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Rhyme and reason - the use and value of poetry in midwifery practice and education

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

We frequently speak of midwifery as a ‘holistic’ occupation. The use of the word holistic implies a belief that the whole is greater than the sum of its parts, and assumes an interrelationship among those parts. In other words, we do not view the childbearing woman from a reductionist, biomedical perspective, as simply a physical entity. We understand her to be a complex being, influenced by the psychological, emotional, spiritual, social and cultural aspects of her life, all of which may impact on her physical health and well being, and vice versa. In order to help the woman to meet her unique needs in this period, we need to work with her with an open heart and an open mind (Anderson & Davies, 2004). We seem to understand that the clinical skills which have historically been given primacy, need to be further augmented with communication and interpersonal skills; emotional and spiritual literacy; team skills; problem-solving; lateral thinking; flexibility and adaptability. These are skills that we now recognise as being essential in developing the critically thinking, solution focused midwife, required to provide care for women in the 21st century (Davies, 2007). By encouraging the development of creative expression in midwifery education, we may begin to draw upon these alternative skills and the arts may provide a vehicle for this.

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Staying or leaving: A telephone survey of midwives, exploring the sustainability of practice as Lead Maternity Carers in one urban region of New Zealand

By Wakelin, K, Skinner, J
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

The sustainability of Lead Maternity Carer (LMC) midwifery practice is an issue of growing concern. In one urban region of New Zealand there appeared to be a large number of LMC midwives indicating that their way of working was unsustainable, resulting in fewer midwives being available to provide primary maternity care. A structured telephone survey of 94 practising and non-practising LMC midwives from this region was undertaken to identify reasons that support midwives to continue practising as LMC midwives and also to identify reasons why midwives leave practice. Continuity of care and the quality of the relationships that are developed with women were the main reasons that supported and sustained LMC midwives in practice. Paradoxically these reasons also caused midwives to leave. Seventy eight percent of the midwives surveyed stayed on-call for births, an indication of the lack of home/work balance that they were able to attain. Midwives need to develop work practices that acknowledge the rewards of continuity, while at the same time provide the space for rest, for family, and for friends.

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Rural midwifery and the sense of difference

By Patterson, J
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

In New Zealand from the late 1960s the visits from the Maternity Services Committee to maternity facilities began the inexorable changes that led to a fully regionalized rural maternity service. Increased surveillance and compliance requirements in the wake of these changes accelerated the rate of rural maternity hospital closures. Throughout the ensuing decades midwives in rural areas have maintained their distinct rural identity while working to maintain a rural birthplace option for women. This identity is primarily founded on their expertise and confidence to support well women to birth at distance from secondary services. They are also firmly enmeshed in their communities and express a sense of both physical and perceptual difference from urban colleagues. Nevertheless the process of regionalization continues in subtle and complex forms driven by a mix of social, scientific and bureaucratic imperatives. Thus midwives and women in rural areas are challenged on a daily basis in their efforts to preserve a viable rural birth option.

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A hermeneutic analysis of the rise of midwifery scholarship in New Zealand

By Smythe, L
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

In the past 25 years there has been a significant rise of scholarly activity, meaning university-based postgraduate education and research, amongst New Zealand midwives. This paper records stories of that change, accessed through a hermeneutic research study. The analysis is through the viewpoint of the author, Liz Smythe, who was one of the first New Zealand midwives to gain a PhD supervised by midwives, about midwifery. She uses her own story as a scaffold to view the stories of her peers. Five other midwives participate in this study, with data drawn from interviews and written reflections. The purpose of the study was to capture stories pertaining to scholarship to reveal the manner in which a variety of individuals, each choosing her own pathway, came to establish an early wave of New Zealand midwifery researchbased scholarship. It is a snapshot of history that offers insight into the play between profession, practice, and scholarship. Some of the key leaders, notably Joan Donley, had minimal involvement with university life. Karen Guilliland and Sally Pairman addressed the professional/practice issues from outside university and later turned to university-based scholarship to document the insights. Others, such as Liz herself, attained tertiary qualifications and were ready for the new era of degree level training. Some doctorally prepared midwives came from overseas to share the leadership of postgraduate education and research. A strong theme emerging from the study is the huge commitment the scholarly leaders made in the development and reshaping of midwifery. Questions are raised about the future of midwifery scholarship in a climate of fierce competition for research funds. It is argued that scholarship is vital to underpin and guide the midwifery profession, but at what cost to the individuals involved? What strategies are needed to ensure scholarship remains strong and responsive? These questions need to be addressed by the profession.

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Iron Supplementation - is it necessary for healthy pregnancy?

By Elias, S
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

Iron is an important mineral during pregnancy for both mother and fetus. Although the food supply provides numerous sources of iron, many women of child-bearing age in New Zealand consume intakes below what is recommended. The beneficial effects of iron supplementation in pregnancy on birth outcomes are controversial however maternal benefits have been clearly identified. The recommended dose for iron supplementation in pregnancy is generally accepted to be between 30-100 mg/day. Even when the women is aware of the importance of obtaining adequate dietary iron and are encouraged by midwives to follow healthy eating practices, iron supplementation may be indicated in some situations. Midwives should therefore assess women based on their iron status and history and provide appropriate advice regarding diet and supplementation to support healthy pregnancy.

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Editorial: Welcome to Dr Joan Skinner as new editor

By Davies, R
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

New editor for New Zealand College of Midwives Journal

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Young and pregnant - Erratum

By Payne, J, Smythe, L
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

Erratum regarding order of authors' names

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Young and Pregnant - letter to editor

By Payne, J, Smythe, L
on Monday, 01 Oct 2007 in New Zealand College of Midwives Journal - Volume: 37

Letter to editor regarding order of authors' names.

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Young and Pregnant

By Smythe, L, Payne, J, Please see Erratum
on Sunday, 01 Apr 2007 in New Zealand College of Midwives Journal - Volume: 36

This study reveals the experience of ‘being pregnant’ as a young woman. The research is set in the context of South Auckland, New Zealand, where women under the age of 19 face the opinions and judgments of a societal view that they are too young to be pregnant. Using a phenomenological approach it captures their perspective of the many tensions they face. ‘Being pregnant’ changed the young women in this study. They talked of ‘coming to accept’ being pregnant while ‘becoming’ significantly different. Even with the ‘shock’ of the news and the implications of it, these young women talk about having a sense that it was ‘right’ to keep on with the pregnancy. In the face of many difficulties young women show how they adapt to the changes thrown upon them. They are influenced by peers, impacted by society and frightened of the future. It is only when the pregnancy ‘hits’ young women that they comprehend what it means to be pregnant. In this experience young women seek out ‘others’ who will provide them with necessary support and care. One significant ‘other’ is the midwife. This study has exposed the need for midwives to ‘work alongside’ young pregnant women assisting them in making the experience of ‘being pregnant’ easier. It is vital that midwives earn the trust of young women so that they can provide effective midwifery care.

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The current global effort to prevent Postpartum Haemorrhage: How likely is it to be effective?

By Guilliland, K
on Sunday, 01 Apr 2007 in New Zealand College of Midwives Journal - Volume: 36

This paper outlines the global effort by health professional agencies to reduce maternal deaths by managing the third stage of labour actively. It explores the tensions in the way midwifery and obstetric practice changes evolve, and are implemented, within developing and developed worlds. It questions the effectiveness of introducing the Western birth management practice of actively intervening in the third stage of every woman’s birth when that intervention relies on certainty of access to pharmaceuticals. It argues that complex problems require complex solutions, and that the midwifery profession should have a clear rationale for its decisions in relation to any intervention in labour and birth before promulgating major change.

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