Australian Midwifery最新文献

Research problem

The way we see or interpret our social world determines how we are and how we act (our ‘being with’) in that world. Midwifery is currently promoting a partnership model of practice (Guilliland & Pairman 1995). Workplace Codes and policies usually promote universal ethical principles and objective ethical decision-making both of which exclude so called subjective aspects such as emotions, context and relationship (Thompson 2004).

A qualitative study conducted in Australia, explored the implicit and explicit ethics surrounding childbirth, including the ethical nature of the mother-midwife relationship. One aspect of that research analysed the impact of any conflict between workplace and personal/professional ethics, as expressed by participating mothers and midwives. This paper discusses one of the emergent themes, ‘Emotions and Feelings’.

Participants

Eight women who had recently birthed a baby, and eight currently practicing midwives recruited from a variety of birthing and midwifery practice areas in Queensland, including public and private health care categories. Method Narrative inquiry was guided by feminist constructivism and feminist ethics. Through in-depth interviews, participants told of their personal experiences, and described how they felt when an encounter with either a midwife or doctor was ethically unsatisfactory for them. Participants were co-researchers in that during both the interview and analysis process, feedback was sought from them to validate the researcher's interpretation and jointly construct consensual meanings.

Findings

Conflict between workplace/service provider ethics and personal/professional ethics has an emotional impact according to the mothers and midwives interviewed for the present research.

Implication

A significant implication of the research is that ethical midwifery practice and decision-making ought to include not exclude, the emotions and feelings of consumers and practitioners. Emotions are our response to a social situation, and reflect our cognitive belief of concepts such as justice and integrity: when we know something is ‘wrong’ we are sad, or angry, or feel ‘bad’. Rarely do we search for which ethical principle has been breached. Ethical practice is based on human engagement in relationship, not merely abstract principles.

During the years 1999-2002 a national three-year research project was undertaken in Australia to investigate both the perceived barriers to the provision of midwifery care within maternity services, and the strategies to overcome these barriers. At the start, the researchers on the Australian Midwifery Action Project (AMAP 2003) were confronted with a seemingly impossible task. The question was: how to access and engage a cross section of the Australian midwifery workforce who represented the profession across the breadth of the continent? There are approximately 10,000 practicing midwives currently working in Australia, and they are scattered over a country that encompasses eight state and territory boundaries, and a land mass the size of Europe. With an objective to enlist the responses of the widest possible sample of midwives and being mindful of their busy day to day lives, we chose a method that fits closest to the metaphorical notion of graffiti. We saw graffiti as the tool for describing how we connect with the complex reality within and around us at a certain moment within our existence. It will interest researchers such as midwives and others who often rely on limited resources to record the views of women and other marginalised groups. It has the benefit of not requiring a lot of time to respond, and the added dimension of a visual interpretation beyond the meaning related by text. Graffiti is an age old pursuit and although it has different contextual meanings, the immediacy of it and its universally understood medium make it an attractive method for gathering thoughts and ideas. This is the first time such a method has been described. The paper presented here takes the reader on an explorative journey, briefly into the realms of the writings of modern French theorists such as Gilles Deleuze, Claire Parnet, Felix Guattari and Roland Barthes, and the feminist theorist, Elizabeth Grosz whose work provides some of the theoretical underpinnings. The method was used in the Midwives Voices study that was published in the Australian Midwifery Journal (Brodie 2002).

This paper reports on a study the aim of which was to describe the expectations and experiences of a first cohort of students in a three-year Bachelor of Midwifery course, which commenced in Victoria in February 2002. Data were collected via focus group interviews at the commencement of each year, excerpts from the students' reflective journals, selective interviewing of some students and course evaluations at the end of each year of the course. Fourteen of the 20 students, predominantly mature age students, had preconceived ideas with regard to expectations of the course, some of which were met, while some adjustments needed to be made over time. At each year level, students were generally happy with the theoretical component of the course, while identifying some overlap in course content and the need for discrete subjects in areas such as pharmacology. While considering that, by the end of the course, they had achieved a beginning level of competence, the most contentious issue identified by the students was the practical experience, namely the organisation of the practical experience in the agencies, the quality of the experience, the number of follow through experiences and the extensive documentation required.

Objective To determine the beliefs of women living in sub-tropical and temperate Australia about the reputed therapeutic uses of sunglight in infancy and the postpartum period.

Methods One hundred and sixty-seven Caucasian postpartum women were recruited from three maternity hospitals in Canberra (August 1998) and one in Brisbane (August 1999), and participated in structured interviews during a seven-day sampling period at each hospital.

Results The prevalence of inappropriate maternal beliefs about therapeutic sun exposure in infancy and the postpartum period was similar in Brisbane and Canberra. Overall, 62% of women had at least one inappropriate belief about the perceived benefits of intentionally sunning their baby. Forty-two percent of women were in favour of using sunlight to treat neonatal jaundice; 31.1% believed sunlight was a good remedy for cracked nipples; 22.2% believed they should intentionally expose their baby to sunlight to prevent vitamin-D deficiency and 16.2% reported they would use sunlight to treat nappy rash. Older maternal age and previously sunning a child to treat jaundice were common predictors of a number of these beliefs.

Conclusions and Implications These women reported a high prevalence of beliefs that may result in their infant being intentionally exposed to sunlight, and which could increase their child's future risk of skin cancer.