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Nurturing the next generation: Midwives' experiences when working with third year midwifery students in New Zealand

By James, L
on Saturday, 01 Jun 2013 in New Zealand College of Midwives Journal - Volume: 47

Midwifery students require appropriate and timely access to clinical learning opportunities while completing a Bachelor of Midwifery and to achieve this they must be supported by practising midwives. This research sought to understand what supports midwives to work effectively with third year midwifery students. Midwives on the school’s database who regularly worked with midwifery students were invited to participate in the research. Data were gathered using midwife focus groups. The results reveal i) most placements were a positive experience, ii) issues were described that related to the students’ professional behaviour, iii) tensions were experienced by the midwife between the needs of the woman and the needs of the student and iv) tensions were experienced by the midwife as they moved between the roles of teacher, supporter and assessor of the student. Potential for further research is suggested.

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A midwife who knows me: Women tertiary students' perceptions of midwifery

By Newick, L, Vares, T, Dixon, L, Johnston, J, Guilliland, K
on Saturday, 01 Jun 2013 in New Zealand College of Midwives Journal - Volume: 47

There is little information about how young women view midwives and the maternity services yet they are the future potential consumers of maternity services. How their expectations are formed is important. This study of young female university students has explored their understanding about midwives and maternity care. Two small focus groups involving eleven undergraduate women were held to discuss midwifery and maternity services. Qualitative thematic analysis was used to identify three overarching themes. Firstly, there was a perception of midwives as providing a highly personalised and professional service but that particular social qualities were also necessary. Secondly,the midwifery partnership model of practice was found to be embedded in the women’s understanding of the maternity system. Lastly, storytelling from friends and relatives was found to be the main source of the construction of these young women’s perceptions. Storytelling was considered a trustworthy source of information and privileged above media representations. Employing the power of personal storytelling is a strategy that may be useful when seeking to connect with young women who are future potential users of midwifery and maternity services. This strategy could support and improve knowledge and understanding of the New Zealand/ Aotearoa midwifery and maternity services.

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Midwifery and assisted reproductive technologies

By Allot, L, Payne, D, Dann, L
on Saturday, 01 Jun 2013 in New Zealand College of Midwives Journal - Volume: 47

Assisted reproductive technologies (ARTs), particularly in vitro fertilisation (IVF), are being used by women who are experiencing difficulties of conception to achieve parenthood. Many of these women and their partners will come to midwives for their maternity care. In this paper we examine the literature regarding the health and wellbeing of women who have used assisted reproductive technologies, and their babies. Our paper aims to provide an overview of fertility/infertility, and to highlight the adverse maternal and perinatal outcomes associated with ART pregnancies. We aim to inform midwives of the issues which they need to be mindful, when caring for these women and their families.

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Women's experience of the Abdominal Palpation in pregnancy: A glimpse into the philosophical and midwifery literature

By Blee, D, Dietsch, E
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

This paper describes a literature review which was undertaken following a personal narrative in which abdominal palpation during pregnancy was experienced. When a midwife touches a woman’s abdomen, the woman is both touched, and touches; perhaps for a moment at least, their worlds are intertwined. The aim of this paper is to try to come a little closer to understanding women’s experience of abdominal palpation in pregnancy. The literature reviewed has been drawn from midwifery, philosophy, sociology, and critical feminism. The opening vignette is one woman’s experience of abdominal palpation. It is her story of recounting experience, and unpacking the meaning of that experience, that steers and drives this work. Some literature explicitly addressed the experience of touch for the pregnant woman; much of the reviewed work did so only obliquely, by inference, or by chance. This gave the opportunity to divide the literature into three clusters or categories: Touching at a Distance, Touching the Edges and Exploring Touch.

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What evidence supports the use of free-standing midwifery led units (primary units) in New Zealand/Aotearoa?

By Dixon, L, Prileszky, G, Guilliland, K, Hendry, C, Miller, S, Anderson, J
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

Background: Free-standing midwifery led units (FMLUs) (known in New Zealand as a primary maternity unit), provide midwifery led care for low-risk women in local, family friendly environments which are generally some distance from an obstetric unit (OU) (known in New Zealand as a secondary or tertiary facility). The majority of women in New Zealand/ Aotearoa choose to give birth in an OU and reasons for this choice may be related to safety concerns. Aim: To identify, compare and critically evaluate published studies on FMLUs to determine the evidence that contributes to safety and may be useful for the New Zealand/Aotearoa maternity context. Method: Five databases were searched using the search terms: place of birth, midwife-led, primary unit, maternal outcomes, neonatal outcomes. The primary outcome of interest was place of birth and the impact on mortality or morbidity rates for maternal and neonatal health. Secondary outcome measures were intervention rates during labour. Findings: Three studies were found which compared maternal and neonatal outcomes for low risk women planning to birth in free standing midwifery led units or obstetric units. These studies found less augmentation during labour and higher rates of normal birth in FMLUs. Low-risk women who planned to birth in an OU had higher rates of epidural anaesthesia, instrumental birth, cesarean section and episiotomy rates. Neonatal health appeared to benefit with no differences in mortality rates but higher Apgar scores at 5 minutes and lower rates of admission to a neonatal intensive care unit for babies when birth was planned at a FMLU. Conclusion: There is strong and consistent evidence to support FMLU birth as a safe option for women experiencing a low-risk pregnancy.

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Editorial: NZCOM journal goes electronic

By Gilkison, A, Dixon, L
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

electronic publishing

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Discerning which qualitative approach fits best

By Smythe, L
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

This paper is designed as a teaching tool to assist in choosing the most appropriate qualitative research methodology. Its key aim in providing broad outlines is to distinguish difference between approaches. Assumptions of each methodology are articulated along with the mood of the approach. Examples of interview questions, data and analysis are given to ‘show’. References are offered, including links to these.

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Research methodology: Discerning which qualitative approach fits best

By Smythe, L
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

This paper is designed as a teaching tool to assist in choosing the most appropriate qualitative research methodology. Its key aim in providing broad outlines is to distinguish difference between approaches. Assumptions of each methodology are articulated along with the mood of the approach. Examples of interview questions, data and analysis are given to ‘show’. References are offered, including links to these.

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Developmental mentoring: New graduates' confidence grows when their needs shape the relationship

By Lennox, S, Foureur, M
on Friday, 01 Jun 2012 in New Zealand College of Midwives Journal - Volume: 46

Background: The transition from student midwife to practising midwife can be supported using the developmental mentoring approach. Aim: This paper describes a research project that explored group mentoring with four new graduate midwives and four experienced midwives. Methods: This longitudinal project used mixed methods to collect data over a period of one year. Data included three in-depth interviews with each participant along with quantitative data from contact logs, self-assessed confidence scales and analysis of practice outcome data. Findings: the four new graduate midwives were able to clearly identify their needs and how those needs could best be met. The most valued aspect of the mentoring support was the ability to discuss practice experiences with the mentors and to hear and learn from all the group members (both other graduates and mentors) during the group meetings. Conclusion: The developmental mentoring approach used in this project was strongly based on a philosophy of supporting the new graduates as competent novices. This approach enabled the new graduates to identify their own needs and decide how to have them met (Lennox, Jutel, & Foureur, 2012). The project appeared to support the new graduates to develop as confident and safe practitioners.

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Assessing Quality Care - the beginning of the journey

By van Uden, A, Freeman, L
on Saturday, 01 Oct 2011 in New Zealand College of Midwives Journal - Volume: 45

Background: When an institution is providing a maternity service it is of utmost importance that the service meets the needs of its consumers. During 2008 a number of reports were published highlighting the necessity of achieving this level of quality outcome. St George’s Maternity service, in providing primary level care to women, was motivated to assess the level of care within the unit and provide data to demonstrate quality delivery of care. Objectives: • To determine an appropriate set of standards to measure maternity care provision in a primary birthing unit. • To develop an assessment template to present the evidence against the identified standards. • To conduct an audit to measure and evaluate care provision at St George’s Maternity against the identified standards and criteria. • To invite similar primary maternity units to benchmark practice against St George’s Maternity services. Method: Care provision at St George’s Maternity was audited, in 2009, against 23 of the 30 Royal College of Obstetricians and Gynaecologists ‘Standards for Maternity Care’ (RCOG, 2008). Results: All criteria were met for 21 of the 23 Standards reviewed. Conclusion: The Royal College of Obstetricians and Gynaecologists’ Standards for Maternity Care (ibid) was found to be an invaluable initial tool to audit practice at St George’s Maternity, and quantitatively acquire evidence that reflects a commitment NEW ZEALAND AUDIT Authors: • Anna van Uden, MMid, BN, RM, RGON. Charge Midwife St George's Hospital Christchurch Email: anna.vanuden@stgeorges.org.nz • Lesa Freeman, PhD, MA(Hons), Grad Cert (Higher Ed), BA, RM, RGON. Midwife St George's Hospital Christchurch to excellence in service provision and ensure continuous quality improvement. An ultimate goal, however, will be to access standards that will measure quality and safety within maternity services, which are designed specifically for the New Zealand context.

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