Nursing Midwifery Commons^™

A Brief History Of Antenatal Colostrum Expression, And Where To From Here, Therese A. O’Sullivan, Connie N. Ihlein

Research outputs 2022 to 2026

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or …

Intrapartum Hydration Assessment And Management: A Cross-Sectional Survey Of Australian And New Zealand Maternity Units, Brianne G. Mcintyre, Debbie Massey, Nigel Lee, Lauren Kearney

Research outputs 2022 to 2026

Background: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols. Aim: Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope …

Emotional Safety In Maternity Care: An Evolutionary Concept Analysis, Elliesha O'Reilly, Kate Buchanan, Sara Bayes

Research outputs 2022 to 2026

Background: Safety in maternity care is a priority, and a broadened view of safety (e.g., emotional, psychological, cultural) is evident in scientific literature and in lay discourse. ‘Emotional safety’ is being referred to with increasing frequency in this context; however, there is a lack of clarity in its use and meaning. Aim: The aim of this concept analysis was to examine the concept of emotional safety in maternity care. Methods: The evolutionary approach was used for this concept analysis. Data sources: This concept analysis was literature-based, with a systematic search conducted of CINAHL, MIDIRS, and MEDLINE databases. Ten articles published …

Through The Looking Glass; Midwifery Students' Experience Of Ethical Issues: A Feminist Explanatory Case Study, D. Bygraves, K. Wissemann, K. Buchanan

Research outputs 2022 to 2026

Background: The ethical component in midwifery education is governed by international professional values, codes, and ethical principles. The aim of midwifery education is to encourage students to develop a lifelong commitment to ethical practice within their midwifery role and scope. However, little evidence is available on the experiences of midwifery students and how they navigate ethical issues in maternity systems. Aim: To present a case study from a midwifery students' perspective that demonstrates observed ethical issues and to provide analysis of the ethical issues identified. Design: A Single explanatory case study design with a feminist lens applied. Explanatory case studies …

Fostering A Resilient Healthcare System: Supportive Practice Environment Initiatives To Support Nurse And Midwives A Scoping Review, Gemma Doleman, Dianne Bloxsome, Rong Wang, Lisa Whitehead

Research outputs 2022 to 2026

Aim: This scoping review aimed to explore supportive practice environment initiatives that support novice and expert nurses and midwives. Design: Scoping review. Methods: Studies were identified through the electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsychInfo, Scopus, and Web of Science. Grey literature was searched using GreyNet, National Grey Literature Collection, ProQuest Dissertation and Theses, and Google Scholar. Results: Thirty-one papers met the criteria for inclusion and data extraction. The key concepts identified were the need for adequate staffing and resources, clear and regular communication, managerial presence and engagement in committees and relationship building, celebration …

Physiological Plateaus During Normal Labor And Birth: A Novel Definition, Marina Weckend, Kylie Mccullough, Christine Duffield, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. Aim: To generate a definition of physiological plateaus as a basis for further research. Methods: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through …

The Work Of Midwives: The Socio-Institutional Theory Of The Meaning Of Midwives’ Work-Life Balance, Kate Buchanan, Kate Dawson, Jacqueline Taylor, Sara Bayes

Research outputs 2022 to 2026

Background: Globally, midwifery is facing a potential workforce crisis. A significant number of midwives intending to leave the profession often cite burnout as contributing to this decision. While it has been reported that work-life balance is a key element in deciding to stay in midwifery, little is known about what constitutes work-life balance and the barriers to achieving this. Aim: The aim of this study was to explore what work-life balance means to Australian midwives, and to determine its crucial features. Methods: Qualitative Description methodology was used for this study. Data were collected from 31 midwives in Australia working in …

Aboriginal, Torres Strait Islander And Māori Nursing And Midwifery Academic Workforce Across Australia And Aotearoa New Zealand, Ann Bonner, Linda Deravin, Jan Dewar, Moira Williamson, Kerri Gillespie, Cheryl Atherfold, Karen Nightingale, Caryn West, Karen Strickland

Research outputs 2022 to 2026

Background: Promoting a representative and supportive industry for Aboriginal, Torres Strait Islander and Māori nursing and midwifery academic staff is a key tenet of Australian and Aotearoa New Zealand universities, and fundamental to strengthening the health workforce. Surprisingly, information about this workforce is unknown. Aim: The aim of the study was to gain an understanding of the Aboriginal, Torres Strait Islander and Māori nursing and midwifery academic workforce. Methods: A cross-sectional study was conducted using an online survey of organisations that provide accredited nursing and midwifery education within Australia and Aotearoa New Zealand. Demographic, academic and employment information relating to …

Should I Stay Or Should I Go? Nursing And Midwifery Academics Intention To Stay In Or Leave Academia: A Scoping Review, Marion Tower, Rachel Muir, Peta Anne Zimmerman, Amanda G. Carter, Robyn Maude, Kathy Hollaway, Lynore Geia, Debbie Massey, Elizabeth Elder

Research outputs 2022 to 2026

Background: There is a chronic lack of appropriately qualified nurses and midwives being attracted into and remaining in the academic workforce. Reasons for this are not well understood but have been linked to stressful work environments related to balancing multiple roles in sometimes unsupportive environments, resulting in overload and demoralisation. Aim: To illuminate factors associated with nursing and midwifery academics' intention to remain in academia and factors associated with intention to leave. Design: A scoping review was undertaken to provide a comprehensive and broad analysis of the related literature. This was guided by Arksey and O'Malley. A search strategy was …

Where's My Baby? A Feminist Phenomenological Study Of Women Experiencing Preventable Separation From Their Baby At Caesarean Birth, Linda J. Deys, Valerie Wilson, Sara Bayes, Shahla Meedya

Research outputs 2022 to 2026

Problem: Separating women and babies immediately after birth contributes to poor birth experience and reduced satisfaction. Background: A negative birth experience can impact a woman's transition to motherhood and emotional well-being beyond the newborn period. Separating women from their baby at birth is known to reduce birth satisfaction and is more likely to happen at caesarean section births. Question: What is the experience of women who are separated from their baby after caesarean section birth without medical necessity? Methods: Unstructured, in-depth phenomenological interviews were conducted with fifteen women who had been separated from their well-baby at caesarean section birth. Data …

Using Interpretive Description To Facilitate Women's Contributions To Maternity Care: Experiences And Views Of Obstetric Fistula Prevention, Lydia Babatunde Bulndi, Sara Bayes, Deborah Ireson, Esther Adama

Research outputs 2022 to 2026

Background/AimsInterpretive description is a qualitative methodology that combines detailed descriptions with thoughtful interpretation. This approach is especially effective for producing practical insights and deepening the understanding of phenomena in clinical or practice-based settings. The aims of this study were to explore how interpretive description could be used to research the experiences and views of women with obstetric fistula. MethodsInterpretive description was used to explore the experiences and views of 15 purposively selected women affected by obstetric fistula. Participants were recruited via the Evangel Vesico Vaginal Fistula Centre of Bingham University Teaching Hospital. Data were collected via in-depth interviews and concurrently …

A Survey Of Students’ Experiences Of Returning To Midwifery Studies After Maternity Leave: A Pilot Survey, Liz Mcneill, Elaine Jefford, Michelle Gray, Dianne Bloxsome, Terri Downer, Jessie Johnson-Cash, Lyn Ebert

Research outputs 2022 to 2026

Aim: To identify the barriers and facilitators having an impact on the progression and completion of studies for students who give birth during their midwifery program. Background: Balancing the demands of pregnancy and new motherhood with the rigorous academic requirements of a tertiary-level midwifery program is challenging for students wishing to progress and complete their studies. Understanding the barriers and facilitators students face when resuming midwifery studies following birth can assist universities in providing educational environments that support students in achieving their midwifery education. Design: Social media online Qualtrics survey with closed and open questions. Method: Participants were Australian midwifery …

The Lived Experience Of Midwives’ Transitioning From A Clinical Role Into Teaching In Higher Education In One Jurisdiction Of Australia: A Pilot Study, Michelle Gray, Annie De Leo, Melanie Baker, Elaine Jefford

Research outputs 2022 to 2026

Aim: The aim of this pilot study was to explore clinician's experience of transitioning from midwifery clinical practice into university in an academic teaching role within one jurisdiction in Australia. Background: There is a dire shortage of midwifery academics globally. In Australia the shortage is symbiotic with the persistent deficit in the midwifery clinical workforce, which is the predominant recruitment pool for universities. The midwifery workforce cannot be replenished without sufficient academics to provide education. Design: Phenomenology was selected as the most appropriate research approach for the study seeking to illuminate the lived experiences of clinicians as they transition into …

A Systematic Review Of The Use Of Routine Versus Selective Episiotomy For Vaginal Birth, Nour A. Alrida, Amal Ababneh, Khawla Al-Sharif, Diana Arabiat, Jafar Alshraidah, Basheer Al-Zu'bi

Research outputs 2022 to 2026

Episiotomy is a common obstetric surgical procedure involving an incision to enlarge the vaginal opening, facilitating the delivery of the fetus during the second stage of labor. Hence, the current review was conducted to assess the impact of using selective versus routine episiotomy during vaginal birth on birth outcomes. This systematic review used the Joanna Briggs Institute (JBI) methodology for systematic reviews and research syntheses. PubMed, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SCOPUS were searched for relevant studies. Two reviewers independently screened and extracted data from relevant studies. Four studies met the eligibility …

Efficacy And Safety Of Transcutaneous Electrical Acupoint Stimulation For The Management Of Primary Dysmenorrhoea: Protocol For A Randomised Controlled Trial In China, Weiting Liu, Yanting Ding, Honggang Xie, Hansheng Liu, Changhao Liang

Research outputs 2022 to 2026

INTRODUCTION: Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in alleviating PD symptoms remain uncertain due to insufficient evidence. This single-centre, parallel, randomised controlled study intends to evaluate the efficacy and safety of TEAS for PD management. METHODS AND ANALYSIS: 60 participants aged 18-40 years diagnosed with moderate to severe PD will be recruited from Tai'an Hospital of Traditional Chinese Medicine (TCM) and randomly assigned to either a TEAS group or a TEAS-sham group (1:1). The TEAS group will undergo 12 sessions of TEAS …

Understanding Research Capacity And Culture Of Nurses And Midwives In Two Health Services In Western Australia, Carrie Janerka, Gavin D. Leslie, Olivia Gallagher, Melissa Mellan, Marguerite Lane, Fenella J. Gill

Research outputs 2022 to 2026

Background: Health services with a strong research culture report better patient outcomes and organisational performance. Measuring research capacity and culture (RCC) is important for understanding baseline research capabilities of a health service and assessing the effectiveness of capacity-building and culture-improving interventions. Aim: To describe the RCC of nurses and midwives in two health services in Western Australia. Methods: A cross-sectional survey of nurses and midwives was undertaken using a previously validated RCC tool to measure RCC in individual, professional group, and organisational domains, and identify barriers, enablers, and research activity. Staff at each health service were recruited via email during …

Development Of A Midwifery Student Peer Debriefing Tool: An Interpretive Descriptive Study, Kate Buchanan, Carolyn Ross, Dianne Bloxsome, Jen Hocking, Sara Bayes

Research outputs 2022 to 2026

Background: Psychosocial traumatisation associated with giving birth, can occur in those present with the woman giving birth, a phenomenon known as vicarious trauma. It has been identified that there are currently no interventions available for midwifery students who have experienced vicarious trauma following difficult birth experiences. Objective: To explore whether the counselling intervention developed by Gamble et al. (2005), can be adapted for midwifery students to be appropriately and feasibly used as a counselling intervention with peers who have experienced midwifery practice-related vicarious trauma. Design: Interpretive descriptive methodology. Setting: This study was set at two Australian universities from which pre-registration …

Using A Novel Approach To Explore Women's Caesarean Birth Experience, Linda J. Deys, Valerie Wilson, Sara Bayes, Shahla Meedya

Research outputs 2022 to 2026

How a woman experiences birth is influenced by how she is treated, and who has power and control in the birthing environment. Focus on 'delivery' of an infant disregards the transformative event for the woman, with poorer physical and psychological outcomes. New evidence is needed to understand how to prevent trauma and improve maternal wellbeing.This paper presents a feminist methodology to view the lived experience of caesarean birth. Feminist birthing theories integrated with a phenomenological perspective provide insight for those working in maternity care and create a novel framework for researchers considering the position of women in a medicalised healthcare …

What Resilience (Strength) Means For Australian Aboriginal And Torres Strait Islander Health Professionals And Practitioners: An Exploratory Study, Eileen Willis, Amy-Louise J. Byrne, Sandy Mclellan, Venessa Curnow, Harvey Clare, Janie Brown, Amelia Britton

Journal of the Australian Indigenous HealthInfoNet

This article explores the concept of resilience from the perspective of Australian Aboriginal and Torres Strait Islander health professionals and practitioners, with the aim of describing what it is and how it is practiced in the workplace. Interviews in the form of Yarns were conducted with ten Aboriginal and Torres Strait Islander health professionals in regional North Queensland. We found that for Aboriginal and Torres Strait Islander health professionals and practitioners, resilience encompasses cultural identity and an ability to manage both Indigenous and western cultures and structures. Resilience, understood as ‘Strength’, draws on strong relationships to family and Country, often …

Consensus-Based Recommendations For The Care Of Women With A Breech Presenting Fetus, Sara Morris, Sadie Geraghty, Deborah Sundin

Research outputs 2022 to 2026

Objective: To establish consensus related to aspects of breech presentation and care. Design: A multinational, three round e-Delphi study. Participants: A panel of 15 midwives, four obstetricians and an academic with knowledge and/or experience of caring for women with a breech presenting fetus. Methods: An initial survey of 45 open-ended questions. Answers were coded and amalgamated to form 448 statements in the second round and three additional statements in the third round. Panellists were asked to provide their level of agreement for each statement using a 5-point Likert scale. Consensus was deemed met if 70% of panellists responded with strongly …

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 …

The Impact Of Final-Year Clinical Placements On Nursing Students' Career Planning For The Graduate Year And Beyond, Edah Anyango, Esther Adama, Janie Brown, Irene Ngune

Research outputs 2022 to 2026

Aims: This study had three objectives: 1) to determine final-year nursing students' career preferences and long-term career plans; 2) to investigate factors influencing nursing students' specialty choices following their final-year clinical placement(s); and 3) to understand how final-year clinical placements can be used to develop the career interests of nursing students to different nursing specialties. Background: Clinical placement provides an insightful experience that may influence students to feel inclined to work in certain specialties. Therefore, each clinical placement should promote students' learning and enhance positive experiences that could develop their career interests and encourage them to seek employment in the …

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 …

How Do Professional Connections And Relationships Impact Midwives’ Well-Being And Career Sustainability? A Grounded Theory Study Protocol, Lynnelle Moran, Sara Bayes, Kim Foster

Research outputs 2022 to 2026

Significant attrition and projected workforce shortages within the midwifery profession are global issues. Extensive research has identified that high levels of workplace adversity, chronic stress, and increasing rates of vicarious trauma and moral injury experienced by midwives, underpin this situation. Researchers have explored midwives’ intention to stay in the midwifery workforce and identified ways to support students’ transition to professional practice. Supportive collegial relationships have been reported to be protective for new and early career midwives’ well-being and resilience. However, there is a gap in knowledge and understanding of the impact and significance of professional connections and relationships for midwives …

Nursing/Midwifery Students' Perceptions Of Caring Pedagogy And Online Learning During The Covid-19 Pandemic, Rikki Jones, Debra Jackson, Kylie Rice, Murray Fisher, Pauline Callega, Martin Hopkins, Caryn West, Pauletta Irwin, Shirley Mcgough, Lauretta Luck, Felicity Walker, Nicola Whiteing, Kim Usher

Research outputs 2022 to 2026

Aim: This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. Design: Mixed methods. Methods: A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students’ experience of learning during the COVID-19 pandemic. Results: There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning …

Study Protocol For A Stepped-Wedge Cluster (Nested) Randomized Controlled Trial Of Antenatal Colostrum Expression (Ace) Instruction In First-Time Mothers: The Ace Study, Cassandra Cuffe, Roslyn Giglia, Matthew N. Cooper, Julie Hill, Desiree Silva, Anita M. Moorhead, Valerie Verhasselt, Joshua R. Lewis, Deborah Ireson, Jill R. Demirci, Talea Cotte, Kathryn Webb, Frances Patey, Therese A. O’Sullivan

Research outputs 2022 to 2026

Background: Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. Methods and Planned Analysis: This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. …

Western Australian Mothers' Experiences Of Breastfeeding Support In Hospital After Birth: A Mixed Methods Study, Justine Van Der Watt

Theses: Doctorates and Masters

Background: The benefits of breastfeeding are well established for infants, mothers and the community, with the World Health Organisation recommending that infants be exclusively breastfed up to six months of age with an achievable goal of 70% globally. Yet in Australia only 15-37% may be reaching that goal. There have also been reported benefits and desires for mothers to be supported with their breastfeeding in order to increase and prolong breastfeeding duration and exclusivity, especially early after birth. However, there is limited research or literature exploring what experiences mothers are having with breastfeeding support, especially during their hospital admissions in …

Navigating Midwifery Solidarity: A Feminist Participatory Action Research Framework, Katherine Buchanan, Elizabeth Newnham, Sadie Geraghty, Lisa Whitehead

Research outputs 2022 to 2026

Background:

A core aspect of midwifery philosophy is the optimisation of normal physiology; however, this has been challenged as a radical idea in the medicalisation of birth. Research has demonstrated the benefits of midwifery in improving outcomes for both mothers and babies. The understanding of midwifery benefits fails to reach wider sociocultural contexts as births becomes more medicalised. Midwifery research requires an action arm, to help translate theory to practice and mobilise midwives in solidarity with women towards action and change.

Aim:

The aim of this article is to describe a Feminist Participatory Action Research (FPAR) by establishing the philosophical …

Woman-Centred Ethics: A Feminist Participatory Action Research [Journal Article], Kate Buchanan, Sadie Geraghty, Lisa Whitehead, Elizabeth Newnham

Research outputs 2022 to 2026

Introduction: Contemporary ethical issues in the maternity system are nuanced, complex and layered. Medicalisation and the reported rise in incidence of mistreatment and birth trauma, has been described as unethical. Some authors suggest bioethical principles are limited in terms of guiding everyday care of pregnancy and birth. There is currently no known published research which explores what birthing people say is ethical. Aims: This study sought to explore women's experience of maternity care from an ethical perspective. Method: A Feminist Participatory Action Research (FPAR) was conducted over three years, in two phases. A Community Action Research Group (CARG) was formed …