Medicine and Health Sciences Commons^™

Midwives’ Experiences Of Providing Pre-Eclampsia Care In A Low- And Middle-Income Country – A Qualitative Study, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Problem: Like other low- and middle-income countries, Ghana has high maternal mortality stemming from pre-eclampsia. Ghanaian midwives are frontline service providers of emergency care in obstetric complications and have the greatest potential to maximise pre-eclampsia outcomes. Little is known about the potential barriers and challenges to midwives' capacity to provide quality care in pre-eclampsia in Ghana. Therefore, we aimed to explore and gain insights into midwives’ experiences of pre-eclampsia care including their knowledge, skills, and psychological aspects such as midwives' resilience. Background: There is a rising global incidence of pre-eclampsia. Quality midwifery care in inter-professional collaborative practice is crucial to …

Failure To Progress Or Just Normal? A Constructivist Grounded Theory Of Physiological Plateaus During Childbirth, Marina Weckend, Kylie Mccullough, Christine Duffield, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background and problem: During childbirth, one of the most common diagnoses of pathology is ‘failure to progress’, frequently resulting in labour augmentation and intervention cascades. However, failure to progress is poorly defined and evidence suggests that some instances of slowing, stalling and pausing labour patterns may represent physiological plateaus. Aim: To explore how midwives conceptualise physiological plateaus and the significance such plateaus may have for women's labour trajectory and birth outcome. Methods: Twenty midwives across Australia participated in semi-structured interviews between September 2020 and February 2022. Constructivist grounded theory methodology was applied to analyse data, including multi-phasic coding and application …

Pre-Eclampsia Training Needs Of Midwives In A Ghanaian Tertiary Hospital: A Cross-Sectional Study, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Aim: This study aimed to assess the specific clinical and non-clinical training needs of midwives and determine their preferred approach to enhancing performance. Background: Pre-eclampsia remains one of the leading causes of maternal deaths in low and middle-income countries. Pre-eclampsia-related deaths may be due to reduced midwifery knowledge and inadequate management. Therefore, a training needs assessment is vital in identifying gaps in practice, especially, in poorly resourced settings for maximal use of training resources. Design: A hospital-based cross-sectional study. Setting: The largest tertiary hospital in Ghana. Methods: An online version of the validated WHO Hennessy-Hicks Training Needs Analysis questionnaire was …

What Is Known About Midwives' Well-Being And Resilience? An Integrative Review Of The International Literature, Lynnelle Moran, Kim Foster, Sara Bayes

Research outputs 2022 to 2026

Background: Internationally, the midwifery workforce is facing a professional crisis due to numerous organizational and individual factors that have led to midwives leaving the profession. These factors include high levels of workplace stress, systemic barriers to providing woman and person-centered care, trauma, and burnout. The COVID-19 pandemic magnified these pre-existing stressors and adversities and has further disrupted midwives' ability to practice within their professional norms. In order to understand how midwives can be better supported, there is a need to understand what contributes to and detracts from their well-being and resilience. Aim: To investigate and synthesize the extant international knowledge …

Clinical Deterioration As A Nurse Sensitive Indicator In The Out-Of-Hospital Context: A Scoping Review, Kylie Mccullough, Melanie Baker, Dianne Bloxsome, Carol Crevacore, Hugh Davies, Gemma Doleman, Michelle Gray, Nilufeur Mckay, Peter Palamara, Gina Richards, Rosemary Saunders, Amanda Towell-Barnard, Linda L. Coventry

Research outputs 2022 to 2026

Aims: To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also …

Woman-Centred Ethics: A Feminist Participatory Action Research, Katherine A. Buchanan

Theses: Doctorates and Masters

Background: The maternity system has a complexity of everyday ethical issues. The bioethical principles: non maleficence, beneficence justice and autonomy, that govern health care practice have been criticised as abstract, patriarchal and even rhetorical in maternity care practice (MacLellan, 2014) and consequently may be insufficient in guiding care of childbearing women. Midwifery-led care is guided by the International Confederation of Midwives International Code of Ethics, which considers more than the bioethical principles, such as the importance of relationship. Care ethics is a relational based feminist ethics first described by Gilligan (1983) and has been theorised as an alternate paradigm for …

Development Of A Tool To Identify Barriers And Enablers To Practice Innovation In Midwifery: A Participatory Action Research Study, Sara D. Davis, Sara Bayes, Sadie Geraghty

Research outputs 2022 to 2026

Introduction: Transferring research evidence into midwifery practice is fraught with challenges and obstacles. Implementation tools can streamline the process and are most effective when they are discipline-specific; however, there are currently no midwifery specific implementation tools. The aim of this study was to develop a midwifery specific tool to identify barriers and enablers to evidence-informed practice change within the clinical setting. Methods: Participatory action research methodology was employed to ensure potential end-users contributed to content and format of the tool. Purposeful sampling ensured participants were selected from a range of midwifery practice settings in Western Australia and the United Kingdom. …

A Qualitative Document Analysis Of Policies Influencing Preeclampsia Management By Midwives In Ghana, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background: Preeclampsia is a global issue that causes significant morbidity and mortality in low- and middle-income countries (LMICs). The care women with preeclampsia receive in LMICs is below the standard experienced by women in westernised countries due to multiple interacting factors. A review of policy factors influencing the management of preeclampsia in Ghana is needed. Aim: This study focuses on the midwife's role and scope of practice concerning preeclampsia management. The study aimed to explore the congruence between Ghanaian preeclampsia guidelines and international best practice recommendations for midwifery practice. The study also aimed to describe how recommendations are incorporated into …

Care Ethics Framework For Midwifery Practice: A Scoping Review, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sadie Geraghty

Research outputs 2022 to 2026

Background:

As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity.

Aim:

The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice.

Method:

The scoping review was conducted according to the Preferred Reporting …

Moving On After Critical Incidents In Health Care: A Qualitative Study Of The Perspectives And Experiences Of Second Victims, Melanie Buhlmann, Beverley Ewens, Amineh Rashidi

Research outputs 2022 to 2026

Aims To gain a deeper understanding of nurses and midwives' experiences following involvement in a critical incident in a non-critical care area and to explore how they have 'moved-on' from the event. Design An interpretive descriptive design guided inductive inquiry to interpret the meaning of moving-on. Methods Purposive sampling recruited 10 nurses and midwives. Data collection comprised semi-structured interviews, memos and field notes. Data were concurrently collected and analysed during 2016–2017 with NVivo 11. The thematic analysis enabled a coherent analytical framework evolving emerging themes and transformation of the data into credible interpretive description findings, adhering to the COREQ reporting …

Women's Experiences Of Breech Birth Decision Making: An Integrated Review, Sara E. Morris, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

INTRODUCTION: Currently, caesarean section is the primary mode of birth for a breech presenting fetus, leading to a deskilling of clinicians and limitation of birth choices for women. The aim of this review is to present a synthesized summary of existing literature related to women's experiences of breech birth mode decision-making. METHODS: A systematic search of the literature was conducted in April 2021, utilizing five databases to identify and obtain peer-reviewed articles meeting the predetermined selection criteria. RESULTS: Four major categories were synthesized from the integrated review: 1) Women who desire a vaginal birth may experience a range of negative …

What Are The Benefits And Challenges Of Mentoring In Midwifery? An Integrative Review, Krystyl Wissemann, Dianne Bloxsome, Annemarie De Leo, Sara Bayes

Research outputs 2022 to 2026

Aim: The aim of this review was to synthesize best available evidence on mentoring programmes for midwives who have worked within the clinical setting for more than 1 year. Background: Lack of job satisfaction, stress, burnout and limited managerial support contributes to midwifery workforce attrition and the ongoing global shortage of midwives. Mentoring may be one way to improve staff retention, leading to positive clinical and organizational outcomes. Design: A five-step integrative review approach, based on a series of articles published by the Joanna Briggs Institute for conducting systematic reviews, was used to develop a search strategy, selection criteria, method …

Understanding The Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: Using Classic Grounded Theory Methodology In A New Context, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2014 to 2021

Background:

Interpretive-naturalist methodologies, including Grounded Theory are increasingly being used in health research in Ghana however, none of the studies that have used Grounded Theory in the setting has used the methodology in full.

Aim:

The main aim of this article is to describe the experiences, the strengths and limitations of using Glaserian Grounded Theory methodology to understand the barriers to Ghanaian midwives’ ability to provide quality maternal and neonatal care.

Design:

Glaserian Grounded Theory methodological principles were adhered to in this study in relation to the use of literature, participant recruitment, data collection and analysis, and theory development. Data …

Development Of A Breech-Specific Integrated Care Pathway For Pregnant Women: Protocol For A Mixed Methods Study, Sara Morris, Sadie Geraghty, Deborah Sundin

Research outputs 2014 to 2021

Background: The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. Objective: This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech …

Exploring The Usability Of The Com-B Model And Theoretical Domains Framework (Tdf) To Define The Helpers Of And Hindrances To Evidence-Based Practice In Midwifery, Annemarie De Leo, Sara J. Bayes, Dianne Bloxsome, Janice Butt

Research outputs 2014 to 2021

Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Methods This qualitative study formed part of a larger action research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were …

How Is Organisational Fit Addressed In Australian Entry Level Midwifery Job Advertisements, Dianne Bloxsome, Courtney Glass, Sara Bayes

Research outputs 2014 to 2021

Background: Midwifery job retention is an ongoing global issue. Prior research has recognised that considering an individual’s attributes in relation to their work environment may assist in improving job satisfaction among midwives, leading to improved long-term job retention in the midwifery profession. The aim of this study was to evaluate whether, and how organisational fit is addressed in current entry level midwifery job advertisements within Australia. Methods: Midwifery jobs were searched for within 12 search engines, using the search term ‘midwife’, including Seek.com, Indeed.com, government employment websites for all Australian states and territories, and private health organisation websites. Data were …

Improving Processes For Implementing Evidence-Based Practice In Midwifery: Development Of An Etool(Kit) For Midwives, Annemarie June De Leo

Theses: Doctorates and Masters

Evidence-based practice (EBP) is well-established as the gold standard for service delivery of quality healthcare around the world, yet there remains a significant gap between best available evidence and its everyday use in maternity services. The numerous benefits of EBP are therefore never realised and although a considerable body of knowledge has evolved on how to promote the uptake of new EBPs, little is known about midwives’ experience of implementing EBP or leading practice change projects in clinical areas.

The aim of this study was to work collaboratively with midwives towards the co-development of an evidence implementation resource, designed to …

Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: A Glaserian Grounded Theory Study, Yakubu Ismaila

Theses: Doctorates and Masters

The midwifery model of care that promotes the employment of trained and regulated midwives for the provision of maternal and neonatal care has been found to be beneficial, especially in Low and Middle-Income Countries that have high maternal and neonatal mortalities. Midwives in those setting are however, facing a myriad of barriers which negatively affect their ability to provide optimal care. Although Ghana is implementing the midwifery model of care, maternal and neonatal mortality remains high in the country. Little is known from the point of view of midwives, who are the primary providers of maternal and neonatal care, about …

Do Midwifery International Clinical Placements Influence Students' Practice And Employment Decisions?, Sadie Geraghty, Carol Davidson, Annemarie Deleo, Dianne Bloxsome

Research outputs 2014 to 2021

AIM: The aim of this study was to investigate whether an International two-week clinical maternity placement enhances, and is beneficial, to midwifery students' future practice and employment decisions during the final year of an undergraduate degree.

BACKGROUND: International placements are common in undergraduate pre-registration nursing midwifery university curricula, with the emphasis on preparing students to work with diverse women in multicultural environments whilst incorporating cultural competence. However, little is known as to whether an International placement influences future graduate's work place choice.

METHODS: Using a qualitative approach, focus groups were undertaken with 16 final year midwifery students from a University …

Factors Associated With Midwives' Job Satisfaction And Intention To Stay In The Profession: An Integrative Review, Dianne Bloxsome, Deborah Ireson, Gemma Doleman, Sara Bayes

Research outputs 2014 to 2021

AIMS AND OBJECTIVES: To conduct an integrative review of the factors associated with why midwives stay in midwifery.

BACKGROUND: Midwifery retention and attrition are globally acknowledged as an issue. However, little is known as to why midwives stay in midwifery as the focus has previously focussed on why they leave.

DESIGN: A structured six-step integrative review approach was used, and this involved the development of a search strategy, study selection and critical appraisal, data abstraction and synthesis, interpretation of findings and recommendations for future practice.

METHODS: The review was conducted using the databases MEDLINE, CINAHL and PsychInfo. Included studies were …

Midwives' Use Of Best Available Evidence In Practice: An Integrative Review, Annemarie De Leo, Sara Bayes, Sadie Geraghty, Janice Butt

Research outputs 2014 to 2021

Aims and objectives: To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care.

Background: Midwifery is a research‐informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice.

Design: A five‐step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search …

"I Love Being A Midwife; It's Who I Am": A Glaserian Grounded Theory Study Of Why Midwives Stay In Midwifery, Dianne Bloxsome, Sara Bayes, Deborah Ireson

Research outputs 2014 to 2021

Aims and objectives: To understand why Western Australian (WA) midwives choose to remain in the profession.

Background: Midwifery shortages and the inability to retain midwives in the midwifery profession is a global problem. The need for effective midwifery staff retention strategies to be implemented is therefore urgent, as is the need for evidence to inform those strategies.

Design: Glaserian grounded theory (GT) methodology was used with constant comparative analysis.

Methods: Fourteen midwives currently working clinically area were interviewed about why they remain in the profession. The GT process of constant comparative analysis resulted in an overarching core category …

Lifestyle Health Behaviors Of Nurses And Midwives: The ‘Fit For The Future’ Study, Lin Perry, Xiaoyue Xu, Robyn Callagher, Rachel Nicholls, David Sibbritt, Christine Duffield

Research outputs 2014 to 2021

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline …

Are Midwifery Students Adequately Prepared For Vaginal Breech Birth In Clinical Practice?, Steffne Nel, Sadie Geraghty

Research outputs 2014 to 2021

While the value of the clinical skills and expertise required to enable safe vaginal breech birth remains high, midwives who possess these skills are becoming scarce. Additionally, for many midwifery students, vaginal breech birth is becoming somewhat of an elusive event, rarely experienced in clinical practice when completing their training. Not so long ago, this was a standard competency taught to and held by obstetricians and midwives alike, but for those in developed nations working within robust healthcare systems, the frequency of planned vaginal breech birth is on a downward trend, and this is reflected in midwifery educational curriculums.

‘Fighting A Losing Battle’: A Glaserian Grounded Theory Of Midwives’ Workplace Stress, Sadie Margaret Geraghty

Theses: Doctorates and Masters

The development of the midwifery profession and the culture of childbirth are inevitably entwined from an historical perspective through to current day practice. Early written accounts describe the fifteenth century midwife as dealing with high maternal and child mortality rates, the invention of forceps, the rise of male obstetric practitioners, and the complex social and cultural changes of that era. The twenty-first century midwife faces challenges in Australia and worldwide, which are not dissimilar to our midwifery predecessors.

Midwifery clinical practice has become more complex due to the medicalisation of childbirth and 21st century lifestyles, which have contributed to a …

Australian Midwifery Students' Views About Profession-Specific Peer Mentoring, Sara J. Bayes, Doreen Collyer, Kirsten Dobbs, Laura Walsh

eCULTURE

Midwifery is one of the most demanding professions there is, and midwifery students can find coping with the practice aspect of their course difficult. Mentoring is one way of supporting health clinicians’ emotional wellbeing; to date however, there is little research on mentoring for midwifery students. In this study, the aim of which was to discover midwifery students’ views of profession-related peer mentoring, qualitative and quantitative data were collected from 21 midwifery students at one Australian university. Analysis of the data revealed that most participants felt they would benefit from and would like to know more about mentoring. The qualitative …

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …

The Development And Evaluation Of A Childbirth Education Program For Malawian Women, Address M. Malata

Theses: Doctorates and Masters

Childbirth education provided to women is an Integral aspect of the childbirth experience. In Malawi, midwives face a major challenge because one of their major roles is to provide childbirth information to women. However, there are no existing Childbirth Education Programs to facilitate this process. The purpose of this study was, therefore, threefold. First, it explored childbirth Information needs of Malawian mothers from the perspectives of both mothers and midwives, as well as strategies that would be appropriate to disseminate this childbirth information to Malawian women. Second, it developed a Childbirth Educational Program (CEP) to meet the specific needs of …