"I know that every day I am gaining experience ... learning more" (Int. 6(a)) This thesis examines the social practices and associated learning that shape the meaning of midwifery for new members of the profession. In doing so it explores the extent to which the implications of practice either liberate or circumscribe midwives' identity formation. The thesis further suggests how this identity formation may impact upon commitment to a long term career in midwifery. The theoretical framework for this thesis acknowledges that continuing professional development and evidence of recognised learning activity is, for all midwives, a professional requirement. However, less attention has historically been paid to the unstructured, unintended and relatively informal learning that occurs within and throughout midwives' involvement in everyday practice. It is through these forms of learning, and drawing upon data elicited through surveys, interviews and diaries, that this thesis seeks to make a contribution. Using a social model of learning, particularly through Wenger's (1998) work on communities of practice, the development of identity is presented as a negotiated process mediated to a greater or lesser degree by workplace relationships. Whilst relationships with pregnant women form an important element of this process, the thesis argues that collegial relationships generally assume greater importance and impact on the development of identity and meaning for newly qualified midwives. By situating the everyday experiences of newly qualified midwives within a broader theoretical debate about social learning, identity and the making of meaning, this thesis suggests that the contemporary 'doing' of hospital based midwifery remains within what are fairly narrowly prescribed, contested, yet firm boundaries. The development, existence and negotiation of these boundaries is central to the space which pregnant women, midwifery and midwives can occupy. These boundaries are simultaneously hierarchical, intra professional and personal. Furthermore, in practice, these boundaries are frequently unclear and rapidly changing. Whilst this contributes to a potentially dynamic opportunity for identity formation, the thesis demonstrates how this also transpires to contribute to an unstable, frustrating and frequently challenging context particularly for newly qualified members of the profession. Overall, this thesis contributes to an understanding of the development, or lack of development, of midwifery practice at theoretical, conceptual and practical levels. Viewing practice as social learning offers a new perspective on the opportunities and challenges inherent in the current model of care. Simultaneously it suggests a new perspective on the recruitment crisis faced by the profession and accordingly the opportunity for new potential solutions.

The purpose of this study was to identify the need for a training programme and to develop the training programme to meet the needs of traditional birth attendants in the management of pregnancy, labour and puerperium. The study was conducted in the Flagstaff district which is one of the districts of the north eastern region (region E) of the Eastern Cape. The target group consisted of all the traditional birth attendants who availed themselves at the residential clinics of Flagstaff district and the number is not known as not all traditional birth attendants who presented themselves are recognized by their communities as traditional birth attendants. The study was a quantitative descriptive design and the data was collected by means of structured interviews using a questionnaire that was designed by the researcher. According to the findings the traditional birth attendants are functioning without being formally trained before. They lack knowledge and skill in the management of pregnancy, labour and puerperium. Some of their practices are reason for concern, for example cephalic versions and not using protective devices. There is a need for the development of the training programme in the Flagstaff district. This programme was developed from the information obtained from the data-analysis and is given as annexure F / Health Sciences / M.A. (Advanced Nursing Sciences)

The purpose of this study was to identify the need for a training programme and to develop the training programme to meet the needs of traditional birth attendants in the management of pregnancy, labour and puerperium. The study was conducted in the Flagstaff district which is one of the districts of the north eastern region (region E) of the Eastern Cape. The target group consisted of all the traditional birth attendants who availed themselves at the residential clinics of Flagstaff district and the number is not known as not all traditional birth attendants who presented themselves are recognized by their communities as traditional birth attendants. The study was a quantitative descriptive design and the data was collected by means of structured interviews using a questionnaire that was designed by the researcher. According to the findings the traditional birth attendants are functioning without being formally trained before. They lack knowledge and skill in the management of pregnancy, labour and puerperium. Some of their practices are reason for concern, for example cephalic versions and not using protective devices. There is a need for the development of the training programme in the Flagstaff district. This programme was developed from the information obtained from the data-analysis and is given as annexure F / Health Sciences / M.A. (Advanced Nursing Sciences)