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Editorial: Different yet similar - ways of being and knowing

By Skinner, J
on Wednesday, 01 Apr 2009 in New Zealand College of Midwives Journal - Volume: 40

International midwifery

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Rhetorical (de)vices and the construction of a 'natural' caesarean

By Douche, J
on Wednesday, 01 Apr 2009 in New Zealand College of Midwives Journal - Volume: 40

Meanings emerging from both popular and professional discourses, have the potential to shape the experience of childbirth. As an embodied practice, childbirth occupies a space in which many shifting meanings are engraved upon the birthing body. These inscriptions are enabled through the availability of reproductive technologies and legitimised in professional and popular discourses. It is in this space that the concept of a ‘natural’ caesarean surfaces in search of authenticity. This article draws from the ideas of Post-structuralism to examine how language can shape reality and argues that the choice for a caesarean section, as an alternative birth mode, is the product of social process and disciplinary practices. These discursive strategies have been played out on a number of platforms, the key of which is the appropriations of the media for the transposition of medical knowledge into common knowledge in the interests of popular appeal and willing truth.

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A comparison of the Postpartum Depression Screening Scale (PDSS) with the Edinburgh Postnatal Depression Scale (EPDS)

By White, G
on Wednesday, 01 Oct 2008 in New Zealand College of Midwives Journal - Volume: 39

The reliability and validity of the Postpartum Depression Screening Scale (PDSS) was determined and compared with the Edinburgh Depression Screening Scale (EPDS), and a structured clinical interview, on a sample of 60 New Zealand women of European origin. Even though the sample was small the PDSS had good validity when compared with the EPDS, and the structured clinical interview. Additionally the result compared well with larger studies undertaken in the USA. Both the PDSS and EPDS are reliable and valid screening tools for New Zealand women of European origin. The use of the PDSS by mental health clinicians and the EPDS or short version PDSS by midwives is supported.

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Mentorship, preceptorship and clinical supervision: Three key processes for supporting midwives

By Lennox, S, Skinner, J, Foureur, M
on Wednesday, 01 Oct 2008 in New Zealand College of Midwives Journal - Volume: 39

New Zealand midwives are increasingly seeking and receiving professional support in clinical practice. This support is gaining acceptance within the profession and is now underpinned by government funding. There are a variety of ways in which support can be provided and this review of the literature describes three main approaches: mentoring, preceptorship and clinical supervision. These three key processes may be undertaken by all midwives whether new to practice or new to New Zealand and also by those who wish ongoing support and development. The first government funded support for all new midwifery graduates is called the Midwifery First Year of Practice programme (MFYP) (New Zealand College of Midwives, 2007). The programme commenced in 2007 and includes a mentoring component. This paper traces the different histories of the terms: mentoring, preceptorship and clinical supervision internationally with reference to their current significance within New Zealand midwifery. These terms have evolved over time, and within different international contexts can manifest quite differently. The array of meanings ascribed to the same concept can cause confusion when midwives begin practice, change from hospital to community practice or change countries. This paper captures the common characteristics of the three terms in the literature. Clarity around the terms is essential if midwives are to gain maximum benefit from the provision of funded support for clinical practice.

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Professional supervision: reflections on experience

By Smythe, L, Young, C
on Wednesday, 01 Oct 2008 in New Zealand College of Midwives Journal - Volume: 39

The authors of this paper engaged in the process of ‘Professional supervision’. Liz was required to ‘supervise’ as part of a postgraduate learning experience and Carolyn offered to be supervised. Our experience revealed the value for the midwife of ‘being listened to’. Transcripts from the sessions revealed how Carolyn kept articulating her practice values, using them as benchmarks on which to judge her own practice. Gentle challenge from the supervisor opened thinking space. The thinking went on between the supervision sessions. The process offered a ‘mirror’ to Carolyn whereby she could see afresh the calibre of her practice. From our experience we argue professional supervision is a valuable strategy towards preventing burnout.

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Sterile water injections for back pain in labour

By Duff, M
on Wednesday, 01 Oct 2008 in New Zealand College of Midwives Journal - Volume: 39

Sterile water injections to reduce low back pain during labour have been used for the last 25 years in Scandinavia and since 1990 in the United States of America (USA) and Canada. The technique is not featured in current midwifery textbooks except for two USA publications. This paper reviews the use of sterile water injections in six studies published between 1990 and 2008, the various techniques used by the researchers and their results. The paper concludes with a discussion around some considerations for practice that emerged from these studies, including the different techniques and the number and type of injections to use. The evidence from the studies suggests that sterile water injections are an effective method to relieve low back pain in labour. They are simple to undertake and may provide women with an alternative option to narcotics and epidurals. The transitory pain experienced by the women immediately after the injection appears to be the only side effect.

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Midwives' and obstetricians' perception of their role in the identification and management of family violence

By Lauti, M, Miller, D
on Tuesday, 01 Apr 2008 in New Zealand College of Midwives Journal - Volume: 38

Background Pregnant women are at risk of family violence. Pregnancy provides a window of opportunity for identification and management of abuse. Practitioners do not adequately identify family violence and abused women tend not to disclose it. This exploratory study aimed to investigate the opinions of midwives and obstetricians, regarding their role in identification and management of family violence. Method Focus groups and semi-structured interviews with midwives and obstetricians were conducted, recorded and analysed. Results Identification themes included concerns about privacy and confidentiality, the doctors’ lack of continuity of patient care, and the role of screening. Management themes included uncertainty regarding management and referral options, the impact of managing family violence on clinicians, and the need for debriefing. Conclusion Maternity health professionals in the locale studied have significant issues and difficulties in the identification and management of family violence. These need to be addressed in training programmes and guidelines to improve patient outcomes, and to provide support and safety for clinicians. Further research is required to achieve saturation of themes and explore identified issues, which can then be used to focus on interventions.

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Third trimester itch: Obstetric Cholestatis a serious condition of pregnancy

By Cronin, R, Maude, R
on Tuesday, 01 Apr 2008 in New Zealand College of Midwives Journal - Volume: 38

Obstetric cholestasis, also known as intrahepatic cholestasis of pregnancy, is a relatively uncommon liver disorder that classically presents in the third trimester (Royal College of Obstetricians and Gynecologists [RCOG], 2006). The main concern with obstetric cholestasis is a risk of prematurity and sudden intrauterine fetal death in previously healthy fetuses (RCOG, 2006). In this article we have used a fictionalized case report, with changes made to protect confidentiality, based on a scenario from practice to provide an overview of obstetric cholestasis, the investigations, diagnosis, risks and management options for this condition.

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Facilitating functional decision making in midwifery: lessons from decision theory

By Tupara, H
on Tuesday, 01 Apr 2008 in New Zealand College of Midwives Journal - Volume: 38

Midwives have a professional and ethical responsibility to facilitate and support a woman’s decision making without coercion. Communicating information to women is a necessity for a midwife and it can be a challenge when each woman is different and will make decisions from her own perspective. Midwives are in a position to influence women in decision making and this paper considers the decision process from a theoretical perspective, focusing on descriptive decision theory, concerning cognition and information processing, as one approach that midwives might find useful to consider in everyday practice. Four strategies are discussed as a response to knowledge of descriptive theory to do with utilising positive affect, involving whanau/family, modes of thinking and narrative.

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Editorial: Growing midwifery research in New Zealand

By Skinner, J
on Tuesday, 01 Apr 2008 in New Zealand College of Midwives Journal - Volume: 38

Research is a systematic examination of how and why we undertake our work, in order to improve the quality of care provided to the childbearing women and her family.

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