In 1994, Ontario midwives became regulated independent providers of midwifery provincially and organized themselves into practices. At each practice two or more midwives act as partners responsible for overseeing a practice as an independent business. The purpose of this descriptive exploratory study was to describe selected aspects of the experiences of being an Ontario midwifery partner, including the benefits and drawbacks and how decisions are made and conflicts are resolved. Convenience sampling was used to recruit nine participants who met inclusion criteria. Semi-structured interviews were conducted via telephone. Findings revealed partnership benefits and drawbacks, decision-making and conflict resolution strategies and indicated that midwives’ experiences of partnership emerged from having been an associate midwife or past partner. Limitations include a small sample size, a novice researcher and telephone interviewing. Recommendations for further studies emphasized how to best prepare midwives for partnership and the impact of partner workload imbalance on intra-partnership relationships. / 2010 - 10

The expectations of a successful outcome are great during childbirth. The overall objective of prenatal care and birth care is that midwives contribute in creating the most positive experience of pregnancy, child birth and infancy as possible. During the past 30 years there has been a significant increase in sectiofrequency both in Sweden and the rest of the Western world. More parents feel an overall insecurity when it comes to child labour. The purpose of this study was to describe how midwives experience the work of creating a sense of security and good nursing when meeting the expectant parents. A phenomenological approach was chosen with the use of eleven qualitative interviews that were analyzed with Giorgis' method of analysis. The result revealed three themes: organizational - professional conditions, the communicative ability and the reflective - emotional competence. Trusting your inner sensibility and intuition was something that characterized all the interviews and was the essence of the results. The way work was lead and organized, as well as the utilization of competence effected the midwives’ possibility of contributing to a sense of security and good care. When the communication was based on sensibility, midwives’ could create a good and trustful relationship with the expectant parents. The emotional involvement was an essential requirement for carrying out the work in a satisfying way. A question for the future is how inner knowledge based on practical experience can benefit new personnel and how the organization and education for healthcare givers can utilize the specialist knowledge of midwives with experience. / Förväntningarna i samband med barnafödande är stora på att en graviditet ska sluta lyckligt. Det övergripande målet inom mödrahälsovård och förlossningsvård är för barnmorskor att medverka till en så positiv upplevelse av graviditet, förlossning och spädbarnstid som möjligt. De sista trettio åren har sectiofrekvensen ökat betydligt både i Sverige och västvärlden. Fler föräldrapar upplever idag en allmän otrygghet i samband med barnafödande. Syftet med denna studie var att beskriva barnmorskors upplevelser av att förmedla trygghet och en god omvårdnad i mötet med det blivande föräldraparet. Fenomenologisk ansats valdes med elva kvalitativa intervjuer som analyserades enligt Giorgis analysmetod. Resultatet visade tre teman: Organisatoriska - professionella förutsättningar, den kommunikativa förmågan och den reflektiva - emotionella kompetensen. Att lita på sin inre känsla och intuition var en upplevelse som genomsyrade hela intervjumaterialet och blev resultatets essens. Hur arbetet leds och organiseras och hur kompetens tillvaratas påverkade i hög grad barnmorskors möjligheter att förmedla trygghet och en god omvårdnad. Genom att vara lyhörd i sitt sätt att kommunicera kunde en god och förtroendefull relation skapas mellan barnmorskor och det blivande föräldraparet. Det känslomässiga engagemanget var en nödvändig förutsättning för att utföra ett bra jobb. En fråga inför framtiden är på vilket sätt den erfarenhetsbaserade inre kunskapen kan komma ny personal tillgodo och hur omvårdnadsarbetets organisation och vårdutbildningar kan ta tillvara det expertmässiga kunnandet hos erfarna barnmorskor.

This project explores the effect eighteenth century reproductive theory had on Laurence Sterne�s use of satire in <i>The Life and Opinions of Tristram Shandy, Gentleman</i> (1759 - 1767). Particular focus will be on the impact of the paternal and maternal imagination on the developing fetus, sexual facts and misconceptions common to eighteenth-century readers, as well as the changes in the gender dynamic of the birthing process (the man-midwife debate). There has been a lack of critical attention specifically on Tristram Shandy and its textual debt to medical treatises, midwifery texts, and folkloric medical tracts. Beyond this, I believe that the visual images also published in these works to be of great value in understanding the socio-historic background to sex and reproduction in the eighteenth century. I propose that the reader should look beyond the child-like antics of Walter and instead focus on Elizabeth as patient and Tristram as �experiment� within the historical-medical context of their contemporary culture. By expanding the context of relevant cultural materials that would have been available to Sterne, it is possible to read certain portions of the novel as a timeline of pregnancy through conception, gestation, and ultimately birth. I wish to examine the physical development not only of Tristram the character but also Tristram the novel, as the parallels between its creation and birth are obvious to even the most casual reader. Images of the autonomous fetus were quite well disseminated at this time and could be used to understand Tristram as a pseudo-fetal narrator, an author trapped somewhere in between a self-reliant free embryo writing and a grown man imprisoned by the calamities that befell him in-utero.

<p>The expectations of a successful outcome are great during childbirth. The overall objective of prenatal care and birth care is that midwives contribute in creating the most positive experience of pregnancy, child birth and infancy as possible. During the past 30 years there has been a significant increase in sectiofrequency both in Sweden and the rest of the Western world. More parents feel an overall insecurity when it comes to child labour. The purpose of this study was to describe how midwives experience the work of creating a sense of security and good nursing when meeting the expectant parents. A phenomenological approach was chosen with the use of eleven qualitative interviews that were analyzed with Giorgis' method of analysis. The result revealed three themes: organizational - professional conditions, the communicative ability and the reflective - emotional competence. Trusting your inner sensibility and intuition was something that characterized all the interviews and was the essence of the results. The way work was lead and organized, as well as the utilization of competence effected the midwives’ possibility of contributing to a sense of security and good care. When the communication was based on sensibility, midwives’ could create a good and trustful relationship with the expectant parents. The emotional involvement was an essential requirement for carrying out the work in a satisfying way. A question for the future is how inner knowledge based on practical experience can benefit new personnel and how the organization and education for healthcare givers can utilize the specialist knowledge of midwives with experience.</p> / <p>Förväntningarna i samband med barnafödande är stora på att en graviditet ska sluta lyckligt. Det övergripande målet inom mödrahälsovård och förlossningsvård är för barnmorskor att medverka till en så positiv upplevelse av graviditet, förlossning och spädbarnstid som möjligt. De sista trettio åren har sectiofrekvensen ökat betydligt både i Sverige och västvärlden. Fler föräldrapar upplever idag en allmän otrygghet i samband med barnafödande. Syftet med denna studie var att beskriva barnmorskors upplevelser av att förmedla trygghet och en god omvårdnad i mötet med det blivande föräldraparet. Fenomenologisk ansats valdes med elva kvalitativa intervjuer som analyserades enligt Giorgis analysmetod. Resultatet visade tre teman: Organisatoriska - professionella förutsättningar, den kommunikativa förmågan och den reflektiva - emotionella kompetensen. Att lita på sin inre känsla och intuition var en upplevelse som genomsyrade hela intervjumaterialet och blev resultatets essens. Hur arbetet leds och organiseras och hur kompetens tillvaratas påverkade i hög grad barnmorskors möjligheter att förmedla trygghet och en god omvårdnad. Genom att vara lyhörd i sitt sätt att kommunicera kunde en god och förtroendefull relation skapas mellan barnmorskor och det blivande föräldraparet. Det känslomässiga engagemanget var en nödvändig förutsättning för att utföra ett bra jobb. En fråga inför framtiden är på vilket sätt den erfarenhetsbaserade inre kunskapen kan komma ny personal tillgodo och hur omvårdnadsarbetets organisation och vårdutbildningar kan ta tillvara det expertmässiga kunnandet hos erfarna barnmorskor.</p>

No description available.

Abstract The nursing and midwifery workforce is becoming increasingly mobile and the globalisation of the midwifery workforce has been fuelled by the marketing strategies used by employers within Queensland to recruit midwives from overseas to fill vacancies within both the public and private sector. The United Kingdom has been specifically targeted, and the numbers of nurses and midwives moving to Queensland has more than doubled in five years and continues to rise. Little is known about the reasons why midwives are leaving the United Kingdom and what their experience is of working within midwifery in Queensland. This research was conducted within a phenomenological framework. A total of 18 midwives who had moved to Queensland within an eight year period were interviewed, who also completed a reflective journal about their motivations for moving, and subsequent experience of midwifery within Queensland. Data analysis was undertaken using an adaptation of the Van Kaam method of analysis of phenomenological data, as described by Moustakas. A Textural –Structural description of the meanings and essences of the experience incorporating the invariant constituents and themes was constructed for each participant. From the Textural –Structural Descriptions from all of the participants a composite description was constructed of the meanings and essences of the group experience. The reasons for leaving the United Kingdom were predominantly associated with an expectation of achieving an improved lifestyle for themselves and their families; and there was also a sense of seeking adventure. Participants also expressed dissatisfaction with life in the United Kingdom, which was particularly associated with work related issues such as bullying and harassment, increased workloads and burn out. Midwives reported choosing Queensland because of weather and lifestyle factors, but were also influenced by having friends, family or former colleagues already settled in the State. The main essences of the reported experience of working within the midwifery profession in Queensland included feelings of fear, frustration, shock and sadness. Despite the initial difficulties experienced in settling in to the midwifery profession, most midwives found a way to resume their midwifery career in Queensland by moving between jobs until they found one that enabled them to practise midwifery in a way they were comfortable with. Recommendations are made based on the findings to guide employers in their recruitment practices and assist with orientation of midwives recruited from the United Kingdom with a view to improved retention. In order to avoid the feelings of frustration and sadness described by the midwives in this study, employers should seek to match the skills of the midwives recruited to the positions available within the unit, and ensure systems are in place to facilitate recognition of prior learning and early credentialing to allow midwives to practise to their full scope and ability. In addition, in order to enable UK trained midwives to practise at their highest potential, supportive management structures should include access for migrant midwives to support in adjusting to midwifery practice differences between the UK and Queensland.

Magister Curationis - MCur / Infections (including healthcare-associated infections) are one of the leading causes of neonatal morbidity and mortality, yet these deaths could be prevented by cost-effective interventions. Handwashing (HW) is crucial to preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs). However, healthcare workers' compliance with optimal practices remains low in most settings.The purpose of this study was to determine the compliance with HW among nurses and midwives caring for newborn babies at Rwamagana Health Facilities, and the extent to which demographic and cognitive characteristics predict nurses' HW compliance. The study’s methodology involved a cross-sectional approach encompassing descriptive and quantitative methods. The data was collected over a period of 3 weeks from a total sample of 139 nursemidwives. An anonymous self-administered questionnaire was used to collect data; out of 139 questionnaires distributed 134 were returned back completed, giving a rate of 96.4%. The data analysis was done using SPSS software version 21.The results demonstrate that a mean self-reported HW compliance rate was 82.00% (SD= 13.60). A compliance rate of 80% or greater was confirmed by most of the participants in the study (79.1%). The highest reported rate of hand washing was HW after exposure to the newborn's body fluids (M= 89.33%; SD= 14.878),while results revealed that nurses tend to perform less HW after touching an object in the vicinity of the patient(73.43%; SD=22.81). A multiple regression analysis revealed that attitudes, subjective norms and intentions were unique independent predictors of HW compliance. However, results did not show any relationship between HW and nurses' demographic characteristics.This study recommends that, strategies aiming to improve HW compliance must be focused on concepts that predict HW. Further research ought to be conducted using observational approach.

This phenomenological study has been conducted to reveal midwives’ experiences working as coordinator/charge midwives in tertiary hospital delivery suite settings. The methodology is informed by Heidegger’s interpretive phenomenological, hermeneutic philosophy (1927/1962). Data analysis is based on van Manen’s (1990) research methodology. Five coordinator/charge midwives who work at three tertiary hospitals were interviewed. These interviews were tape recorded, transcribed and analyzed to uncover commonality of themes which revealed what it felt like ‘being’ a coordinator/charge midwife. The three themes which emerged and are discussed in the data analysis chapters are: “The performing art of leadership”, “Time as lived” and “In the face of the ‘known’ and the ‘unknown’”. The findings of this study reveal coordinators are the ‘hub’ or the ‘pivot’ at their workplace with their art and soul of midwifery at the very core of their ‘being’. They ‘know’ the unpredictability of childbirth and are regularly challenged by ‘lived time’ as they ‘leap in’ to situations and ‘leap ahead’. Their ability to facilitate teamwork and their resilience in the face, at times, of seemingly insurmountable obstacles shines through.

This phenomenological study has been conducted to reveal midwives’ experiences working as coordinator/charge midwives in tertiary hospital delivery suite settings. The methodology is informed by Heidegger’s interpretive phenomenological, hermeneutic philosophy (1927/1962). Data analysis is based on van Manen’s (1990) research methodology. Five coordinator/charge midwives who work at three tertiary hospitals were interviewed. These interviews were tape recorded, transcribed and analyzed to uncover commonality of themes which revealed what it felt like ‘being’ a coordinator/charge midwife. The three themes which emerged and are discussed in the data analysis chapters are: “The performing art of leadership”, “Time as lived” and “In the face of the ‘known’ and the ‘unknown’”. The findings of this study reveal coordinators are the ‘hub’ or the ‘pivot’ at their workplace with their art and soul of midwifery at the very core of their ‘being’. They ‘know’ the unpredictability of childbirth and are regularly challenged by ‘lived time’ as they ‘leap in’ to situations and ‘leap ahead’. Their ability to facilitate teamwork and their resilience in the face, at times, of seemingly insurmountable obstacles shines through.

This thesis explores the newly established role of midwife practitioner (MP) and its impact on midwives and obstetricians in a maternity unit in Wales. MPs manage the care of women at high obstetric risk and carry out aspects of care, such as assessment, diagnosis and the development of management plans, which in the past were predominantly performed by obstetricians. This qualitative study employs a focused ethnographic approach and uses a purposive sample. Phase one consisted of seven focus groups, which were held between May and August 2004, with midwives (n=48) from maternity units in Mid and South Wales. In Phase two, participant observation was undertaken with MPs (n=3) over a two-week period encompassing eight 12-hour night shifts, during November and December 2004. For Phase three, semi-structured interviews were conducted with midwives (n=10), clients (n=10) and obstetricians (n=7), between July and December 2005. Phases two and three were carried out in a maternity unit in South Wales. The key findings of this study demonstrate that the lack of planning for the MP role inadvertently resulted in the creation of a distinct health care role, which encompasses positive aspects of both midwives' and obstetricians' work to provide safe and acceptable care for clients. The MPs in this study are committed to providing holistic care that takes into consideration the emotional and social needs of women and their families. In addition, these MPs are developing confidence and analytical skills, normally demonstrated by medical staff. However, further initiatives such as allowing MPs to prescribe, or to refer to other specialties, have not yet been adapted to support these new roles. It is too early to see the full impact of this role, but it is argued that it will have no significant effect on the work of the other midwives. MPs, however, do have the potential to impact upon the work of the obstetricians. This study contributes to the current body of knowledge concerning policy and practice for maternity care by examining a new role early in its genesis. This study makes a number of recommendations, including extending the number of MPs employed in Wales, the need for careful planning of future extensions to the midwives' role and further research into the safety and effectiveness of the MP role.