: This paper reports a study examining midwives' perceptions of the way in which they diagnose labour. BACKGROUND: Diagnosis of active labour is often problematic. A midwifery workforce planning tool identified that up to 30% of women admitted to United Kingdom labour wards subsequently turned out not to have been in labour. There is evidence that if a woman is admitted to a labour ward in early labour, she is more likely to have some form of medical intervention. However, despite the impact of misdiagnosis, there is little research on the process of decision-making by midwives in relation to diagnosis of labour. METHODS: This was a qualitative study, employing focus group methods. Participants were a convenience sample of midwives working in a maternity unit in the North of England during 2002. They were asked to discuss their experience of admission of women in labour. Data were analysed using latent content analysis. FINDINGS: Thirteen midwives participated in one of two groups. They described using information cues, which could be separated into two categories: those arising from the woman (Physical signs, Distress and coping, Woman's expectations and Social factors) and those from the institution (Midwifery care, Organizational factors and Justifying actions). Midwives' decision-making process could be divided into two stages. The diagnostic judgement was based on the physical signs of labour: the management decision would then be made by considering the diagnostic judgement as well as cues such as how the woman was coping, her expectations and those of her family and the requirements of the institution. CONCLUSIONS: Midwives may experience more difficulty with the management decision than with the initial diagnosis. It may be that the number of inappropriate admissions to labour wards could be reduced by supporting midwives to negotiate the complex management hurdles, which accompany diagnosis of labour.

Adaptation, Psychological↗
PubMed1994

Obstetricians' resistance to independent, private practice by nurse-midwives in Washington, D.C. hospitals.

This paper examines obstetricians' explanations for the longstanding and current conflict between obstetricians and nurse-midwives in the District of Columbia over the struggle for independent practice for nurse-midwives. Based on extended interviews with obstetricians, this study shows they are reluctant to provide nurse-midwives with medical backup, a requirement of D.C. law for nurse-midwives to deliver babies in District hospitals. Obstetricians' concerns involve the boundaries of professional responsibility, and economic constraints. Obstetricians believe their more extensive training better qualifies them to handle difficult pregnancies, and they are concerned that nurse-midwives may not call for their help when it is needed. They argue that expanding the use of nurse-midwives will lead to a competition for healthy clients, a competition for paying clients, increased exposure to malpractice liability for obstetricians providing backup, and difficulty obtaining reimbursement from nurse-midwives for their services.

Clinical Competence↗
PubMed2003

Midwives' perceptions and experiences of routine enquiry for domestic violence.

OBJECTIVE: To examine midwives' perceptions and experiences of routine enquiry for domestic violence. DESIGN: Focus groups and semi-structured interviews. SETTING: The study was conducted in the maternity services of Guy's and St Thomas' NHS Hospital Trust, an inner London teaching hospital. SAMPLE: Twenty-eight midwives were interviewed. METHODS: One hundred and sixteen out of 145 (80%) midwives were trained to screen routinely pregnant women for domestic violence at booking, at 34 weeks of gestation and postpartum. Twenty midwives attended one of four focus groups and eight semi-structured interviews were conducted. Interviews were transcribed and analysed using content analysis. MAIN OUTCOME MEASURES: Midwives' views of routine enquiry for domestic violence. RESULTS: Midwives felt that domestic violence was an important issue to be addressed. However, practical and personal difficulties were encountered during the study. These included: time constraints, lack of confidential time, safety issues, staff shortages, low staff morale and midwives' personal experiences of domestic violence. The study produced a raised awareness about domestic violence within the maternity unit. There was considerable support for the idea of a specialist domestic violence midwife. CONCLUSIONS: Routine enquiry for domestic violence cannot be implemented effectively without ensuring that in-depth training, resources, staff support and policies to ensure that screening can be conducted safely and confidentially are in place.

Attitude of Health Personnel↗
PubMed1993

A comparison of labor and delivery management between nurse midwives and family physicians.

BACKGROUND: Practice associations between family physicians and nurse midwives have been suggested as a means to increase the availability of obstetric care in rural areas. No evidence exists, however, that family physicians and midwives have comparable practice styles or achieve similar outcomes in obstetric patients. METHODS: The study examines patients cared for by a co-practice of nurse midwives and family physicians at a rural hospital. Data were collected through a retrospective chart audit for all patients whose prenatal care, labor, or delivery was managed by members of the practice in 1990 and 1991. RESULTS: Few differences were noted between nurse midwives and family physicians in the management of labor or delivery. The only consistent finding was that family physicians were more likely than midwives to use an episiotomy for delivery (40% vs 30% in primiparous women, P = .02; and 20% vs 10% in multiparous women, P = .007). Despite seemingly similar management styles, primiparous women managed by family physicians were more likely to undergo cesarean section (14% vs 8%, P = .05) resulting from the diagnosis of dystocia. When practice specialty was included in a logistic regression model with parity and the number of preexisting risk factors, the effect of specialty on cesarean sections remained significant with a relative risk of 2.79 for cesarean section if patients had their labor managed by a family physician (P < .001). CONCLUSIONS: Family physicians and nurse midwives managed patients in labor similarly, but nurse midwives were more likely to achieve a vaginal delivery in primiparous women and do so without an episiotomy. Although the differences found would not interfere with a collaborative practice, subtle differences in patient management do exist. Further exploration of these differences may be helpful in understanding the impact of these differences on mixed-specialty practices.

Adolescent↗
PubMed2026

Exploring the perceptions, experiences, and behaviours that nurses and midwives face in relation to sleep: A systematic review of qualitative evidence.

BACKGROUND: The importance of sleep for nurses and midwives is increasingly being recognised. Poor sleep is known to have negative impacts on physical health, mental wellbeing, and work performance. This has prompted efforts to promote and support staff sleep. However, further efforts are needed to understand how nurses and midwives consider and manage sleep to ensure that meaningful and effective interventions are adopted and sustained. AIMS: This review of qualitative evidence aims to examine nurses' and midwives' perceptions, experiences, and behaviours around sleep. METHODS: This review followed JBI's systematic meta-aggregative approach including development of an a priori protocol. A systematic search of six electronic databases (MEDLINE, Embase, Emcare, PsycINFO, CINAHL, and Scopus) was undertaken to identify qualitative studies that examine nurses' and midwives' perceptions, experiences, and behaviours related to sleep. The search was conducted on the 10th of October 2024. Study selection, quality appraisal, data extraction, and synthesis followed JBI approaches and the ConQual approach was used to report assessment of synthesised findings. RESULTS: Thirty-three studies were included for review, and 245 findings were aggregated into 24 categories and nine synthesised findings related to the perceptions, behaviours, and experiences. While sleep was perceived as important, poor sleep was often understood as an expected and inevitable part of the job and that there was a need to always be awake to provide continual care. Experiences influencing sleep related to personal circumstances and work-related factors, as well as professional training and institutional practices. A range of behaviours, including planning time to sleep, using sleep aids, modifying the sleep environment, and altering daytime behaviours were also described. CONCLUSION: This review identified a range of perceptions, behaviours, and experiences that may influence the sleep of nurses and midwives which are vital to supporting individual and workforce wellbeing and safe, effective clinical practice. Insights from this review can be used to better understand nurses' and midwives' relationship with sleep and to develop and enhance targeted sleep interventions and programs that aim to promote and support healthy sleep among nurses and midwives. Open Science Framework Registration: 10.17605/OSF.IO/F32UM.

Humans↗
PubMed2005

Guidelines on anaemia: effect on primary-care midwives in The Netherlands.

OBJECTIVE: To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands. DESIGN: Cross-sectional survey study. SETTING: Primary-care midwifery in The Netherlands. PARTICIPANTS: 160 midwives (60% response rate). MEASUREMENTS: Questionnaire on the knowledge of, and attitudes and self-reported adherence to, 14 key recommendations in the guideline; attitudes to guidelines in general; and perceived barriers to implementation. FINDINGS: The number of midwives agreeing with and adhering to specific recommendations varied between 29 and 90%. Most midwives had a positive attitude to the guidelines. The most relevant general barriers were related to the behaviour of general practitioners and obstetricians (32% of the midwives reported this). Larger numbers of midwives mentioned barriers to specific aspects of the guideline, particularly alternative iron supplementation or dietary supplements (59%), and not prescribing iron supplementation if haemoglobin was low but mean corpuscular volume was normal (49%). KEY CONCLUSIONS: The guideline on anaemia was well received by primary-care midwives in The Netherlands, but implementation of specific recommendations needs further attention. IMPLICATIONS FOR PRACTICE: The study provides evidence for the national organisation of midwives to continue with the development and implementation of clinical guidelines.

Adult↗