Australian Midwifery最新文献

This quantitative descriptive study explored primigravidas' perception of the role of a midwife. Primigravidas aged 17 years and over, irrespective of their hospital classification (private or hospital patients), were approached to participate in this study.

The study found that a majority of primigravidas in Australia recognised and acknowledged that midwives are trained and qualified to provide midwifery care during pregnancy and childbirth but not qualified to perform medical procedures or surgical and manipulative deliveries. Ethnicity and age did not influence the women's perceptions of the role of a midwife; however older age women were likely to believe a midwife is not qualified to perform medical or surgical related procedures. The reasons why pregnant women deemed it necessary for a doctor to be present at delivery were not captured.

Findings from this study will contribute to existing information about midwives' role and help to create better community awareness by disseminating information to the community regarding the role of a midwife and what a midwife is capable of providing in terms of maternity care.

A prospective longitudinal study of 620 women investigated the association between a range of risk factors and postnatal depression (PND). Univariate analyses of results demonstrated seven antenatal and three perinatal variables significantly associated with PND. Antenatal risk factors included relationship problems, antenatal depression and limited supports. These factors had previously been reported in the literature. Additionally this study highlighted the significance of domestic violence as a risk factor. Perinatal factors significantly associated with PND were severe blues/highs, no partner or support person at birth and dissatisfaction with care in labour. Logistic regression analysis of the 10 combined antenatal and perinatal risk factors demonstrated that only three factors were found to be significant predictors of depression in the final model. These were antenatal depression, severe blues/highs and dissatisfaction with care in labour. With these variables in the regression equation, none of the other risk factors were contributing significantly to the prediction of PND.

Conducted as the first phase of the Improving Patient Outcomes Project, a structured literature review aimed to determine an evidence base for the development of a midwifery-led antenatal model of care. In particular, evidence was sought for those elements of antenatal care that were proven effective and were valued by women. There is good quality evidence that women are satisfied with receiving antenatal care from midwives and that antenatal visit schedules can be made more flexible. The literature provided practical assistance in defining maternity outcome measures but was not able to provide a strong evidence base for all aspects of antenatal care. This paper reports on a systematic approach to reviewing literature in which the intuitive and practical experience of expert reviewers and clinicians contributes to assessing the overall quality of currently available research evidence. This combined approach ensures a judicious and sensitive application of available evidence to the development of safe and appropriate models of care.

The development and implementation of a model of midwifery-led antenatal care was the second phase of a larger project known as the Improving Patient Outcomes Project. The overall project aim was to demonstrate the effectiveness of evidencebased models and systems of care on improving patient outcomes.

Survey results from local antenatal clinics had revealed an absence of evidence-based guidelines for the provision of antenatal midwifery care. Midwives and expert reviewers combined their experience to appraise the quality and relevance of currently available research evidence to develop a best practice model of antenatal care for low risk women in which the midwife is the lead antenatal care professional. The model offered a care plan for the pregnancy trimesters and outlined circumstances requiring referral to, or consultation with, a medical officer. In addition it offered women a flexible visit schedule and continuity of carer throughout the antenatal period. The methods used in this study may have general applicability to developing best practice models of antenatal care and for the validation of contemporary midwifery antenatal practice. The value of the model will be realised through its successful implementation by the midwifery profession and the evaluation of its effectiveness for women and their families.

In current practice electronic fetal monitoring is used extensively to assess fetal well-being in normal or low-risk labour. Within this clinical context there are a number of issues concerning the comparative benefits or problems of this practice when compared with intermittent auscultation. The purpose of this study was to explore factors influencing current practice by systematically investigating and describing changes in practice, encompassing the period of time prior to and following, the introduction of electronic fetal monitoring, and up to the present day. To do this text from the 13 editions of Margaret Myles's ‘Text Book for Midwives’, was subjected to a qualitative content analysis. The data revealed five distinct patterns of practice, each correlating loosely to a calendar decade and each reflecting different norms for childbirth and midwifery practice. The findings suggest that there is a significant shift in the skills and context associated with fetal monitoring, changes that require reflection and debate.

This research report addresses the question ‘Whose interests are served by the portrayal of childbearing in popular magazines for women?’. The methodology was feminist content analysis using semiology. Sixty-nine womens' magazines of women's were assessed for analysis and four were finally selected because they represented a detailed description of women's thoughts and feelings about birth.

This paper presents a single in-depth analysis as an exemplar of how childbearing is portrayed in popular magazine's for women.

This qualitative study investigated midwives' perception of a team midwifery model of care implemented in North Queensland, Australia. A midwifery model of care is the use of primary health care principles to deliver care throughout the woman's entire pregnancy and postpartum period in partnership with other members of the health care team. Four focus groups were undertaken with 22 midwives to determine their perception of the team midwifery model of care. The study found the experience of the team midwifery model of care for midwives had been influenced by organisational characteristics, team structures, and accountability.

Recommendations from this study include the need for an appropriate environmental scan and implementation of planning process and team building before the introduction of any new model of care, transportability of health care services to any new model of care, and a shared governance to allow midwives to meet both organisational and professional goals.