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Active Breech Birth: The Point of Least Resistance

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

In March 2006 I attended the first international Breech Birth Conference in Vancouver, Canada, which gathered together midwives, medical practitioners and researchers to discuss such issues as research, safety and techniques used during vaginal breech birth. Presenters came from eight different countries - Canada, Germany, Norway, Belgium, United Kingdom, Netherlands, Australia and New Zealand. It was a valuable time of exchanging ideas and heartening to meet other supporters of vaginal breech birth equally committed to growing and maintaining the skills necessary to support women during the experience. The multi-disciplinary programme meant accessibility to different approaches as well as an international flavour.

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Iodine and selenium - 'trace' minerals in New Zealand

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

The trace minerals iodine and selenium have many important functions during pregnancy and lactation, including a vital role in fetal and neonatal brain development. Although these nutrients are only required in small amounts, the dietary intake of these trace minerals in New Zealand has been reported to be suboptimal. There is a limited supply of iodine and selenium available in the New Zealand food supply. Therefore strategies, including regular consumption of foods containing these minerals and possibly supplementation, are required to ensure pregnant and lactating women consume adequate amounts of these minerals.

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Is it time for midwives in New Zealand to review sexually transmitted infection screening in pregnancy?

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

Increasing rates of sexually transmitted infections (STIs) in the developed world have been documented both internationally and within New Zealand, with the adverse effects of STIs on fetal, neonatal and women’s health recurring themes within the midwifery, obstetric and sexual health literature. Rates of STIs are also unequally distributed amongst the New Zealand population affecting higher proportions of youth, Maori and Pacific peoples. Although provision is made for maternal sexual health screening, the deteriorating sexual health profile of New Zealand and high rates of mother-to-child-transmitted STIs raise questions as to the effectiveness of this programme. This paper considers the existing literature to reaffirm the grounds for a competent sexual health component to maternity care and its contribution to equality of outcome and the promotion of normal birth. The findings of a small local survey of midwives’ sexual health screening practice are presented, suggesting the need for closer examination of midwives’ current knowledge, understanding and practice. A case is made for a nationwide strategy to address sexual health issues in New Zealand that takes advantage of the important role midwives could play in executing such a strategy.

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New Zealand Midwives and Tertiary Study

By Patterson, J, Davis, D
on Sunday, 01 Apr 2007 in New Zealand College of Midwives Journal - Volume: 36

To elicit factors influencing practising midwives with regard to tertiary study, a national survey was distributed attracting 386 responses from midwives working in a variety of settings. Many midwives engaged in tertiary study, cited personal interest and practice development as motivational factors, with midwifery practice topics providing the most interest. However midwives’ time restrictions, the cost of papers and lack of financial or other incentives inhibited study. Midwives preferred face-to-face delivery with other midwives rather than mixed classes, followed by distance delivery with paper-based materials. Mixed modes of face-to-face and distance, or Internet based delivery, were not favoured by the midwives. These factors should be considered when designing tertiary programmes for practising midwives, incorporating adequate information, interaction and communication.

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The faces of mentoring in New Zealand: Realities for the new graduate midwife

By Kensington, M
on Sunday, 01 Oct 2006 in New Zealand College of Midwives Journal - Volume: 35

This research examines the experiences of nine graduate midwives who were mentored in their first year of self-employed practice. The research used a feminist phenomenological approach, which gave me the opportunity to honour and respect what the midwives shared with me. In-depth semi-structured interviews were used to collect data that traced the transition the midwife makes in becoming an autonomous practitioner and the importance of a supportive mentoring relationship in assisting this journey. Being a self-employed midwife carrying a caseload can involve a range of personal and professional stresses. Midwives moving into self-employed practice, although registered competent to practice, identified that they wanted support to help establish confidence and discuss professional issues.

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The challenges of offering post mortem: an exemplar

By Bain, A
on Sunday, 01 Oct 2006 in New Zealand College of Midwives Journal - Volume: 35

Six thirty am and the phone was ringing. I was happy. It would be the lady who was five days overdue; finally we would be underway. It was, however, not to be. The call was from a woman who was only 35 weeks pregnant and who had had a stillbirth less than a year ago. She was bleeding. I was on the road within minutes after having rung my colleague to attend first as she was only three minutes’ drive from their house. My fifteen-minute drive had me covering many things in my mind but not the one I was greeted with. No fetal heart. The bleed was minimal. I had seen much more than that during labours with other women. The loss of the baby was huge. We transferred in the ambulance to the base hospital one hour away. We hoped for the best while we travelled. On arrival an ultrasound was performed which confirmed that the baby had died. We shed tears and struggled to believe that it could happen again. The woman went on to birth beautifully a very normal looking daughter. However this story is not about the birth but about the decision to proceed with a postmortem and the challenges that this presented to me as a midwife.

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Bipolar disorder: Implications and guidelines for midwifery practice

By Kenney, C
on Sunday, 01 Oct 2006 in New Zealand College of Midwives Journal - Volume: 35

Research suggests that potentially 2-2.5% of childbearing women in New Zealand may be affected by bipolar disorder; a psychiatric illness characterized by acute alterations in mood. It is therefore probable that midwives will provide care for women affected by this illness. This article examines the incidence of bipolar disorder and the implications for midwifery practice and maternity care provision in New Zealand. Guidelines are proposed for midwives, who provide care for women affected by this disorder during pregnancy, labour and the postpartum period. Maternal, fetal, and neonatal implications of standard pharmacological therapy for bipolar disorder are presented in tabular format.

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Exercise barriers faced by first-time mothers

By Jenkins, C, Handcock, P, Burrows, L, Hodge, K
on Sunday, 01 Oct 2006 in New Zealand College of Midwives Journal - Volume: 35

This qualitative research project explored the experiences of first-time mothers attempting to resume exercise after pregnancy. Emerging themes indicated that from pre-pregnancy to postpartum, barriers to exercise for first-time mothers increased and changed. Furthermore, the findings suggested that although the mothers shared several common barriers, each mother’s experience was unique. The non-resumers accepted their inability to undertake exercise and did not seek to negotiate their barriers. In contrast, resumers perceived that exercise was an important part of their new lifestyle and utilised cognitive and/or behavioural strategies to avoid or negotiate these barriers. These findings have implications for midwives, health and exercise professionals who are involved in helping first-time mothers resume exercise. In order to provide appropriate advice and support it is paramount that midwives, health and exercise professionals identify the mother’s expectations, knowledge, benefits, barriers, preferences and goals towards exercise.

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One mother’s experience – one midwife’s lesson

By Kiss, G
on Sunday, 01 Oct 2006 in New Zealand College of Midwives Journal - Volume: 35

Until recently reflux was one of those issues that I brushed off as an “overused label” that anxious parents gave to their fussy babies. It was of no interest to me as a midwife. Karma has a way of making you sit up and take notice. Since the birth of my 6th child I have ridden the “reflux rollercoaster” and had to embrace and confront my ignorance of this condition. Over the past year I have come to realise how traumatic having a reflux baby can be for parents and that reflux is a midwifery issue.

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Induction of labour: the influences on decision making

By Austin, D, Benn, C
on Saturday, 01 Apr 2006 in New Zealand College of Midwives Journal - Volume: 34

Th e study was undertaken to gain an understanding of why nulliparous women were having an induction of labour (IOL) and what influenced the decision to induce. Using an interpretive approach, 79 nulliparous women and 74 of the Lead Maternity Carers (LMC – Midwife, Obstetrician and General Practitioner) who cared for these women, were interviewed prior to induction, using a structured questionnaire with open ended questions, between December 2002 and April 2003. This paper focuses on the reasons identified for induction of labour by women and their LMCs, their understanding of the positive and negative effects of induction of labour, as well as some of the key themes identified from the interviews using a modified Boyatzis’ method of analysis.

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