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 19 recordsLinked to original sources
PubMed2002

Identifying the midwifery practice component of Australian Midwifery Education Programs. Results of the Australian Midwifery Action Project (AMAP) Education Survey.

This paper is the first in a series of papers reporting on the findings of the AMAP Education Survey of the 27 universities providing a program for initial authorization to practise midwifery. It concentrates on issues related to the practice component of courses. Subsequent papers will present findings related to workforce issues and the barriers to effective midwifery education as identified by the midwifery course coordinators. Serious concerns are raised about the standards of Australian midwifery education, particularly when international comparisons are made, in terms of the length of courses, clinical practice requirements and the opportunities for students to engage with contemporary midwifery practice across community and acute settings.

Australia↗
PubMedDate not supplied

New directions in midwifery education: the master's of science in midwifery degree.

Midwifery is reclaiming its perspective as a discipline separate from, yet integrally related to nursing and medicine. Emerging trends in health care place increased demands on the knowledge base and clinical practice of midwifery, stimulating a need for new directions in midwifery education. The master's of science with a major in midwifery is a new degree option available to midwifery students in the United States. This article presents the argument that midwifery is a distinct discipline and describes the importance of a master's of science in midwifery degree toward furthering the work of the discipline of midwifery. Descriptions of the current master's of science in midwifery degree programs are included.

Clinical Competence↗
PubMed2001

Postmodern negotiations with medical technology: the role of midwifery clients in the new midwifery in Canada.

In 1994, after more than a century of uncertain legal status, the Province of Ontario legalized midwifery and incorporated midwives into the formal health care system. Midwifery is now accessible and publicly funded for all women experiencing "normal" uncomplicated pregnancy and birth. Yet midwifery's move from the margins into the mainstream health care system has brought many new challenges. Midwives must now contend with an expanded scope of practice; they use more medical technology both to fulfill their professional obligations and to respond to the choices of women. This and an increased accessibility to a wider clientele seem to work against midwifery as a critical, low-tech alternative to "technocratic birth." In this article, through re-telling and analyzing women's narratives of pregnancy and birth, I explore the role of midwifery clients in re-shaping midwifery's relationship to medical technology. Steering away from essentialist explanations that hold that women are either inherently opposed to technology by virtue of their closeness to nature or wholly oppressed by technology and the systems within which it is imbedded, my analysis focuses on women's agency (on what women do rather than on what is done to them). My study suggests that women act pragmatically both with regard to biomedical technology and to midwifery. I argue that women's negotiations with medical technology have been instrumental in re-shaping midwifery as a postmodern phenomenon.

Biomedical Technology↗
PubMed2002

A delphi survey of midwives and midwifery students to identify non-midwifery duties.

AIM OF THE STUDY: to explore the skill mix requirements for the potential role of an unqualified midwifery assistant in the clinical setting. Using results from the study we report the difference between student midwives' and qualified midwives' perceptions of what constitute non-midwifery duties. DESIGN: a two-round Delphi survey. SETTING: large maternity hospital in Ireland. PARTICIPANTS: population of midwives (n=194) and midwifery students (n=79). FINDINGS: the non-midwifery duties identified were wide ranging and could be categorised under the headings of clerical, stock, porter, domestic and other basic-care-related duties. CONCLUSION: although no agreed definition of non-midwifery duty exists it can be seen that, through the process undertaken in this study, a definition is created. This suggests that the values and beliefs that qualified midwives and students hold regarding their role shapes the role of the care assistant. IMPLICATIONS FOR PRACTICE: the inclusion of perceptions from student and staff midwives enabled the researchers to compare and contrast similarities and differences regarding how these different parties constitute a non-midwifery duty. The process also gave respondents a sense of ownership and involvement in the development of the midwifery assistant role. In addition, this study has demonstrated the need for further clarification of how midwives perceive and understand their role.

Attitude of Health Personnel↗
PubMed2001

[A study of the organizing process of the modern midwifery system in Yamagata Prefecture focusing on the enactment of "Midwifery Regulation" in the 32th year of Meiji].

The Japanese modern midwifery system was provided at the start by the "Medical regulation" in the 7th year of Meiji and was organized to national unity by the Imperial Ordinance "Midwifery Regulation" in the 32th year of Meiji (1899). During these twenty-five years, Hokkaido and each of the prefectures enacted their own "Midwifery Regulation" to conform with the "Midwifery Regulation," and they organized the original midwifery system. This study focuses on the Yamagata Prefecture and midwifery system in the Tohoku district, and considers the organizing process of the system. Because the Yamagata district continued the Edo Period custom of infanticide, the Yamagata prefectual administration maintained strict control of that custom. At the same time it repeatedly enacted and revised the "Mid-wifery Regulation" to adjust it to the conditions of farm and mountain villages. Finally, it established the original "Registered Midwife System" in the 22th year of Meiji. That organizing process was classified into four stages. The present study shows that the system was not contradictory to the Imperial Ordinance "Midwifery Regulation" enacted in the 32th year of Meiji, which was amended to the unified national midwife system.

History, 19th Century↗
PubMed1998

Working with team midwifery: health visitors' views of one team midwifery scheme.

The fragmented nature of maternity services in the UK has led to the introduction of various forms of team midwifery scheme. The aim of such schemes is usually to increase continuity through the provision of antenatal, intrapartum and postnatal care to women by a small team of midwives. Few published studies of this organization of midwifery care exist, and even fewer consider the impact of such schemes on related health professionals. This paper presents the results of an independent survey of health visitors working alongside one team midwifery scheme in the south-east of England. Eighty per cent of the health visitors thought that team midwifery was a good idea in theory; however, just 27% thought it was working well locally and 70% reported that they would like to go back to working in the way they did before the introduction of team midwifery. The survey highlighted the health visitors' concerns in relation to team midwifery locally. Two issues were paramount: firstly a reported deterioration in interdisciplinary communications, and secondly a perceived loss of continuity for the women. Thus team midwifery, as implemented in this locality, may not attain the goals aimed at by the organization of care in this way.

Continuity of Patient Care↗
PubMedDate not supplied

Midwifery in the 21st century. Recommendations from the Pew Health Professions Commission/UCSF Center for the Health Professions 1998 Taskforce on Midwifery.

Unprecedented changes in the delivery and financing of health care have produced angst and opportunity, criticism, and innovation. To explore the effects of these market-driven changes on midwifery, the University of California at San Francisco Center for the Health Professions convened a Taskforce on Midwifery in 1998. Consisting of eight experts from across the country, the Taskforce was charged with exploring the impact of health care system developments on midwifery, and identifying issues facing the profession and the roles midwives play in women's health care. The Taskforce answered its charge by offering 14 recommendations related to midwifery practice, regulation, education, research, and policy. The recommendations incorporate the Taskforce vision that the midwifery model of care should be embraced by, and incorporated into, the health care system in order to make it available to all women and their families. Midwives, educators, collaborators, and policymakers can use the recommendations to develop curricula, practice sites, and laws for an improved health care system that fully includes midwives and encompasses the midwifery model of care.

Delivery of Health Care↗
PubMedDate not supplied

One-to-one midwifery: restoring the "with woman" relationship in midwifery.

One-to-One Midwifery, a model of care developed in the United Kingdom, provides a continuous and personal relationship between each woman and her midwife. The organization of care and the outcomes are relevant to midwifery policy in all industrialized countries. One-to-One Midwifery is not solo practice. An important principle of the organization of the practice is to enable individual midwives to take time off and to provide supportive structures for the midwives. Here the implications of One-to-One Midwifery for childbearing women and their families, and the midwives involved, are explored. The One-to-One Midwifery model has particular relevance for Canada because it is very similar to the model of practice being developed in at least two provinces. It may also be of importance in the United States, particularly for midwives working shifts in hospitals who may want to develop a system that allows them to provide continuity to the women they serve.

Adult↗
PubMed2000

Developing high-quality research in midwifery: lessons learned from the midwifery research database, MIRIAD.

BACKGROUND: Research in midwifery is a relatively new development in many countries, and as a consequence it can be difficult to identify ongoing and completed research, to network with other researchers in similar fields, and to plan appropriately to develop research and research capacity. This paper describes the establishment of the UK Midwifery Research Database, MIRIAD, which aimed to address these problems. METHOD: Funding from the Department of Health (England) supported the establishment of MIRIAD in 1988. Systems and procedures were set in place to collect, store, analyse and disseminate information about ongoing and completed research in midwifery. Six detailed reports were published. MIRIAD was closed in 1999 as a result of lack of ongoing funding. KEY FINDINGS: 466 studies were registered with MIRIAD, with start dates ranging from 1974 to 1998. The majority of studies examined clinical topics. A wide range of research approaches were used. Studies were supported by a range of sources, including employers and national funding agencies. There were many examples of high-quality, peer-reviewed, and externally funded studies which can be used to inform practice. Issues raised by some studies, however, included concerns about research quality, inadequacy of some supervision, low rate of publication, and inconsistency in gaining ethics committee approval. CONCLUSIONS: Research in midwifery in the UK has matured over the past 25 years. It still faces many challenges, including the need to maintain quality and to gain more national funding support. Lessons have also been learned about the need for quality in research information systems. Ongoing assessment of the growth and direction of research in midwifery is recommended, possibly through monitoring of the generic NHS database, the National Research Register (NRR), to inform strategic developments in research and research capacity at national; regional and local levels.

Databases, Factual↗
PubMed2001

A comparison of partnership caseload midwifery care with conventional team midwifery care: labour and birth outcomes.

OBJECTIVES: to compare the effects of partnership caseload midwifery care, with conventional team midwifery care. Comparisons of labour interventions and birth outcomes were made between the two models of care. DESIGN: a prospective, non-randomised clinical trial. SETTING: Women's Hospital at Leicester Royal Infirmary, Leicester, UK in 1998. PARTICIPANTS: 303 women from the experimental group and 308 from the control group (611 in total) matched for age, ethnicity, marital status, parity, gravida and height who gave birth between April 1997 and August 1998. INTERVENTION: the control group received conventional team midwifery care during pregnancy, labour and birth, and the experimental group received care from midwives working in partnerships that provided continuity of care during pregnancy, labour and birth. KEY FINDINGS: 21% of women in the experimental group had an epidural compared with 32% of the controls (OR 0.56 95%, CI 0.39-0.81, P=0.002). The normal vaginal birth rate (74% v 66%, OR 1.45, 95% CI 1.02-2.05, P=0.038), upright birth posture rate (60% v 14%, OR 9.64, 95% CI 5.96-15.61, P= or <0.001), intact perineum rate (40% v 30%, OR 1.57, 95% CI 1.05-2.35, P=0.027), and physiological third stage rate (37% v 1.5%, OR 38.69, 95% CI 11.98-124.89, P= or <0.001) were significantly higher in the experimental group. The induction of labour rate (16% v 23%, OR 0.66, 95% CI 0.44-0.98, P=0.042) was significantly lower in the experimental group. Women in the experimental group had more home births (17% v 1.3%, OR 15.38. 95% CI 5.48-43.14, P= or <0.001); used the midwife-led birthing suite more often (28% v 12%, OR 2.77, 95% CI 1.82-4.22, P= or <0.001); were more likely to take an early discharge (two to six hours) from hospital following birth (25% v 3%, OR 11.32. 95% CI 5.55-23.06, P= or <0.001); and were attended in birth more often by either their named midwife (67% v 5%, OR 39.65, 95% CI 22.38-70.25, P= or <0.001) or her partner (known midwife) (84% v 14%, OR 32.74, CI 20.96-51.14, P= or <0.001). IMPLICATIONS FOR PRACTICE: partnership caseload midwifery care resulted in less interventionist labour and more normal birth than conventional team midwifery care. Women in the experimental group had more home births, birth in a midwife-led suite and opted for early discharge home postnatally more often than the controls. They also experienced much higher levels of continuity, particularly of a known midwife during labour and birth. The study findings should encourage other maternity units in the UK to pilot and evaluate the model to see if these benefits are transferable.

Adult↗
PubMedDate not supplied

Community-based nurse-midwifery education program. Distance learning in nurse-midwifery education.

Distance-learning has greatly expanded the number of students admitted to a nurse-midwifery education program. This article describes the Community-Based Nurse-Midwifery Education Program (CNEP) of the Frontier School of Midwifery and Family Nursing. The organizational structure and curriculum of the CNEP combines apprenticeship learning with academic rigor, permitting students who cannot relocate to the university to pursue graduate education. New technology, such as an interactive electronic bulletin board, networks students and faculty. The program emphasizes theories of independent, adult learning. There is a master's completion option available through the affiliation with Case Western Reserve University.

Community Health Nursing↗
PubMedDate not supplied

Development of an academic nurse-midwifery service program. A partnership model between medicine and midwifery.

Academic nurse-midwifery services have shown themselves to be strong collaborators with medical education. The development and functioning of an academic nurse-midwifery service program built on a partnership model between medicine and midwifery are highlighted. Organizational relationships, philosophical approach, and practice dimensions including responsibilities for clinical practice, medical student, and obstetrical resident education are explored. As the obstetrical patient pool diminishes in academic service settings, this model may prove useful.

Faculty, Nursing↗
PubMed1996

Pre-registration midwifery programmes: a case study evaluation of the non-midwifery placements.

OBJECTIVE: to evaluate the effectiveness of non-midwifery placements in enabling pre-registration (direct entry) student midwives to learn about caring for childbearing women with medical, surgical or mental health problems and needs. DESIGN: case study. SETTING: a large midwifery education department and three acute general hospitals in England. PARTICIPANTS: 15 student midwives in the first intake of one college's three-year diploma programme in midwifery plus the practitioners involved in their education. MAIN OUTCOME MEASURES: the learning needs of student midwives, who have no previous health-care experience, to enable them to care effectively for women with medical/surgical/mental health problems; the teaching processes and learning opportunities related to these aspects of care; how the views of teachers and practice placement staff compare with those of the students; the factors that influence the teaching and learning processes and experiences for pre-registration student midwives. FINDINGS: the broad range of experiences in medical/surgical/metal health placements enabled students to increase in maturity, and confidence and develop their communication skills. The variety of placements enhanced student understanding of the multi-disciplinary team's contribution to health care, students learned new practical skills which were transferable to maternity care contexts and all students had opportunities to care for adults with most of the medical/surgical/mental health problems seen in childbearing women. CONCLUSION: this action research project provided data for curriculum development and helped to avoid premature reaction to individual staff and student response. The value of the medical/surgical/mental health placements and the importance of staff and student preparation for effective learning was established. Whilst it might be essential to identify what and where student midwives should learn, it would appear that developing each student must be an equal, if not greater, priority for curriculum designers.

Adult↗
PubMedDate not supplied

Development and outcomes of the multiple-choice format national certification examination in nurse-midwifery and midwifery.

The national certification examination in nurse-midwifery and midwifery now is offered exclusively in the multiple-choice format. The strategies used to develop equivalent examination forms are described. The manner of criterion-referenced standard setting is explained. Outcomes of the first five multiple-choice examination forms include an aggregate first-time failure rate of 8.3%. Multiple- and logistic-regression analyses indicate that examination scores of African-American and Hispanic ethnic candidates, and older candidates, are lower with regard to statistical significance; however, these differences are too modest to be of practical significance. No substantive relationship was observed between any demographic or academic variable and the probability of passing the examination. The experience gained by the ACNM Certification Council during development, administration, and evaluation of these first five multiple-choice examination forms has provided strong support for the transition to multiple-choice testing for the assessment of entry into practice of this competency-based profession.

Certification↗