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Showing papers in "The British Journal of Midwifery in 2010"


Journal ArticleDOI
TL;DR: A review of the existing midwifery literature associated with reflexivity can be found in this article, where the importance of this process is highlighted demonstrating how it remains an integral part of ensuring the transparency and quality of research inquiry.
Abstract: This article critically examines the existing midwifery literature associated with reflexivity. Reflexivity is a widely accepted concept central to qualitative research methodology. The importance of this process is highlighted demonstrating how it remains an integral part of ensuring the transparency and quality of research inquiry. This article sets out to review the literature; expand the concept of reflexivity from a midwifery perspective and reinforces the need for practitioner researchers to gain understanding and acknowledge reflexivity. This will ensure strong and trustworthy inquiry and allow the researcher to explore and make sense of the relationship between themselves, the research and the object of research.

113 citations


Journal ArticleDOI
TL;DR: It is estimated that 100–140 million girls and women worldwide are currently living with the consequences of female genital mutilation (FGM) (World Health Organization, 2008).
Abstract: It is estimated that 100–140 million girls and women worldwide are currently living with the consequences of female genital mutilation (FGM) (World Health Organization, 2008).

41 citations


Journal ArticleDOI
TL;DR: In this article, the authors investigated what is shaping the understanding of the public and also the practice of health professionals in relation to increasing rates of intervention in childbirth in New Zealand using critical hermeneutics methodology.
Abstract: This article presents the findings of research which investigated what is shaping the understanding of the public and also the practice of health professionals in relation to rising rates of intervention in childbirth. This research was carried out in response to the increasing rates of intervention in childbirth in Aotearoa, New Zealand using critical hermeneutics methodology. The particular approach used was critical interpretation as formulated by Hans Kogler. The findings revealed that the everyday world and its associated processes of socialization in the 21st century—in particular pain, choice, and technology—shapes the practice of health professionals and the understanding of the public in relation to increasing intervention. These findings are supported by the revelation that many of the social and cultural values that underpin Western society in the 21st century, such as convenience, ease, and control, correlate with intervention being increasingly sought after and used. This milieu of interventi...

36 citations


Journal ArticleDOI
TL;DR: Advice from midwives to stay at home in early labour may be insufficient to reassure women who lack trust in their own ability to interpret what is happening in labour, and who depend on health professionals.
Abstract: The aim was to explore women's experiences of staying at home following advice from an obstetric triage unit. Semi-structured interviews were undertaken with eight women who contacted a triage unit in early labour and were advised to remain at home; interviews were analysed using thematic analysis. Four themes were identified: reassurance (the need to have labour validated by health professionals); uncertainty about early labour; pressure from women's families to go to hospital; and seeking permission to come in. The overall theme reflected women's sense that advice to stay at home was a professional rather than a woman-centred response to early labour. Advice from midwives to stay at home in early labour may be insufficient to reassure women who lack trust in their own ability to interpret what is happening in labour, and who depend on health professionals. Until women's own faith in their ability to labour and give birth can be restored, women may feel obliged to stay at home in early labour, rather than feeling comfortable to do so.

34 citations


Journal ArticleDOI
TL;DR: In order to support the relationship of same-sex parents in parenthood it is important for midwifery staff to recognize co-mothers as an equal parent of the child.
Abstract: Growing numbers of openly gay women choose to have children, but there have been few studies on the topic. The aim of this study was to describe the co-mother's experiences of care provided during their partner's pregnancy, childbirth and the postnatal period. Six co-mothers were interviewed between six weeks and three years after the birth of their child. The open interviews were analysed using content analysis. The overall theme of the findings was 'like everyone else, but not quite'. The following main categories were identified: need for acknowledgement, need for care designed to suit same-sex couples, and in the hands of nursing staff. Co-mothers felt themselves to be 'like everyone else but not quite'. In order to support the relationship of same-sex parents in parenthood it is important for midwifery staff to recognize co-mothers as an equal parent of the child

26 citations


Journal ArticleDOI
TL;DR: This analysis presents definitions and defining characteristics of bonding, and model, contrary and borderline cases are presented to further enhance clarity and thereby inform operational definitions.
Abstract: Bonding is a complex phenomenon that occurs during a significant phase for the mother and her infant. However, the definition and use of the term bonding, frequently misleads because of the inclination to refine and oversimplify the attachment phenomenon. The objective of this concept analysis is, therefore, to clarify the meaning of this concept with specific reference to maternal-infant bonding. Adopting Walker and Avant's (2005) adaptation of Wilson's (1963) concept analysis procedure, bonding, as a concept, is analysed to arrive at a clearer and more accurate meaning. This analysis presents definitions and defining characteristics of bonding. Antecedents and consequences of maternal-infant bonding are also explored, while model, contrary and borderline cases are presented to further enhance clarity and thereby inform operational definitions. Implications for nursing and midwifery practice are discussed.

23 citations


Journal ArticleDOI
TL;DR: In this paper, a bullying and harassment protocol has been written to guide managers to use appropriate strategies to diminish the intensity of bullying within their maternity unit, and a Bullying and Harassment Scale (BAHS) has been devised to measure effectiveness of interventions targeted at reducing the problem.
Abstract: Bullying and harassment is a significant predicament that midwives face on a regular basis. Bullying and harassment may be characterized by unpleasant, threatening, malevolent or offensive behaviour. It involves abuse or misuse of power intended to undermine, humiliate, denigrate or harm the recipient. Deliberate bullying and/or harassment can have a major impact upon physical and mental health, as well as function within role. There are consequences for the persecutor, victim and institution in terms of health, cost and reputation. The objective of this paper is to provide managers with solutions to diminish levels of bullying and harassment within maternity units. To this effect, a bullying and harassment protocol has been written to guide managers to use appropriate strategies to diminish the intensity of bullying and harassment within their unit. To audit success, a Bullying and Harassment Scale (BAHS) has been devised to measure effectiveness of interventions targeted at reducing the problem.

22 citations


Journal ArticleDOI
TL;DR: The central findings of this Australian study were that women worry about their own health and their baby's; normality and the effects of their pregnant and potential birthing behaviours; and that pain is linked with vulnerability.
Abstract: The aim of this research was to provide a qualitative account of a number of women's everyday worries about childbirth. This was facilitated by asking women about their worries and identifying their social and personal contexts. The central findings of this Australian study were that women worry about their own health and their baby's; normality and the effects of their pregnant and potential birthing behaviours. In addition the study showed that pain is linked with vulnerability and that women feel they are not valued for their individual selves. This study has implications for professionals offering health services for pregnant women. It challenges health providers to reconsider assumptions about what it is women worry about and what measures should be taken. Understanding the complex ways that women worry about childbirth within social and personal contexts can improve knowledge and practice, and the experience of pregnancy and childbirth for women.

19 citations


Journal ArticleDOI
TL;DR: The findings suggested that, where there was an embedded use of traditional practice within the workplace, the students were more likely to adopt these traditional practices of their mentors.
Abstract: The aim of this study was to find out whether final-year student midwives were influenced by traditional (non evidence-based) practices of their clinical mentors. Questionnaires were used to collect data from 145 students from five different universities spread across the North of England. Despite students having perceived that the higher education institution (HEI) advocated evidence-based practices (EBP), the majority of students felt that what was taught in the HEI, did not always correspond to what happened in the workplace. Most agreed that within the clinical setting there were some practices that were based on tradition and agreed that some of these practices were good because they appeared to work. While the majority of students indicated a preference towards using EBP, the findings suggested that, where there was an embedded use of traditional practice within the workplace, the students were more likely to adopt these traditional practices of their mentors. While statistically most perceived they...

17 citations


Journal ArticleDOI
TL;DR: New undergraduate students of midwifery are provided ideas on how to plan for success through goal setting and time management.
Abstract: This article is aimed at new undergraduate students of midwifery. Health-care programmes are a mix of theory and practice and therefore have unique challenges. Juggling study and practice requirements, as well as your personal life can be daunting. This article provides ideas on how to plan for success through goal setting and time management.

16 citations


Journal ArticleDOI
TL;DR: It would appear that a combination of systemic and localized treatments is necessary to achieve adequate pain relief which will meet individual women's needs.
Abstract: This article discusses the care and consequences of perineal trauma which affects the majority of women. It is clearly evident from the literature that failure to recognize the extent of trauma, incorrect repair and inadequate pain relief can lead to negative consequences in both the short and long term. Women complain of varying degrees of perineal pain and discomfort and pain relief is an important aspect of midwifery care. It would appear that a combination of systemic and localized treatments is necessary to achieve adequate pain relief which will meet individual women's needs.

Journal ArticleDOI
TL;DR: Studies show that birth support can improve outcomes for mothers and babies and the feedback from women in Holloway is very encouraging, however, there is a need for more research into the needs and experiences of women and babies who are in prison during the perinatal period.
Abstract: The needs of women giving birth from prison were highlighted in 1995. A group of antenatal teachers and midwives in London met and decided to offer birth support to women in Holloway prison. Birth Companions has been working with pregnant women and mothers and babies in Holloway for 14 years and has expanded the birth support service to include breastfeeding and working with women post release. The aim of the project is to improve the experience of this vulnerable group of women and babies. Studies show that birth support can improve outcomes for mothers and babies and the feedback from women in Holloway is very encouraging. However, there is a need for more research into the needs and experiences of women and babies who are in prison during the perinatal period.

Journal ArticleDOI
TL;DR: This research highlights the need to understand more fully the rationale behind the continued use of these devices, as well as the barriers to their use, which are currently in place.
Abstract: Original article can be found at : http://www.intermid.co.uk/ Copyright Mark Allen Healthcare [Full text of this article is not available in the UHRA]

Journal ArticleDOI
TL;DR: In this paper, a descriptive prospective cohort study of all women who booked to give birth at a stand-alone birth centre (SABC) between March 2000 and April 2008 was conducted.
Abstract: The objective was to determine outcomes for women booked at a stand-alone birth centre (SABC) between March 2000 and April 2008. The design used was a descriptive prospective cohort study of all women who booked to give birth at a SABC from 2000 to 2008. All women who intended to deliver at the birth centre during the study period were approached. The main outcome measures were antenatal, intrapartum and postpartum transfer rates and reasons for consultant-led care, mode of delivery and perinatal outcome. Information was available for 5099 women who intended to deliver. Of this group, 29.9% of women were transferred in the antenatal period, 13.96% were transferred in labour and 5.09% transferred in the postnatal period. During the study period 3573 women were admitted to the Edgware Birth Centre (EBC) in labour and 2861 (80.07%) delivered at the EBC. The overall intrapartum transfer rate was 20%. Transfer rate was eight times higher in the primigravida cohort (35.9% vs 4.61%). Approximately 6% of women we...

Journal ArticleDOI
TL;DR: With the authors' professional backgrounds of midwifery, and one a professor of ethics, the reader can be assured the authors have the knowledge and expertise to write this book.
Abstract: With the authors' professional backgrounds of midwifery, and one a professor of ethics, the reader can be assured the authors have the knowledge and expertise to write this book.

Journal ArticleDOI
TL;DR: The exploration of the pattern of the MHR during labour and delivery demonstrates how an incorrect assessment of fetal wellbeing could be made if the monitor was used in isolation and the M HR was being reported rather than the FHR.
Abstract: Continuous electronic fetal heart rate monitoring is commonly used by clinicians during labour and delivery to assess fetal wellbeing. The Doppler ultrasound cardiotocograph (CTG) detects the fetal heart rate (FHR) and the uterine activity (toco) simultaneously and displays it in the form of graph. There have been reports of the FHR being substituted by the maternal heart rate (MHR) with this method of monitoring. FHR/MHR confusion left undetected can lead to adverse outcomes. This article gives an overview of the pattern of the MHR during labour in continuous maternal and fetal heart rate monitoring using an abdominal maternal and fetal electrocardiograph monitor (abfECG) in contrast with more traditional Doppler methods. The exploration of the pattern of the MHR during labour and delivery demonstrates how an incorrect assessment of fetal wellbeing could be made if the monitor was used in isolation and the MHR was being reported rather than the FHR. This article also explores how midwives can minimize th...

Journal ArticleDOI
TL;DR: This article will attempt to provide information on clinical practice to provide support and encourage women to continue to breastfeed while they receive treatment for postpartum depression.
Abstract: For many new mothers who suffer from postpartum depression, breastfeeding is a lifeline to their newborn baby. It may be the only validation of mothering they experience during this time. Mothers who continue to breastfeed while receiving treatment for postpartum depression have reported that breastfeeding was the only act that they felt identified them as the newborn's mother. There are many obstacles to the continuation of breastfeeding while a new mother experiences depression, such as medication management, sleep deprivation, and apathy and depressed mood. This article will attempt to provide information on clinical practice to provide support and encourage these women to continue to breastfeed while they receive treatment.

Journal ArticleDOI
TL;DR: This article considers the ongoing debate regarding the role of complementary and alternative medicine in a modern maternity setting and how the effectiveness of therapies should be assessed.
Abstract: Currently there is very limited research on efficacy and safety of complementary and alternative medicine when consumed by pregnant women. Yet the lack of scientific validation does not appear to be a deterrent and these therapies are becoming increasingly popular with both expectant mothers and midwives. Evidence‑based practice provides a structure to encourage good care in a clinical setting. However, there are a number of limitations when applying this approach to complementary therapies as much of the expertise is based on traditional knowledge and empirical wisdom, rather than contemporary scientific experimentation. This article considers the ongoing debate regarding the role of complementary and alternative medicine in a modern maternity setting and how the effectiveness of therapies should be assessed.

Journal ArticleDOI
TL;DR: This article addresses the range of issues that arise when an area is struck by disasters of natural and human origin, and considers how infant feeding practices are affected in a compromised environs.
Abstract: This article addresses the range of issues that arise when an area is struck by disasters of natural and human origin, and considers how infant feeding practices are affected in a compromised envir...

Journal ArticleDOI
TL;DR: The article finds that women should be allowed to push spontaneously and whether further research is necessary, or whether a change in the definitions used for the stages of labour would allow midwives to let women dictate when to push.
Abstract: There have been many papers written about the issue of pushing in the second stage of labour, and yet anecdotally some midwives are still restricted by labour ward policies of timed second stages, ...

Journal ArticleDOI
TL;DR: The individual nature of a woman's labour pain and how they cope with it is looked into, posing reasoning to practices such as birthing partners, certain complementary and alternative medicines, water births and home birth requests and their relationship to pain relief in labour based around a core concept of environmental changes in the birthing place from the Dutch word gezellig.
Abstract: Pain is a defining element of the labouring women's experience. This article explores and discusses the potential of gezellig as an underlying concept for the management of pain during labour. Pain is the psychological, emotional and learnt response to signals induced by noxious stimuli sent from around the body via the spinal cord, to the brain. How we react to them and perceive them is what we feel as pain and is as individual as a person is. Pain felt during labour and childbirth is a unique pain at a deeply emotional time for women. This article looks into the individual nature of a woman's labour pain and how they cope with it. It poses reasoning to practices such as birthing partners, certain complementary and alternative medicines, water births and home birth requests and their relationship to pain relief in labour based around a core concept of environmental changes in the birthing place from the Dutch word gezellig.

Journal ArticleDOI
TL;DR: This article discusses how students identify their own concerns related to specific NHS Trust placement sites and how they are solved using action learning.
Abstract: Caseloading is a relatively new aspect of midwifery education and as such it is useful to share information with students at other institutions. This article discusses how students identify their own concerns related to specific NHS Trust placement sites and how they are solved using action learning. This article makes reference to several articles that have been written on the topic of caseloading.

Journal ArticleDOI
TL;DR: Factors that influence some women's preference for elective caesarean section over vaginal delivery are explored and the existing evidence is discussed.
Abstract: UK caesarean section rates have seen an exponential rise in recent years. Despite recommendations from the Expert Maternity Group to implement woman-centred maternity services that encourage natural birth, and despite the publication of National Institute for Health and Clinical Excellence (NICE) guidelines in 2004, rates of abdominal delivery continue to increase. Caesarean section performed at a patient's request in the absence of medical indications is the source of extensive debate in the media and the medical professions. In 2002, 7.3% of all primary caesarean sections in the UK were performed at maternal request, costing the NHS in excess of £10 million. The reasons behind such requests are varied and often are influenced by social, cultural, emotional and economic factors. This review explores factors that influence some women's preference for elective caesarean section over vaginal delivery and discusses the existing evidence.

Journal ArticleDOI
TL;DR: A grounded theory study of pregnancy and childbirth experiences of women in rural Cambodia reveals high levels of clinically significant antenatal anxiety and depression with consequent links to low birth weight in the infant.
Abstract: This article is a report of a grounded theory study of pregnancy and childbirth experiences of women in rural Cambodia. Antenatal anxiety and depression have been linked to adverse outcomes of preterm delivery and low birth weight in the baby. Recent study findings from Cambodia reveal high levels of clinically significant antenatal anxiety and depression with consequent links to low birth weight in the infant. Thirteen in-depth interviews with rural pregnant women were conducted in December 2008 over 3 days during the midwifery outreach service to the villages. The research process followed the principles of grounded theory methodology. Four core categories were identified during the interview analysis: fear of childbirth, lack of information, traditional versus allopathic practice, and access to the government midwife. Childbirth causes fear, largely owing to a lack of knowledge about the normal physiological process and fear of death in the case of complications due to poor access to health services. T...

Journal ArticleDOI
TL;DR: A personal digital assistant was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet.
Abstract: Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women's participation in their maternity care; gives them an increased sense of control and improves communication among care providers. They have been successfully used in the UK and New Zealand for almost 20 years. Despite evidence that supports the use of hand-held records, widespread introduction has not occurred in Australia. The need for an electronic version of pregnancy hand-held records has become apparent, especially after the introduction of the Electronic Medical Record in Australia. A personal digital assistant (PDA) was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet. This article will describe the testing of the antenatal electronic maternity record.

Journal ArticleDOI
TL;DR: In this paper, a qualitative phenomenological research approach was used to evaluate student midwives' experiences of enquiry-based learning and evaluate their satisfaction with EBL as a teaching and learning strategy.
Abstract: Studies have evaluated enquiry-based learning (EBL) and problem-based learning in terms of student learning (Connelly and Seneque, 1999; Yeung et al, 2003; Williams, 2004), but the aim of this study was to listen to student midwives' experiences of EBL and evaluate their satisfaction with EBL as a teaching and learning strategy. The study took a qualitative phenomenological research approach. Analysis of the data identified five themes: students' satisfaction with EBL; impact on clinical learning; students' motivation; issues around group work; and the role of the facilitator. These themes are discussed in detail in this article with relation to available published literature. Overall, the students enjoyed and valued EBL as a learning strategy. A number of issues were identified and this article makes various recommendations to inform future developments in midwifery education.

Journal ArticleDOI
TL;DR: In this article, the authors present a template specifically designed to direct midwives through the procedures of constructing a research proposal, which is then used to communicate intent to the ethics committees and grant funding bodies before authorization and money are awarded.
Abstract: On occasion midwives may be required to construct a research proposal. In the current climate of evidence-based practice. Such activity is considered an elemental skill for career progression in both education and service. Examples of where writing a research proposal may be required include: writing an assessment for under and post graduate research modules or designing a dissertation, MPhil, Prof Doc or PhD. Within clinical practice there are also audit and evaluation of practice responsibilities. With these factors at the forefront, this article provides a template specifically designed to direct midwives through the procedures of constructing a research proposal. The purpose of a research proposal is to produce a template of common understanding from which tasks are allocated, divided and discussed by researchers, clinical staff and in some cases participants. The finished product is then used to communicate intent to the ethics committees and grant funding bodies before authorization and money are awarded.

Journal ArticleDOI
TL;DR: It is suggested that the longer the midwife has been out of practice the moredifficult it is for her to stay in practice.
Abstract: Over the last 10 years the government has been committed to a return to practice initiative to increase the number of practising midwives (Department of Health, 1999). In 2003, an audit undertaken locally found that only a third of those midwives remained in practice following a return to midwifery practice programme. It therefore seemed imperative to find out why, having completed the programme, midwives did not stay in practice. The sample group were those returnees who had completed the programme at the university since 2000. The research methodology included all returnees being sent questionnaires, of which 36% were returned, completed. The 21% who were not currently in practice were then interviewed. The results were similar to the findings of Ball et al (2002) and Kirkham and Morgan (2006), that dissatisfaction with midwifery practice and family commitments were the main reasons for not staying in practice. The findings also suggest that the longer the midwife has been out of practice the more diffi...

Journal ArticleDOI
TL;DR: An episode of Channel 4's One Born Every Minute involved a young couple having their second baby and choosing a vaginal birth after having an emergency caesarean the first time around.
Abstract: I watched with great interest a recent episode of Channel 4's One Born Every Minute. If you haven't seen it yet I recommend it because I found it compelling viewing. The particular episode I saw involved a young couple having their second baby and choosing a vaginal birth after having an emergency caesarean the first time around. The woman is post dates so an elective caesarean is booked but it is clear she is desperate to go into labour before this appointment because, she says, she felt she had ‘failed’ by not giving birth vaginally with her first child. She wants to be able to do ‘the one thing a woman's supposed to do’.

Journal ArticleDOI
TL;DR: Four main interconnected themes emerged: the need to define and understand the leadership role and its remit; theneed to develop the person within the role; the concept of having the space and time to meet the requirements of the role%; and the need for a career pathway to the role.
Abstract: The education and support of leaders at the level of ward or team leader is essential to move the government's plan forward for modernizing the NHS. This study considered the experiences of midwifery team leaders in a local community midwifery service in the NHS in England. A critical ethnographical approach was used. In-depth interviews with midwife leaders were the main source of data. Non-participant observation of team meetings and an examination of relevant job descriptions ensured immersion in the culture. Four main interconnected themes emerged: the need to define and understand the leadership role and its remit; the need to develop the person within the role; the concept of having the space and time to meet the requirements of the role; and the need for a career pathway to the role.