Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1995.

This qualitative study was aimed at exploring midwives’ responses and attitudes towards women in labour, as well as their perception of the pain experienced during labour. A non-probability purposive sampling method was followed, and the data collection methods selected were in-depth individual interviews and focus-group interviews, with the aid of an interview guide for both methods, the researcher being the main data collecting instrument. More than one data collection method (triangulation) was used to ensure the trustworthiness of the study. Concerning the perception of midwives towards women experiencing labour pain, the study revealed that firstly, labour pain is unique to individual women, it is natural and bearable. Secondly, labour pain may be unbearable, and the women in labour need to be given medication for pain. Furthermore, certain behaviour was identified and viewed as unacceptable by participating midwives because it could put both the lives of the mother and the unborn baby at risk; these include: drinking herbal medicines during pregnancy and childbirth; extreme activities like jumping out of bed and rolling on the floor. These behaviours were sources of frustration to midwives. / Health Studies / M.A. (Health Studies)

Thesis (M.Sc. (Nursing)) -- University of Limpopo, 2016 / The aim of this study was to determine the adaptations of midwives to their work after maternal deaths at a tertiary hospital complex in Limpopo Province. Qualitative phenomenological, exploratory, descriptive and contextual research design was used. Snowball sampling was used to select 22 midwives who experienced maternal deaths. Semi-structured interviews with a guide and audiotape were used to collect data. Tesch’s eight steps of qualitative data analysis were adopted. The study revealed that the midwives had traumatic experiences after maternal deaths and were failing to adapt to their work. Strategies to enhance the adaptation of midwives to their work after maternal death were developed. The study recommends that support, debriefing session, group therapy and counselling should be provided to the affected midwives. There should be provision of adequate number of midwives and material resources in the maternity units to maintain acceptable midwifery care. Sufficient number of midwives should be trained for advanced midwifery to increase capacity in the maternity units. Keywords: Adaptations, midwives, maternal deaths, tertiary hospital

PhD (Health Sciences) / Department of Advanced Nursing Science / Introduction: For newly graduated midwives to function effectively with regard to provision of quality midwifery services, successful transition from student status to professional status should be enhanced. It is therefore important that transition support programmes be put in place in order to provide a baseline for guidance and support of newly graduated midwives. Purpose: The purpose of this study was to develop a transition support programme to enhance effective support of newly graduated midwives during their transition period in Limpopo Province, South Africa. Setting: The study was conducted in maternity units of selected regional hospitals and a tertiary hospital in all the districts of Limpopo Province, South Africa. Methods: Phase 1: A qualitative, exploratory and descriptive design was used for the study. The population comprised of all newly graduated midwives who have undergone a comprehensive nursing programme (R425 of 19 February 1985, as amended) and qualified as nurses (General, Psychiatric and Community) and Midwifery from the universities and nursing colleges; as well as all professional nurses working at selected hospitals. A non-probability, purposive sampling method was used to select five newly graduated midwives who have been working for a period less or equals to one year following their successful completion of training, and were working in maternity units of the selected hospitals. Five professional nurses qualified as midwives and have been working in maternity units of the selected hospitals for at least five years, were also sampled through a non-probability, purposive sampling method. Data were collected through in-depth individual face-to-face interviews; a ABSTRACT vii voice recorder was used to capture information shared by participants, and field notes were also taken. An open-coding method was used to analyze data. Ethical principles and measures to ensure trustworthiness were considered. Major themes, themes and sub-themes were identified from the analyzed data. The following major themes emerged from data analysis: Experiences of being a newly graduated midwife in labour ward, Support provided by experienced midwives, Relationship between experienced and newly graduated midwives in labour ward, Expectations of experienced midwives from newly graduated midwives as well as Newly graduated midwives’ views related to placement in the labour ward. Empirical findings revealed that newly graduated midwives viewed labour ward as a traumatic environment as it is very busy with serious shortage of staff. Graduates also expressed a professional nurse’s role as stressful as it demands high level of responsibility and accountability which they did not have, resulting in frustration and anger. Newly graduated midwives felt that the support they received from the experienced midwives was ineffective, as they were neither mentored nor properly supervised and the environment was not conducive for learning. The relationship between graduates and experienced midwives was poor and some experienced midwives displayed negative attitudes towards the graduates. Results showed that graduates failed to meet experienced midwives’ expectations as they were unable to function independently, resulting in failure to reduce the workload. Newly graduated midwives recommended that their placement in maternity ward be extended from a period of six months to a year in order for them to build confidence in midwifery practice. Phase 2: Results of phase 1 of the study revealed transition support gaps which led the researcher to analyze ‘effective transition support’ as a core concept. Concept analysis was done in accordance with Walker and Avant’s method; in order to clarify its meaning. The findings of both phase 1 and concept analysis guided the ABSTRACT viii development of a transition support programme aimed to enhance effective support of newly graduated midwives during their transition period. Development of a transition support programme was based on Duchscher’s transition theory as well as ADDIE’s model for training and instructional design, the steps of which were: analysis, design, development, implementation and evaluation. A developed transition support programme was validated using a quantitative approach, whereby exploratory and descriptive designs were employed. The main aim was to validate for effectiveness and applicability of a developed transition support programme. Validation was conducted in a similar setting as in phase 1, with the same population. Puposive sampling method was used to select participants who met inclusion criteria. A sample consisted of twelve (12) newly graduated midwives, thirty eight (38) experienced midwives of which thirteen (13) were operational managers. A self developed questionnaire was used for data collection. The validation process was based on a framework for programme evaluation in public health by the Centers for Disease Control and Prevention. According to the validation results, the developed transition support programme met the standard as it can be easily implemented, it is practical, utilizable, appropriate and will benefit patients, family members, health care facilities and the community at large. Recommendations: The developed transition support programme addressed the major challenges identified in the findings of the main study. Only aspects of the results which were not addressed by the developed transition support programme were covered in the recommendations. Recommendations were directed to the nursing education, nursing practice as well as future research. / NRF

Thesis (M.Dev.) --University of Limpopo, 2007 / The study sought to develop guidelines that are aimed at improving Termination of Pregnancy (TOP) services that are rendered by public hospital based midwives. The researcher applied a qualitative and descriptive design. The study targeted midwives in the Bohlabela District, which has three hospitals. A non-probability purposive sampling was used to 6 midwives who are currently conducting TOP services in the hospitals. Data collection was both in-depth and conducted in face-to-face interviews with each participant. The findings of the study were analyzed, categorized into sub-themes, and revealed that midwives who conduct TOP services experience the following challenges, namely: inadequate human resource, poor infrastructure, lack of equipments, poor management support, and lack of support from doctors. Based on the findings of the study, it is imperative that all hospitals be designated centres for TOP services, so as to reduce the workload in the few hospitals that currently are inundated. The infrastructure needs to be improved, information about TOP services to the public has to be disseminated through awareness campaigns, and scarce skills allowances must be introduced. In addition, more staff members need to be employed. The study further recommends that the TOP policy guideline be reviewed in terms of allowing other competent health professionals to perform TOP. Chapter two discusses the literature review regarding the challenges that affect midwives who conduct TOP. In this study, theresearch compares the practice of TOP by the developing and developed countries, looks at related to laws at on TOP; gives an overview of sterilization Act in South Africa; mentions the amendments of laws on TOP; considers other legal restrictions; presents mandatory counseling for TOP clients; focuses on religious, cultural and traditional beliefs. The researcher has consulted different literatures, journals articles and website on challenges that affect midwives in rendering TOP in Limpopo, South Africa and world wild. Chapter three presents research methodology that consists of research design; area of study; population; sampling method; data collection method and procedure; ensuring trust worthiness; and ethical consideration, to be followed by limitation of the study. Chapter deals with data analysis and interpretation. Chapter five presents the researcher’s conclusions and recommendations.

Thesis (M.A. (Nursing Science)) -- University of Limpopo, 2020 / The aim of the study is to determine the knowledge and practices of midwives regarding the utilization of cardiotocography in labour units, at Hospital A and Hospital B, Waterberg District in Limpopo Province. Further, the objective of the study is to explore and describe the knowledge and practices of midwives regarding the utilization of cardiotocography in labour units and to develop strategies to enhance midwifery practices and knowledge regarding the utilization of cardiotocography in the labour units of Hospital A and Hospital B. The research question is:” What is the knowledge and practices of midwives regarding the utilization of cardiotocography in the labour units of Hospital A and Hospital B?” The Donabedian Model has been used as a theoretical framework. A qualitative exploratory, descriptive and contextual research design has been used in this study. Purposive sampling was used to sample eighteen (18) participants from Hospital A and Hospital B. Data was collected using semi-structured interviews. Tesch’s eight steps of qualitative data analysis were followed and two themes and ten sub-themes emerged. The study found that there were several challenges encountered by participants such as a shortage of material and human resources and lack of continuous training which has a negative impact on the provision of midwifery care. The study recommends that the Department of Health should appointment new skilled midwives as there is shortage of staff, to improve service delivery. It should ensure that there is a guaranteed supply and availability of equipment, such as CTG. The nursing administration should ensure that there is adequate training for midwives. This includes in-service training, workshops and a post basic advanced midwifery course.

This study examines the oral histories of midwives who practiced in Ontario without legal status in the two decades prior to the enactment of midwifery legislation on December 31, 1993. The following questions are answered: Who were Ontario’s pre-legislation midwives? What inspired and motivated them to take up practice on the margins of official health care? Current scholarship on late twentieth century Ontario midwifery focuses on a social scientific analysis of midwifery’s transition from a grassroots movement to a regulated profession. Pre-legislation midwives are commonly portrayed as a homogenous group of white, educated, middle class women practicing a “pure” midwifery unmediated by medicine and the law. Analysis of the oral history narratives of twenty-one “alegal” Ontario midwives reveals more complex and nuanced understandings of midwives and why they practiced during this period. The midwives’ oral histories make an important contribution to the growing historiography on modern Canadian midwifery.

This study examines the oral histories of midwives who practiced in Ontario without legal status in the two decades prior to the enactment of midwifery legislation on December 31, 1993. The following questions are answered: Who were Ontario’s pre-legislation midwives? What inspired and motivated them to take up practice on the margins of official health care? Current scholarship on late twentieth century Ontario midwifery focuses on a social scientific analysis of midwifery’s transition from a grassroots movement to a regulated profession. Pre-legislation midwives are commonly portrayed as a homogenous group of white, educated, middle class women practicing a “pure” midwifery unmediated by medicine and the law. Analysis of the oral history narratives of twenty-one “alegal” Ontario midwives reveals more complex and nuanced understandings of midwives and why they practiced during this period. The midwives’ oral histories make an important contribution to the growing historiography on modern Canadian midwifery.