No

Yes

Yes / Pregnant women seeking asylum in the UK may be particularly vulnerable with poor underlying health, more complex pregnancies and an increased risk of maternal and perinatal mortality. Studies have shown that some women seeking asylum have poor experiences of maternity care. This is despite the implementation of NICE guidelines to improve care for women with complex social factors. This article reports on a phenomenological study undertaken in West Yorkshire, aiming to explore the maternity care experiences of local pregnant asylum seeking women, to inform service development. Six women were interviewed over a three-month period. The findings focused more broadly on their experiences of living in the UK whilst being an asylum seeker and pregnant rather than focusing on maternity care, although this was included. Five key themes emerged: ‘pre-booking challenges’, ‘inappropriate accommodation’, ‘being pregnant and dispersed’, ‘being alone and pregnant’ and ‘not being asked or listened to’. These findings could be used as the basis for training midwives to understand how the difficulties women experience can impact on their health and social needs.

Background: Perinatal depression disproportionately affects asylum seeking and refugee (AS&R) women, but they are less likely to receive support than other women. There is no published research which considers the assessment and support for symptoms of perinatal depression provided by midwives for AS&R women navigating England’s maternity services. Aim: To investigate how midwifery practice can be developed to support asylum seeking and refugee women with symptoms of perinatal depression. Methods: A post-colonial feminist inquiry consisting of a scoping survey (study one) and a qualitative research study (study two) using remote interviews with AS&R women and midwives. Qualitative data was analysed using reflexive thematic analysis. Findings: Study one demonstrated that midwives who care for AS&R women work within diverse roles and service structures across England. Study two identified that midwives lack the resources and support structures required to effectively recognise and support symptoms of perinatal depression in AS&R women. These factors were sometimes invisible to AS&R women, but still negatively affected their ability to effectively discuss perinatal depression with a midwife and access help for any symptoms. The lack of appropriate resources was harmful to both AS&R women and midwives. Conclusion: AS&R women and midwives who care for them navigate an inequitable maternity system in England. Midwives do not have the appropriate resources to provide a level of care which is equitable to women in the general maternity population. This leaves AS&R women’s perinatal mental health needs unrecognised and unmet, acting as a barrier to receiving effective support. / Mary Seacole research development scholarship

M.Cur. / In this study a qualitative design which is explorative, descriptive and contextual in nature is followed. The objective of the study is three-fold: firstly, to explore and describe the opinions of members of the community about the reasons for the under-utilization of the Midwifery Obstetrical Unit ; secondly, to explore and describe the suggestions of the community for improving the utilization of the Midwifery Obstetrical Unit and, thirdly, to formulate intervention strategies for community nurses to improve the utilization of the MOU. Data was collected by means of focus group interviews, and was analysed using Tesch's method of data analysis. Trustworthiness was ensured by using the method of Guba and Lincoln. The participants in research were mothers who delivered their babies at the hospital, mothers who delivered their babies at the MOU, members of the Community Health Committee and MOU nurses.

No / It is becoming increasingly common for midwives to care for women who do not speak English, and UK interpreting services are often inadequate and underused. Persistent language barriers have been found to contribute to maternal and perinatal mortality thus it is essential that these barriers are overcome to provide safe maternity care. This article reports on a two-stage study undertaken to address this. The study aimed to: • Identify difficulties midwives experience when communicating with non-English-speaking women. Through undertaking a group interview with 11 senior students, four themes emerged: accessing interpreters, working with interpreters, cultural barriers and strategies to address persistent language barriers • Explore the feasibility of using mobile devices with a translation application to communicate in clinical practice. Google Translate was tested in a simulated clinical environment with multi-lingual service users. Google Translate was not adequately developed to be safely used in maternity services. However, a maternity-specific mobile application could be built to help midwives and women communicate in the presence of a persistent language barrier.

Yes / Asylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women.

Current literature has indicated a concern about standards of maternity care experienced by pregnant asylum seeking women. As the next generation of midwives, it would appear essential that students are educated in a way that prepares them to effectively care for pregnant asylum seekers. Consequently, this study examined the way in which midwifery students constructed a pregnant asylum seeker's health and social needs, the discourses that influenced their constructions and the implications of these findings for midwifery education. For the duration of year two of a pre-registration midwifery programme, eleven midwifery students participated in the study. Two focus group interviews using a problem based learning (PBL) scenario were conducted. In addition, three students were individually interviewed and two students' written reflections on practice were used to construct data. Following a critical discourse analysis, dominant discourses were identified which appeared to influence the way that pregnant asylum seekers were perceived. The findings suggested an underpinning discourse around the asylum seeker as different and of a criminal persuasion. In addition, managerial and medico-scientific discourses were identified, which appeared to influence how midwifery students approach their care of women in general, at the expense of a woman centred, midwifery perspective. The findings from this study were used to develop 'the pregnant woman within the global context' model for midwifery education and it is recommended that this be used in midwifery education, to facilitate the holistic assessment of pregnant asylum seekers' and other newly arrived migrants' health and social needs.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Registered midwives are expected to practice their duties within the parameters of their scope of practice. Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact for both the pregnant woman and the Department of Health. Aim of the study The aim of this study was to explore and describe the experiences of midwives working in maternity units, concerning midwifery practice breakdown in maternity units at a public hospital in KZN. Methodology A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim then organised into codes. Results The study revealed that the majority of the participants faced practice breakdown almost daily and most of the midwifery practice breakdowns start during antenatal care visits. Midwives who attended to pregnant women during antenatal care did not follow set protocols and guidelines and this resulted in complications during delivery. Most midwives were emotionally stressed and did not wish to continue practicing midwifery. Midwives were of the opinion that the management did not care about their challenges and did nothing to resolve the challenges. / M

In India, globalized flows of bio-medical discourse, practices and technologies are reshaping the field of reproductive healthcare, and the performance of childbirth more specifically. These projects aim to produce institutional delivery rooms that are "safe and modernized" by equating the utilization of westernized, obstetric techniques for managing delivery with better birth outcomes. Yet, these projects often evoke dynamic tensions between the imagined labor rooms NGOs seek to produce and the lived realties of labor in a local context. In this thesis, I examine the ways NGOs market and disseminate state and global discourses around safe, institutional delivers to local communities through a case study of one NGO working in rural southern Rajasthan. Drawing on data from participant observation and in-depth, semi-structured interviews with NGO staff and skilled-birth attendants employed by community health centers, I argue that at the interface of NGO, state, and global relations of power, a commodified discourse in the form of Evidenced-based Delivery (EBD) practices is emerging. This discourse is marketed through a political economy of hope that promotes EBDs as essential for safe delivery. In this system, NGOs function as conduits for transmitting idealized notions of the safe and modern delivery room, and thereby affect a shift in what skilled-birth attendants and communities come to expect from their childbirth experiences -- expectations that I argue are often difficult to meet given current training levels, limited economic resources, and a diverse set of cultural values around childbirth. My findings indicate that while Evidence-based Delivery practices may improve birth outcomes in some contexts, in the delivery rooms of rural Rajasthan, they are functioning essentially as technologies that capitalize on the political economy of hope by evoking the medical imaginary. / Graduation date: 2012