Applying Salutogenesis in Midwifery Practice

This chapter presents midwifery as unique amongst the healthcare professions because it mostly focuses on physiological processes and a period of transition in the life of a woman and her family. Thus, midwives work across a childbearing continuum and the health-ease dis-ease continuum. The “midwifery model of care” and its approach to childbearing focuses on wellness rather than illness and works closely with women to help them mobilize their own resources to move towards greater health. But the contrasting pathogenic approach to maternity care is still ubiquitous in contemporary healthcare provision with over-medicalization of childbirth and overuse of interventions, which can also cause more harm than good.While there is resonance between midwifery practice and salutogenesis, research examining the relationship is still in its infancy. Few researchers explicitly draw on salutogenic theory. Of these, few studies and scoping reviews are described in more detail. They suggest that there is an alignment between salutogenesis and midwifery practice.The chapter concludes by stressing that salutogenesis, with its focus on health rather than pathology, offers a promising way forward to underline that much of midwifery work is health promotion and must be operationalized accordingly in midwifery practice.

Impact of Electronic Medical Records Within the Maternity Environment: An Ethnographic Exploration of Midwifery Practice

Integration of care through digitalisation of paper records is important for childbearing women who may see multiple clinicians both within the hospital and the community. It is important that in the implementation of an EMR, the established benefits of a paper and handheld records are transferred and not lost. Acceptance and positive use of digital records in maternity settings has occurred despite concerns regarding workload interrupting women centred care.

Ways of knowing

Clare Davison examines how different forms of knowledge, from scientific evidence to intuition, play a role in midwifery practice

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.

Practice-based Reflection: Considerations for Re-engineering Secondary Healthcare in New Zealand

<p>Re-engineering is the "buzz" word of the nineties. Re-engineering has been successful in industry. Now the principals of re-engineering are being applied to healthcare. Considerations for re-engineering secondary healthcare in New Zealand will be examined in this literature review, which is divided into two sections. The first section provides the aims of the literature review, my background interest and knowledge of the topic, it's relevance to nursing practice, plans for addressing the literature review, and proposed sources of information. Section two illustrates the learning contract to manage the task of conducting the literature review. It identifies timelines for managing the project and agreed arrangements for communication with my mentor. Finally, a report will address my progress in relation to my learning contract articulating insights gained and hopes and dreams for successfully incorporating process re-engineering in my area of nursing and midwifery practice in the future.</p>

Practice-based Reflection: Considerations for Re-engineering Secondary Healthcare in New Zealand

<p>Re-engineering is the "buzz" word of the nineties. Re-engineering has been successful in industry. Now the principals of re-engineering are being applied to healthcare. Considerations for re-engineering secondary healthcare in New Zealand will be examined in this literature review, which is divided into two sections. The first section provides the aims of the literature review, my background interest and knowledge of the topic, it's relevance to nursing practice, plans for addressing the literature review, and proposed sources of information. Section two illustrates the learning contract to manage the task of conducting the literature review. It identifies timelines for managing the project and agreed arrangements for communication with my mentor. Finally, a report will address my progress in relation to my learning contract articulating insights gained and hopes and dreams for successfully incorporating process re-engineering in my area of nursing and midwifery practice in the future.</p>

Honouring the Sacred in Childbirth: a Midwife's Stories of Women's Developing Sense of Self

<p><b>Thirty years of midwifery practice has shown me the beauty of birthing. After spending time working with a homebirth midwife I had an awakening which affected me deeply, both personally and professionally. I looked on birth in a different light and started recognising new possibilities. I learned new skills and understandings working in a variety of settings during a time of major change for New Zealand midwifery.</b></p> <p>This experience has led me to this study the aim of which was to explore the relationship between the woman and myself the midwife as I experienced it and understood it in practice. I use an auto/biographical method: reflecting on my own story and on both factual and fictionalised exemplars from my practice.</p> <p>My research led me to the following conclusions. As women prepare for and reflect on their births they often tell stories about themselves based on a mix of recent events interspersed with their ideas and hopes. Telling stories helps women learn about aspects of themselves that reconstruct their identity, leading to a greater integration of their sense of self. Woman-centred midwifery care takes on new meaning when midwives practice midwifery by engaging with women’s narratives.</p> <p>Each woman and her birthing reinforce the sacredness of childbirth. By combining an awareness of sacred possibilities with scientific understandings, midwives offer a bridge so that through childbirth experiences, women can enhance and reconstruct their inner lives. This study indicates that further research on the familiar but undeveloped aspects of ‘everydayness’ in midwifery practice is necessary. In particular, the emotional and spiritual aspects of midwifery deserve greater attention.</p>

Honouring the Sacred in Childbirth: a Midwife's Stories of Women's Developing Sense of Self

<p><b>Thirty years of midwifery practice has shown me the beauty of birthing. After spending time working with a homebirth midwife I had an awakening which affected me deeply, both personally and professionally. I looked on birth in a different light and started recognising new possibilities. I learned new skills and understandings working in a variety of settings during a time of major change for New Zealand midwifery.</b></p> <p>This experience has led me to this study the aim of which was to explore the relationship between the woman and myself the midwife as I experienced it and understood it in practice. I use an auto/biographical method: reflecting on my own story and on both factual and fictionalised exemplars from my practice.</p> <p>My research led me to the following conclusions. As women prepare for and reflect on their births they often tell stories about themselves based on a mix of recent events interspersed with their ideas and hopes. Telling stories helps women learn about aspects of themselves that reconstruct their identity, leading to a greater integration of their sense of self. Woman-centred midwifery care takes on new meaning when midwives practice midwifery by engaging with women’s narratives.</p> <p>Each woman and her birthing reinforce the sacredness of childbirth. By combining an awareness of sacred possibilities with scientific understandings, midwives offer a bridge so that through childbirth experiences, women can enhance and reconstruct their inner lives. This study indicates that further research on the familiar but undeveloped aspects of ‘everydayness’ in midwifery practice is necessary. In particular, the emotional and spiritual aspects of midwifery deserve greater attention.</p>

Essential Professional Competencies for Basic Midwifery Practice in Disasters: A Qualitative Study

Objective: Educated midwives have a range of abilities to use their skills in normal situations. Given that working under normal situations is different from critical conditions, the recognition of skills and competencies required for midwifery practice is important. The purpose of this study was to explore specific professional competencies that midwives need to have for the provision of reproductive health services during disasters. Methods: This was a qualitative study using a content analysis method. Subjects were 19 midwives with the work experience of practice in disaster situations. Data were collected using semi-structured interviews and analysis was based on the approach suggested by Graneheim and Lundman. Results: Six major categories developed in this study were “safe pregnancy,” “safe childbirth,” “women’s health care,” “contraception,” “violence and sexually transmitted infections,” and “infant care.” Conclusions: Midwives can play a very important role in the provision of reproductive health services. Therefore, they must have special capabilities and capacities. Policies and curriculum development are recommended in accordance with the needs of reproductive health in disaster-affected communities.