prisons. The study took place during 2015-2016 and involved semi-structured interviews with 28
female prisoners in England who were pregnant, or had recently given birth whilst imprisoned,
ten members of staff, and ten months of non-participant observation. Follow-up interviews with five women were undertaken as their pregnancies progressed to birth and the post-natal phase.
Using a sociological framework of Sykes’ (1958) ‘pains of imprisonment’, this study builds upon existing knowledge and highlights the institutional responses to the pregnant prisoner. My original contribution to knowledge focuses on the fact that pregnancy is an anomaly within the patriarchal prison system. The main findings of the study can be divided into four broad concepts, namely: (a) ‘institutional thoughtlessness’, whereby prison life continues with little thought for those with unique physical needs, such as pregnant women; and (b) ‘institutional
ignominy’ where the women experience ‘shaming’ as a result of institutional practices which
entail their being displayed in public and characterised with institutional symbols of
imprisonment. The study also reveals new information about the (c) coping strategies adopted
by pregnant prisoners; and (d) elucidates how the women navigate the system to negotiate
entitlements and seek information about their rights. Additionally, a new typology of prison officer has emerged from this study: the ‘maternal’ is a member of prison staff who accompanies pregnant, labouring women to hospital where the role of ‘bed watch officer’ can become that of
a birth supporter. This research has tried to give voice to pregnant imprisoned women and to highlight gaps in existing policy guidelines and occasional blatant disregard for them. In this sense, the study has the potential to springboard future inquiry and to be a vehicle for positive
reform for pregnant women across the prison estate.
Threatened preterm labour: a prospective cohort study for the development of a clinical risk assessment tool and a qualitative exploration of women's experiences of risk assessment and management.
Preterm birth, risk, prediction
Background: Preterm birth (PTB) is a major cause of infant morbidity and mortality, and accurate assessment of women in threatened preterm labour (TPTL) is vital for identifying need for appropriate intervention. Risk assessment in TPTL is challenging, however, due to its complex and multifactoral nature. In many women, TPTL symptoms do not progress to spontaneous PTB (sPTB) so assessment that reassures quickly, often through use of tests, e.g. fetal fibronectin (fFN) and cervical length(CL), may reduce unnecessary intervention and decrease anxiety. Aims: This PhD project had two main objectives: first to improve TPTL risk assessment by further developing the clinical decision support tool, the “QUIPP” mobile phone application, which simplifies risk assessment by calculating individual % risk of sPTB based on risk status, fFN and CL results. The second objective was to understand TPTL from the women’s perspective in order to inform future improvements in care.
Method: The study comprised three components: 1) a prospective cohort study, collecting data on risk factors, test results and interventions. Predictive utility of fFN and CL were investigated, as well as generation and validation of risk prediction algorithms for the second version of QUIPP; 2) a qualitative study of women’s experience of TPTL through one-to-one semi-structured interviews; 3) a qualitative study of clinicians using the first version of QUIPP.
Results: Cohort study: 1186women were recruited at 11 UK hospitals between March 2015 and October 2017, with data available for analysis on 1037. Prevalence of sPTB was 3.9% (40/1037)and 12.1% (125/1037) at <34 and <37 weeks’ gestation, respectively. Validation of QUIPP algorithms, using risk factors and fFN results alone, demonstrated good prediction of sPTB <30 weeks’ gestation (AUC 0.96, 95% CI 0.94-0.99) and at <1 week of testing (AUC 0.91, 95% CI 0.87-0.96). Qualitative study: Four themes emerged following interviews with 19 women: i) coping with uncertainty; ii) dealing with conflicts; iii) aspects of care and iv) interactions with professionals. QUIPP users’ study: 10 clinicians expressed predominantly positive views and suggested improvements.
Conclusion: All components of this project informed development of QUIPP v.2 (algorithms and design), which appears superior in predicting sPTB compared to previously reported predictive utility of fFN, CL and QUIPP v.1 algorithms. The qualitative study was the first exploring women’s experience of TPTL in a UK hospital with a specialist preterm service, and findings further support the need for women of all risk groups to have timely access to advice and information, and continuity of care.
Grading student midwives’ practice: a case study exploring relationships, identity, and authority.
Grading practice, students, Assessment, Midwifery knowledge
Grading students’ practice in the UK is a mandatory requirement of midwifery programmes regulated by the Nursing and Midwifery Council. This thesis explores how grading affects midwifery students, mentors and lecturers’ relationships, identity and authority. Individual and group interviews with fifty-one students, fifteen mentors and five lecturers, recruited from three local NHS Hospital Trusts and a university provided a diversity of views and experiences. This was complemented with documentary data from student practice grades, practice assessment documents and action plans from underperforming students. The analytical framework for this case study draws on Basil Bernstein's pedagogic codes using the concepts of classification and framing. This enabled an exploration of what counted as valid practice knowledge, teaching and learning in clinical practice and the evaluation of learning.Differences between students, with respect to their orientation to midwifery knowledge, types of practice knowledge and relationships between the hospital and community mentors were identified. Despite these, students were consistently awarded high practice grades. The environment seemed to affect the structural and interactional practices between students and mentors and, according to Bernstein’s theory, should have affected the practice grade. However, there was limited stratification of grades. Therefore, the grades have been interpreted as competence rather than performance of midwifery and symbolise acceptance into the profession. Reasons for this were offered. This study provides a unique insight into grading students’ practice, resulting in recommendations such as the separation of the role of mentor from assessor as well asa call for greater assessment of communication skills and evidence to inform midwifery practice. New models of teaching and assessment in clinical practice may enable a change of pedagogic code. Understanding the complexity of the practice area and the types of discourses it produces is necessary to enable all students equal access to midwifery specific knowledge.
Home birth and the English NHS: Exploring the dynamics of institutional change in the context of health care.
Home birth; deinstitutionalisation; midwifery
This study aimed to understand and explain the work involved in creating, maintaining and disrupting divergent models of health service organisation and delivery, with a specific focus on maternity care provided to healthy women who chose to give birth at home. It investigated questions about the priorities that frame the allocation and management of health service resources and sought to understand how opportunities to advance new institutional practices were recognised, created or resisted by different stakeholders. This study drew upon concepts of deinstitutionalisation to examine why the disappearance of older institutional practices [in this instance, home birth] were not always inevitable when a newer practice [such as an obstetric unit birth] became prevalent or dominant. Work examining mature institutional fields exposed to modernising influences has suggested that non-dominant professional groups appear to engage in countervailing activities that maintain the persistence of older institutional practices while making efforts towards reinstitutionalisation. To date, studies have tended to focus attention at the top of organisations or on embedded or dominant occupational groups. This study has expanded and developed understandings of the agentic activity undertaken by a non-dominant professional group that sit largely outside strategic management and funding structures who sought to re-legitimise institutional practices which had been eroded or threatened with extinction. Methodology and methods: This was a multiple case site study that employed a variety of qualitative research methods. This was compatible with institutional theory which has sought to examine how enduring social patterns and arrangements are constructed, become taken for granted and treated as inevitable. This study engaged with three separate organisations providing maternity services and a range of organisations and individuals associated with, or affected by this activity. The case sites were selected to represent a range of settings, conditions and relationships that are recognisable across the English National Health Service (NHS). Intended contribution: The theoretical contribution of this study is to organisational and medical sociology questions about occupational relationships and the priorities that frame the allocation and management of health service resources. This was achieved by identifying institutional work both seeking to reinforce or resist existing medicalised and acute-focused maternity services. Practically, this study engaged with the socio-cultural and political complexities of maternity services’ organisation and delivery. It provides information for policy-makers, service leaders and innovators who are contemplating implementing changes in contexts where home birth services are under-developed or under-performing.
Meeting the health and social needs of pregnant asylum seekers; midwifery students' perspectives.
Critical discourse analysis, midwifery students, problem-based learning as a research method,
pregnant asylum seekers.
Current literature has indicated a concern about standards of maternity care experienced by
pregnant asylum seeking women. As the next generation of midwives, it would appear essential that students are educated in a way that prepares them to effectively care for pregnant asylum seekers. Consequently, this study examined the way in which midwifery students constructed a pregnant asylum seeker’s health and social needs, the discourses that influenced their
constructions and the implications of these findings for midwifery education. For the duration of year two of a pre-registration midwifery programme, eleven midwifery students participated in
the study. Two focus group interviews using a problem based learning (PBL) scenario were conducted. In addition, three students were individually interviewed and two students’ written reflections on practice were used to construct data. 2 Following a critical discourse analysis, dominant discourses were identified which appeared to influence the way that pregnant asylum seekers were perceived. The findings suggested an underpinning discourse around the asylum
seeker as different and of a criminal persuasion. In addition, managerial and medico-scientific discourses were identified, which appeared to influence how midwifery students approach their
care of women in general, at the expense of a woman centred, midwifery perspective. The findings from this study were used to develop “the pregnant woman within the global context” model for midwifery education and it is recommended that this be used in midwifery education, to facilitate the holistic assessment of pregnant asylum seekers’ and other newly arrived migrants’ health and social needs.
Birth Place Decisions: A prospective qualitative study of how women and their partners make sense of risk and safety when choosing where to give birth
Place of birth, risk, narrative, longitudinal
For the past two decades, English health policy has proposed that women should have a choice of place of birth, but despite this, almost all births still take place in hospital. The policy context is one of contested evidence about birth outcomes in relation to place of birth, and of international debate about the safety of birth in non-hospital settings; partly as a consequence of this, ‘birth place decisions’ have become morally and politically charged. Given the perceived lack of consensus about birth place safety, this study sought to explore the experience of making birth place decisions from the perspectives of women and their partners, in the context of contemporary NHS maternity care.
Longitudinal narrative interviews were conducted with 41 women and 15 birth partners recruited from three English NHS trusts, each of which provided different birth place options. Initial interviews were conducted during pregnancy, and follow up interviews took place at the end of pregnancy and again up to three months after the birth. Altogether, 141 interviews were conducted and analysed using a thematic narrative approach.
This research contributes new knowledge about how birth place decisions are undertaken and negotiated, and about the extent to which some are excluded from these choices. Participants’ beliefs about birth place risk originated in upbringing and drew upon normative discourses which positioned hospital as an appropriate setting for birth. Individual worldviews informed conceptualisations of birth place risk, and these were premised upon prioritisation of medical risks of birth, perceived quality of the maternity service or the likelihood that medical intervention would interfere with birth. These beliefs were often enduring and the overall tendency was for women to be increasingly conservative about their birth place options over time, but during their first pregnancies, participants views were most fluid and open to change.
An Interpretive Exploration of the Experiences of Mothers with Obesity and Midwives Who Care for the Mother During Childbirth
Obesity; Childbearing.
Obesity, as defined as a BMI ≥ 30 (kg/m2) had been established as a risk factor for increased morbidity and mortality during childbearing. There was a need for empirical research to explore the experiences of obese women and midwives during childbearing to stimulate debate and inform the delivery of care to this client group. This thesis provides a justification for a qualitative interpretivist study using semi-structured interviews with obese women and midwives. This study found that once an obese mother has been placed on the high-risk medicalised pathway, her choices are reduced and the ability to bring a sense of agency and choice to promote and support her own health is limited. The relationship with the midwife, which could have been focused on promoting the health and wellbeing of mother and baby, instead becomes a relationship of managing risk in a reductionist way. This makes it harder for both mothers and midwives to raise the issue of obesity, resulting in a tendency not to deal with the issue. Subsequently, the opportunities for health promotion offered by the midwife-mother relationship sustained over 7
to 8 months are lost, so that encouraging self-understanding and self-help in managing and reducing obesity cannot be achieved. The findings of this study suggest the need to enhance the health promotion role of the midwife. This thesis suggests reviewing the use of BMI, developing discussions about gestational weight gain and healthy lifestyle choices with women during antenatal care, and listening to mother’s lay theories, perceptions and concerns around weight. Midwifery care, which uses positive discourses and forward-facing care approaches and supported by continuity of carer schemes and access to midwifery-led care, could enhance the midwife’s health promotion role. This could lessen the risk of post-partum weight retention post-birth and enhance a new mother’s physical and emotional wellbeing.
Can an educational web intervention, co-created by service users, affect nulliparous women's experiences of early labour? (A randomised control trial)
Latent, Early, Digital, Experience
Women without complications have less obstetric intervention if they remain at home in early labour, yet report dissatisfaction in doing this, describing a disparity between expectations and the reality of this phase. A dichotomy exists between what is clinically beneficial (remaining at home) and what women require emotionally(support and reassurance). Previous research has been driven by maternity services’ needs, focusing on the transition between labour phases, commonly testing interventions that aim to improve clinical outcomes. Using self-efficacy theory, a web-based intervention was co-created providing early labour advice, alongside videoed, real-experiences of women who have previously had babies. The primary aim of this study was to evaluate the intervention’s impact on women’s self-reported early labour experiences. The intervention was trialled in a pragmatic RCT at an NHS Trust between 2018 and 2020. A total of 140 low-risk, nulliparous, pregnant women were randomised to the intervention group (n=69) or the control group (n=71). Data was collected at 7-28 days postnatally using the pre-validated Early Labour Experience Questionnaire (ELEQ). Secondary, clinical outcomes were also collected, as well as information about the acceptability and usability of the intervention. There were no statistically significant differences in the ELEQ scores between trial arms. The intervention group scored more positively in two of the three ELEQ subscale domains (emotional wellbeing and emotional distress) and less positively in the perceptions of midwifery subscale. Participants in the intervention group were less likely to require labour augmentation. The L-TEL Trial demonstrates that women evaluate aspects of their early labour experience continuum independently: an improved emotional experience does not necessarily equate to an overall improved experience of this phase. Equipping women to have better emotional experiences at home may negatively impact on their perceptions of midwifery care when sought. Further research is recommended on a larger scale to explore this.
A qualitative exploration of the role frontline health workers play in defining the quality of services provided to women experiencing an early miscarriage
Quality of Care, Early Miscarriage, Micro Organisational Theory, Frontline Staff
It is proposed that frontline health care workers in the English National Health Service (NHS) should have an important role in managing the quality of the services they deliver. Formal NHS quality management processes are structured in a highly rationalised way and the extent to which frontline workers have agency to apply their own knowledge to address suboptimal care practices is not well understood. This study explores how frontline NHS workers manage the quality of services offered to women experiencing an early miscarriage using qualitative semi-structured interview data collected from 34 frontline health care workers and managers from three hospitals in the North East of England. Secondary thematic data analysis, informed by micro-organisational theories, was used to explore the role of frontline health care workers in managing the quality of their services. This secondary analysis identified three key themes in the data; (1) the link between the quality gap and the difficulties associated with delivering humane and individualised care, (2) the role of collective understandings in defining the parameters of acceptable versus ideal quality of care, and (3) the use of discretionary practices to manipulate quality of care. These findings suggest that management of health care quality is complex and characterised by bureaucratic constraints that support
narratives of powerlessness and compromise amongst NHS workers. Structures that privilege rational models of organisational management pose a significant challenge to the delivery of relational
aspects of care. This study contributes to the evidence base by providing insight into the unseen discretionary practices frontline workers engage in to improve quality of care whilst also maintaining organisational functionality. These practices, based on collective beliefs about the parameters of “acceptable” quality of care, are paradoxical; they can improve quality for individual
patients but they also support the structures that create quality shortfalls in the first place. The findings of this study offer a model of optimal care for early pregnancy loss that could be used as a
framework on which to base quality improvement activities in this area. They also offer a unique insight into the issues that may result in suboptimal care practices perpetuating in the NHS, especially in relation to the delivery of humane and relational aspects of health care; this finding has implications for frontline clinicians, managers, educationalists and policymakers alike.
‘Practising outside of the box, whilst within the system’: A feminist narrative inquiry of NHS midwives supporting and facilitating women’s alternative physiological birthing choices.
Birth, guidelines, autonomy, midwives
This thesis presents the findings of an original study that explored NHS midwives practice of facilitating women’s alternative physiological birthing choices - defined in this study as ‘birth choices that go outside of local/national maternity guidelines or when women decline recommended treatment of care, in the pursuit of a physiological birth’. The premise for this research relates to dominant sociocultural-political discourses of medicalisation, technocratic, risk-averse and institutionalisation that has shaped childbirth practices in the UK. For midwives working in the NHS, sociocultural-political and institutional constraints can negatively impact their ability to provide care to women making alternative birth choices. A meta-ethnography was carried out, highlighting a paucity of literature in this area. Therefore, the aim of this study was to generate practice-based knowledge to answer the broad research question: ‘what are the processes, experiences, and sociocultural-political influences upon NHS midwives’ who self-define as facilitative of women’s alternative birthing choices’.Underpinned by a feminist pragmatist theoretical framework, a narrative methodology was used to conduct this study. Professional stories of practice were collected via self-written narratives and interviews to understand the processes of facilitation (the what, how, why), their experiences of carrying out facilitative actions (subjective sense-making), and what sociocultural-political factors influenced their practice. Through purposive and snowball sampling, a diverse sample of 45 NHS midwives from across the UK was recruited. A sequential, pluralistic narrative approach to data analysis was carried out, and a theoretical model was developed using the whole dataset. The findings were subjected to three levels of analysis.First, ‘Narratives of Doing’ highlight how and what midwives did to facilitate women’s alternative choices. The sub-themes reflect the temporal nature of a wide range of actions/activities involved when caring for women making alternative birthing decisions. The second analysis; ‘Narratives of Experience’ - highlighted the midwives polarised experiences captured as ‘stories of distress’, ‘stories of transition,’ and ‘stories of fulfilment’. For the third level of analysis, a theoretical model of ‘stigmatised to normalised practice’ was developed using notions of stigma/normal, deviance/positive deviance. A six-domain model was developed that accounted for the midwives sociocultural-political working contexts; micro, me so, and macro. The implications of this research related to a number of identified constraints, protective factors, and enabling factors for midwifery practice. Key barriers included negative organisational cultures that restricted both midwives’ and women’s autonomy. Disparities between the midwives’ philosophy and their workplace culture were highlighted as a key stressor and barrier to delivering woman-centred care. Protective factors related to the benefits of working in supportive, like-minded teams that mitigated against their wider stressful working environments. Facilitating factors included positive organisational cultures characterised by strong leadership where midwives were trusted and women’s autonomy was supported.Therefore, this study has captured what has been achieved, and what can be achieved within NHS institutional settings. Through the identification of both challenges and facilitators, the findings can be used to provide maternity professionals and services with insights of how they too can facilitate women’s alternative birthing choices.
Exploring decision making to create an active offer of planned home birth
Active offer, Planned home birth, Decision making, Social networks
Historically, the focus of the UK and international research exploring planned home birth decision making has been largely focused on understanding the experiences of women who decide to birth at home. As a result of high-profile research that suggests that non-OU birth locations are safe for low risk women, there has been a recent shift in focus resulting in research studies that aim to increase the rates of planned home birth, or more often the rates of all non-obstetric unit birth within the UK. However, despite this increased level of attention, the rate of home birth remains stubbornly low. Whilst there is some research to indicate why this might be the case, research that sheds a new light on the issue, and that develops an evidence base for new interventions is required. This thesis illuminates the factors that need to be considered in order to increase women’s abilities to make an informed decision about planned birth. A pragmatic approach, using mixed methods, was used to explore the current way that we offer planned home birth to maternity service users, and to ultimately make suggestions about how this could be improved. The application of active offer theory to the offer of planned home birth has been undertaken for the first time, and this has generated a new and useful perspective on this area of midwifery practice.
The resultant two-stage AOPHB process has the potential for developing midwifery practice in terms of supporting midwives to understand and facilitate women’s decision making around home birth, providing a flexible tool that can be used in clinical practice. This is the first approach that has been developed with the aim of increasing the ability of women to make an informed decision about whether they wish to birth at home.
Returning to the Path. A hermeneutic phenomenological study of parental expectations and the meaning of transition to early parenting in couples with a pregnancy conceived using in-vitro fertilisation
In Vitro Fertilisation, Hermeneutic Phenomenology, Pregnancy, Parenthood
Aim: To gain insight into the lived experience of the transition to parenthood for couples with a singleton IVF pregnancy.
Design: Heideggerian hermeneuticphenomenological study.
Methods: Data was collected in 2015, three couples were interviewed on three occasions each, using unstructured interviews; at 34weeks of pregnancy, six weeks and three months postpartum. Interviews lasted 32 -80 minutes (mean: 53) audio data later transcribed. Crafted stories (Crowther et al 2016) were used for analysis and an adaptation of Diekelman et al (1989) on both cross-sectional and longitudinal data.
Findings: The experience of pregnancy and parenting is influenced by the journey to conception and through pregnancy. ‘Returning to the Path’ was identified as the point couples had anticipated being at several years earlier. It drew on three over-arching themes: Seeking the Way, Returning to the Path and Journeying On.
Conclusion: Infertility is a deviation from the life path that a couple anticipated, returning to that path occurs at different times for different couples and is influenced by differing factors. The pregnancy may be experienced as a ‘tentative’ progression, however following birth, parenthood was embraced with an instinctive, baby-led style. Transition to parenthood was aided by social support and reliance on the couple relationship.
Impact: Findings have implications for those who support couples with IVF pregnancies in recognising their, often unspoken, concerns throughout pregnancy, shown as a reluctance to look too far ahead. They also need to appreciate the differing points at which these anxieties can recede.
Twitter: @suzannehardacr1
The experience of pregnant women being offered influenza vaccination by their midwife, a
qualitative descriptive approach
Pregnancy, Vaccination, Influenza, Risk
Aim To explore, interpret and develop an understanding of pregnant women’s experience of
being offered the seasonal influenza vaccination by their midwife and whether this affects the woman’s decision to either accept or decline the vaccine. Research Question ‘Does the
relationship between the woman and the midwife impact on the woman’s decision to accept or
decline the seasonal influenza vaccination in pregnancy?’ Objectives 1 To investigate factors
which when drawn from women’s experience of being offered the seasonal influenza vaccination, influence their decision to accept or decline the vaccine. 2 To explore whether women’s experience of the antenatal environment in which the midwife/ woman discussion takes place has any influence on the decision to accept or decline the vaccine. 3 To identify whether women’s experience differs according to their geographical location.
Methods The study was carried out within five geographical Boroughs within a large University Health Board in South East Wales. Semi-structured interviews were held with twelve pregnant women. A qualitative descriptive approach was used and data were analysed thematically. The theoretical framework of ‘reproductive citizenship’ developed by Wiley et al (2015) was used for interpretation of the study findings
Findings Women’s beliefs conflicted with their actions. Participants believed they were not at risk of influenza yet had the vaccination regardless. Characteristics of wanting to be a good mother and doing the right thing were evident, despite many competing priorities of pregnancy. The environment in which the women had their vaccination was not of concern and they displayed a quiescent approach to the influenza vaccination within the context of their antenatal care. Women placed trust in the midwife, relying on their advice without question. Discussion Fatalism, passive acceptance and influence of the healthcare professional was apparent, and participants spoke warmly of the ‘good midwife’. Magical beliefs and superstition explained the women’s perception of risk, derived from family experience. Fate, luck and perceived lack of control over life events framed women’s views. Women placed trust in the midwife taking comfort in that the knowledgeable professional was making the iii right decision ‘for them’ displaying traits of quiescent reproductive citizenship as characterised by Wiley et al (2015). Conclusion Influenza vaccination and the consequence of disease were perceived to be low down amongst many competing priorities of pregnancy. Participants did not believe that they were at risk of influenza disease and sometimes shifted responsibility for decision making to the midwife, placing trust in the mother / midwife relationship.
Rethinking postnatal care: A Heideggerian hermeneutic phenomenological study of postnatal care in Ireland
Postnatal care; Women's lived experiences; Future postnatal care possibilities; Heideggerian hermeneutical phenomenology
The postnatal period is an important and extremely vulnerable time for new mothers and their infants. Research has outlined the considerable extent of maternal physiological and psychological morbidity following childbirth. The underreporting and undiagnosed aspect of this morbidity has also been highlighted. Newborn infants are totally dependent on their needs being met and are also at risk of newborn conditions particularly if they are undiagnosed, for example neonatal jaundice. There is however, mounting evidence regarding the lack of postnatal support from health professionals, with women continuing to report their dissatisfaction with postnatal care. Research into postnatal care is pre-dominantly quantitative and clinically focused. Few empirical studies have examined the meaning women give to their postnatal care experiences. This research aims to generate a deeper understanding of the meanings, and lived experiences of postnatal care. In addition, it aims to reveal future possibilities to enhance women’s postnatal care experiences. Initially, an in-depth examination of relevant literature is undertaken followed by a presentation of the process and findings from a qualitative meta-synthesis. An in-depth exploration of Martin Heidegger’s biography and explication of his philosophy is then outlined. This research is a Heideggerian hermeneutical phenomenological study of Irish women’s aspirations for, and experiences of, postnatal care. Purposive sampling is utilised in this research, which was undertaken in two phases. Phase one involved group interviews over three different time periods
(between 28-38 weeks gestation, 2-8 weeks and 3-4 months postnatally), with a cohort of primigravid women and a cohort of multigravid women. The second phase involved recruiting two further cohorts of primigravid and multigravid women who participated in individual in-depth interviews over the same longitudinal period. In total nineteen women completed the study. Thirty-three interviews were held in total. The data analysis is guided by Crist and Tanner’s (2003) interpretative hermeneutic framework. The women’s aspirations/expectations for their postnatal care are represented through three interpretive themes: ‘Presencing’, ‘Breastfeeding help and support’ and ‘Dispirited perception of postnatal care’. In addition, five main themes emerged from the data and capture the meanings the women gave to their lived experiences of postnatal care: ‘Becoming Family’, ‘Seen or not seen’, ‘Saying what matters’, ‘Checked in but not always checked out’ and ‘The struggle of postnatal fatigue’. The original insights from this research clearly illuminate the vulnerability women face in the days following birth. A further in-depth interpretation and synthesis of the findings was undertaken. This philosophical-based discussion drew from the work of Heidegger (1962) and Arendt (1998). Engaging with these theoretical perspectives contributed to a new understanding about why some women within a similar context, have positive experiences of postnatal care while others do not. As such, the very nature that midwives and other postnatal carers are human beings has an influence on a woman’s experience of her care. These carers, in their exposition of ‘being’ have the ability to demonstrate ‘inauthentic’ or ‘authentic’ caring practices. It is those who choose to be ‘the sparkling gems’ that
are the postnatal carers who make a difference and stand out from the others. For the women in this study, their postnatal care experiences mattered. While some new mothers reported positive and meaningful experiences others revealed experiences which impacted unnecessarily. The relevance of these findings, recommendations and suggestions for future research are offered.
Conscientization for practice: The design and delivery of an immersive educational programme to
sensitise maternity professionals to the potential for traumatic birth experiences amongst
disadvantaged and vulnerable women.
Critical pedagogy, Birth trauma, immersive education, maternity
Birth is an important time in a woman’s life. While the journey into motherhood can be a
transformational and liminal experience, unfortunately, this is not the case for every woman. It is estimated that approximately 30 % of women experience childbirth as a traumatic event, with up
to 4% of women in community samples developing Post Traumatic Stress Disorder (PTSD) following childbirth. It is also highlighted that women who are vulnerable and disadvantaged, due to complex life situations such as poor mental health, poverty and social isolation, are more
likely to experience birth trauma and PTSD onset. Recent research highlights that women’s subjective experience of birth is one of the most important factors in determining birth trauma, and that negative interactions with health care professionals are a key contributor to its development. The aim of this study was to develop and evaluate a training programme for maternity care providers to raise awareness of birth trauma amongst disadvantaged and
vulnerable women. A critical pedagogical approach was adopted so that the design of the programme would aid reflection, critical thinking and conscientization. This study includes a meta-ethnographic review, empirical interviews and the design and delivery of a tailored educational programme within an NHS Trust. Firstly, a meta- ethnography was undertaken to explore disadvantaged and vulnerable women’s negative experiences of maternity care in high
income countries. Noblit & Hare’s (1988) meta ethnographic approach was used and four themes were identified through the synthesis of eighteen studies; ‘Depersonalisation’
‘Dehumanisation’, ‘Them & us’ and ‘No care in the care’. Secondly, ten local disadvantaged and vulnerable women in North West of England were recruited and interviewed, exploring their
negative experiences of birth. A framework analysis was used to interpret the data, identifying
key triggers for birth trauma, focused on interpersonal interactions with maternity healthcare professionals. These findings were then compared against studies included in the metaethnography. Following these stages an innovative educational programme focused on birth trauma and PTSD was developed and evaluated. Key findings from the meta- ethnography and the empirical interviews informed the content of a filmed childbirth scenario that was embedded within a critical pedagogical framework. The scenario was delivered to participants’ using virtual reality (VR) technology, forming part of a 90- minute educational programme, in which maternity
professionals view the scenario iii from a first-person perspective. Other elements of the education programme involved providing statistical evidence on birth trauma and PTSD, a presentation of qualitative data collected during empirical phases, critical reflections and the development of actionable practice points to change/influence care practice, for self and others. Ten maternity professionals participated in the evaluation, with pre/post questionnaires and a follow-up session used to assess participants attitudes, knowledge and experiences prior, during and following attendance. Findings suggest the immersive educational programme increased participants understanding and knowledge of birth trauma and PTSD, with the use of VR as a tool for knowledge translation found to enhance critical reflection and facilitate praxis. While further research to test the efficacy of the educational programme on women’s birth experiences is needed, simulated first person realities, embedded within a critical pedagogical framework, offer
a unique and innovative approach to addressing interpersonal care in maternity and wider health- related contexts of care.
Twitter: @ClaireHooks
An exploration of student midwives’ attitudes toward substance misusing women following a specialist education programme.
Substance Misuse, Pregnancy, Attitudes, Education
Substance misuse is a complex issue, fraught with many challenges for those affected. Whilst the literature suggests that pregnancy may be a ‘window of
opportunity’ for substance misusing women, it also suggests that there are barriers to women engaging with health care. One of these is fear of being judged and
stigmatised by healthcare professionals, including midwives. Previous research indicates midwives have negative regard toward substance users and that this in turn may lead to stigmatising behaviours and consequential substandard care provision. Midwives however, stress that they do not have appropriate training to effectively provide appropriate care for substance misusers. Research suggests that education is needed in this area to improve attitudes. In this study, the role of education in changing attitude toward substance use in pregnancy was explored using case study methodology. The case was a single delivery of a university degree programme distance learning module ‘Substance Misusing Parents,’ undertaken by 48 final year student midwives across 8 NHS Trusts. The research was carried out in 3 phases, using a mixture of Likert style questionnaires (Jefferson Scale of Physician Empathy and Medical Condition Regard Scale), Virtual Learning Environment discussion board qualitative data and semi structured interviews. The findings of the questionnaires showed empathy toward pregnant drug using women significantly improved following the module (p=0.012). Furthermore, exploration of the students’ experiences of the module demonstrated the importance of sharing and reflecting on practice; the experiences of drug users, both positive and negative; and having an opportunity to make sense of these experiences, as key in influencing their views. Furthermore, the findings indicated value in the mode of delivery, suggesting e-learning to be an effective approach. This research
demonstrates the potential of education in this area but also offers suggestions for educational delivery to reduce stigma in other areas of practice.
Twitter: @ljenkinsmidwife
Recovering the clinical history of the vectis: the role of standardised medical education and changing obstetric practice.
Vectis Education Practice
This thesis explores the use, and later non-use, of the vectis – an instrument invented in the seventeenth century by the Chamberlen family, along with its sister instrument, the forceps. Both instruments were designed to deliver a living baby when birth was obstructed by the head, but their histories were very different. In Britain, the forceps came into the public domain in 1733, the vectis in 1783, after which their respective merits were debated for over a century. Throughout that time, it was clear that both instruments were effective in sufficiently skilled hands, yet the forceps took over so decisively that by the early twentieth century the vectis had disappeared not only from clinical use, but also from the historiography of obstetric instruments. The central question addressed by the thesis is: why did the vectis disappear from clinical use? The thesis argues that the answer to that question is to be sought in the characteristics of clinical practice, skills and training. The vectis required a subtle set of manual skills, and the teaching of such skills was best favoured by individual apprenticeship; the use of the forceps was more easily reduced to rigid rules, and could therefore be taught in large classes. Thus, the shift to such classes around the middle of the nineteenth century favoured the forceps. To reconstruct that shift, this thesis explores the developing debates around medical education in the first half of the nineteenth century, bringing out the hitherto-neglected theme of the importance of midwifery training as a desideratum for the reformers. The link between pedagogic processes and clinical practice reflects the co-construction of users and technology of the Social Construction of Technology (SCOT) model, but requires some modification of that model, not least because the technological consequences of pedagogic change were entirely unintended.
Engaging with the ‘modern birth story’ in pregnancy: A hermeneutic phenomenological study ofwomen’s experiences across two generations
Birth stories, Hermeneutic phenomenology, Heidegger, idle talk
This study considered how women from two different generations came to understand birth inthe context of their own experience but also in the milieu of other women’s stories. For thepurposes of this thesis the birth story (described as the ‘modern birth story’) encompassedpersonal oral stories as well as media and other representations of contemporary childbirth, allof which had the potential to elicit emotional responses and generate meaning in theinterlocutor. The research utilised a hermeneutic phenomenological approach underpinned bythe philosophies of Heidegger and Gadamer. Phenomenological conversations with theparticipants took place in the iterative circle of reading, writing and thinking. This revealed theexperience of ‘being-in-the-world’ of birth for the two generations of women and the way ofcommunicating within that world. From a Heideggerian perspective, the birth story wasconstructed through ‘idle talk’ (the taken for granted assumptions of how things are which comeinto being through language) and took place across a variety of media accessed by women, aswell as through face-to-face conversations. The data revealed that the lifeworld of birth beingsustained in stories (for both generations) was one of product and process, concentrating on thestages and progression of labour and the birth of a healthy baby as the only significantoutcome. This thesis revealed that the information gleaned from birth stories did not in factcreate meaningful knowledge and understanding about birth for these women. The workhighlights a need for further research to qualify the relationship between what women see andhear about birth and their expectation and consequent experience of birth. Further itdemonstrates that women should be given help and guidance to ‘unpack’ and understandnegative stories and portrayals of birth to mitigate the damaging effects of expectant fear.
Twitter: @DrAngelaK
Care of obese women during labour: The development of a midwifery intervention to promote normal birth.
Obesity, Normal birth, Labour, Intervention
Normal birth, defined as birth without induction of labour, anaesthetic, instruments or caesarean section conveys significant maternal and neonatal benefits. Currently one-fifth of women in the United Kingdom are obese. There is evidence of the detrimental effects obesity has on intrapartum outcomes. There is a lack of research on how to minimise the associated risks of obesity through non-medicalised interventions and how to support obese women to maximise their opportunity for normal birth. This thesis aims to provide evidence to address this and develop an evidence-based intervention to promote normal birth. Using a methodological approach aligned with pragmatism, this research was conducted in four parts and underpinned by the MRC framework for the development of complex interventions. Part one was a national survey involving 24 maternity units. Part two was a qualitative study of the experiences of 24 health professionals and part three involved 8 obese women. The final part was a multi-disciplinary workshop that used consensus decision-making to design the intervention. Collectively, the findings suggest that intrapartum care of obese women is medicalised. Health professionals face challenges when caring for obese women but many strive to optimise the potential for normal birth by challenging practice and utilising ‘interventions’ to promote normality. The findings demonstrate that obese women have an intrinsic fear of pregnancy and birth, have a desire for normal birth and ‘obese pregnancy’ presents a window of opportunity for change. The intervention consists of three component parts: an educational aspect, a clinical aspect and a leadership aspect. Whilst acknowledging the importance of safety, increasing intervention during labour for obese women may further increase the risk of complications, with detrimental effects. Addressing intrapartum management of obese women through non-medicalised interventions is of paramount importance to promote normality, maximise the opportunity for normal birth and reduce the associated morbidities.
Las matronas en el Jaén del siglo XX. El caso de la Comarca de Sierra Mágina
Matronas, Género, Historia de las Profesiones Sanitarias
Con la aproximación que hacemos en esta investigación a las matronas, parteras y cultura de nacimiento de la Comarca de Sierra Mágina hemos pretendidocontribuir al estudio de la historia de las mujeres en general, al de las matronas y parteras en particular y recuperar para siempre la historia de la cultura delnacimiento más reciente de la Comarca estudiada, una parcela del saber que estaba en peligro de ser enterrada por la propia actualización científica de lapráctica profesional. Nos hemos acercado a la dimensión socio-familiar, académica, profesional y humana de unas mujeres que jugaron un papel muyimportante en la salud de las mujeres y hombres de la provincia de Jaén. Este acercamiento lo hemos hecho a través de quienes configuraron su espacio derelaciones. El estudio de mujeres, parteras y matronas desde los grupos de discusión, la entrevista en profundidad, las visitas a los pueblos de la Comarca, y lainmersión en documentación archivística nos ha permitido, recoger de cerca, para después contar de lejos, con la objetividad que permiten estosinstrumentos, la experiencia individual de cada matrona y las relaciones que configuraron como consecuencia de su práctica profesional. La segunda parte deesta tesis aborda la cultura popular de nacimiento en una Comarca andaluza de la España rural de mediados del siglo XX.
Experiences of Women and Other Birthing People Who Make Non-Normative Choices in Childbearing: A Constructivist Grounded Theory
Non-Normative, Choice, Autonomy, Outside-Guideline
The thesis aimed to explore why and how participants construct non-normative choices in the context of pregnancy and childbearing, alongside the underlying social processes participants navigate within UK maternity systems. Non-normative choices include outside-of-guideline care, declining routinely offered care and interventions or requesting care outside sociocultural norms. Such choices represent a critical test against which claims of women centred care and authentic informed decision-making can be tested. To date, emphasis on empirical research in this area has primarily focussed on clinician-based understandings of supporting non-normative choices and women’s experiences of more extremely positioned, mostly intrapartum choices. These have often excluded service users’ voices within more nuanced choices across the childbearing continuum, situated firmly within consent, autonomy, and agency issues. By exploring these issues, the thesis will present a constructivist grounded theory exploring the social processes experienced by and affecting women’s experience in making non-normative choices, offering a substantive theory to explain how women’s reproductive identity shapes and informs non normative choice-making. I present how non-normative choices represent a strategy by which, in the presence of institutional and systemic identity threat, reproductive identity is expressed, reinforced, or defended through common strategies, represented in the QuEEN model of common strategies for reproductive identity reinforcement and defence. The thesis will argue that contrary to choices being seen as ‘non-normative’ within contemporary maternity care, women view their choices as normative within their unique contexts and that a paradigm shift is required to reframe how non-normative choices are viewed. Rigid, risk-based systems of care designed to categorise women throughout their pregnancy journey work directly against aspirations for personalised care planning and frameworks of choice, reinforcing the urgent ongoing need for emphasis on personalised care within the UK maternity system to achieve equitable and safe perinatal outcomes in the presence of facilitative choice and relational care models.
Twitter: @jayneemarshall
Informed consent during the intrapartum period: an observational study of the interactions between health professionals and women in labour involving consent to procedures.
Informed consent, Medical personnel and patient, Communication on the labour ward, Women in labour
This ethnographic study using participant observation, aimed to explore the issue of informed consent to procedures undertaken during the intrapartum period. It involved recruiting 100 healthy women, who went into labour spontaneously at term, at the point they were admitted to the labour ward. The data collection took place in a large teaching hospital in an East Midlands city from April 1997 until December 1999. The subjects (health professionals and women) were observed throughout the labour until the woman and baby were transferred to the postnatal area. Follow-up interviews were conducted with the woman and midwives, within24 hours, using a semi-structured format based on the observations. The study revealed that it was difficult to obtain informed consent during labour. Contrary to professional belief, not all women wanted to be fully informed about intrapartum care and procedures, or wanted anything other than a pain free and easy labour that they perceived the western medical-technocratic model of care would offer them. Although the midwives' knowledge of legal and ethical issues concerning consent was variable and limited in the majority of cases, they attempted to empower women to make intrapartum choices. However, this was often constrained by the culture of the labour ward environment and the extent to which they adhered to policies and procedures. In cases where medical intervention became necessary, a minority of midwives felt personally disempowered. The obstetricians and paediatricians observed, appeared to be less effective communicators than anaesthetists, often leaving it to the midwife to explain issues to the woman. It is envisaged that these findings, as well as the stereotypical models of the labouring woman and the attending midwife that developed, and the resulting recommendations, be used in partnership between maternity service and education providers to ensure that health professionals not only have effective communication and interpersonal skills, but also are more conversant with the legal and ethical implications of consent.
Voicing the silence: the maternity care experiences of women who were sexually abused in
childhood
Childhood sexual abuse, Maternity Care, Feminist research, Narrative
Childhood sexual abuse is a major but hidden public health issue estimated to affect approximately 20% of females and 7% of males. As most women do not disclose to healthcare professionals, midwives may unwittingly care for women who have been sexually abused. The purpose of this study was to address the gap in our understanding of women’s maternity care experiences when they have a history of childhood sexual abuse with the aim of informing healthcare practice. This narrative study from a feminist perspective, explored the maternity care experiences of women who were sexually abused in childhood. In-depth interviews with women, review of their maternity care records and individual and group interviews with maternity care professionals were conducted. The Voice-centred Relational Method (VCRM) was employed to analyse data from the in-depth interviews with women. Thematic analysis synthesised findings, translating the women’s narratives into a more readily accessible form. The main themes identified were: narratives of self, narratives of relationship, narratives of context and the childbirth journey. Medical records provided an additional narrative and data source providing an alternative perspective on the women’s stories. Silence emerged as a key concept in the narratives. This thesis contributes to ‘Voicing the silence’. The particular contribution of the study is its focus on the women’s voices and the use and development of VCRM to listen to them. It highlights where those voices are absent and where they are not heard. Women want their distress to be noticed, even if they do not want to voice their silence. The challenge for those providing maternity care is to listen and respond to their unspoken messages and to hear and receive their spoken ones with sensitivity.
Using a birth ball in the latent phase of labour to reduce pain perception, a randomised controlled trial.
Birth ball, Latent labour, Pain
Hospital admission in the latent phase of labour is associated with higher rates of obstetric intervention, with increased maternal and fetal morbidity. Women sent home from hospital in the latent phase to 'await events' feel anxious and cite pain as their main drive to seeking hospital admission. Using a birth ball to assume upright positions and remain mobile in the latent phase of labour in hospital is associated with less pain and anxiety. However, no research has examined the effect of using birth balls at home in the latent phase on pain perception, hospital admission or obstetric intervention. An animated infomercial was developed to promote birth ball use at home in the latent phase of labour to enhance women's self-efficacy, in order to reduce their pain perception. As a pragmatic randomised controlled single centre trial, 294 low risk women were randomly allocated to two groups. At 36 weeks’ gestation the Intervention Arm accessed the infomercial online and completed a modified Childbirth Self- Efficacy Inventory before and after viewing. They were also offered the loan of a birth ball to use at home. The Control Arm received standard care. On admission to hospital in spontaneous labour, all participants were asked to provide a Visual Analogue Scale score. Both groups were followed up six weeks postpartum with an online questionnaire. Data were analysed on an Intention To Treat basis. A significant increase was found in Outcome Expectancy and Self-efficacy Expectancy after accessing the infomercial and Intervention Arm participants were more likely to be admitted in active labour. No significant differences were found between the VAS scores, or intervention rates. Most respondents (89.2%) described the birth ball as helpful and reported high satisfaction, with comfort, empowerment and progress. The birth ball is a promising intervention to support women in the latent phase. Further research should consider a randomised cluster design.
Life history theory : how the childhood environment affects humans' later life outcomes such as reproductive and marriage behavior, educational attainment and income
Life history theory, Fertility, Female Reproductive Behavior
Human fertility behaviour and reproductive decision-making is highly influenced by social and economic factors and is expected to be driven also by evolutionary processes. The present thesis is looking at human fertility behaviour through the evolutionary lens and therefore provides novel insights to what extent biological, ecological and socio-economic factors shape fertility patterns and reproductive decision-making in different stages of the demographic transition and how they interfere with each other. The first study tests if exposure to high mortality within the natal family in
early childhood leads to faster and riskier reproductive strategies in pre-industrial European society. The results reveal that women who were exposed to high mortality cues within the natal family
were at a greater risk to reproduce earlier and outside a stable union. Giving birth to an illegitimate child served as a proxy for risky sexual behaviour. Further, the study shows that the risk of giving
birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in marital reproductive timing are influenced more by family-level effects than by individual mortality experience. The second study therefore investigates the impact of famine-related high mortality and social factors on union formation in a pretransitional/ transitional
European population. The results show that individuals accelerate their transition to marriage when they were exposed to high mortality cues during early childhood. These results further stress the importance of individual’s early life conditions on their life-history trajectory. The third study considers the findings that fertility behaviour and reproductive decision-making varies across social classes and sheds some light on sex-biased parental investment in a post-transitional Western population. The study reveals that parents bias their parental investment/support depending on their social class towards the sex with the higher expected reproductive success. Low status parents invest more in their daughters’ higher education, whereas high status parents invest more in their sons’ higher education.
Models of maternity care for women with low socioeconomic status and social risk factors: what works, for whom, in what circumstances, and how? A realist synthesis and evaluation
Social risk, models of care, inequality, continuity
Background Factors associated with poor childbirth outcomes and experiences of maternity care include; Black and minority ethnicity, poverty, young motherhood, homelessness, difficulty speaking or understanding English, domestic violence, mental illness and substance abuse. These women struggle to access and engage with services. It is not known what aspects of maternity care work to improve outcomes and experiences for women with social risk factors.
Methods This research aimed to uncover the mechanisms that lead to improved experiences and outcomes through an evaluation of two specialist models of maternity care. One model of care takes a local approach and was placed within an area of significant health inequality. The other was based within a hospital setting and provides care for women based on an inclusion criteria of social risk factors. Using a realist approach a synthesis of qualitative literature and focus groups with midwives working in the specialist models was conducted to develop preliminary theories regarding how, for whom and under what circumstances the model of care is thought to work. Quantitative data on birth outcome and service use measures for 1000 women accessing different models, including standard care, group practice and specialist models of care at two large, inner-city maternity services were prospectively collected analysed using multinominal regression. Longitudinal interviews with 20 women with social risk factors were conducted to refine the theories.
Results The specialist models of care appeared to mitigate the effects of inequality and revealed no adverse outcomes compared to other models of care. Women receiving the specialist models of care were significantly more likely to use water for pain relief in labour, have skin to skin contact with their baby shortly after birth, and be referred to social care and support services. Maternity care based in the community setting was associated with a significant decrease in induction of labour, preterm birth and low birth weight. A subgroup analysis found that the improved preterm birth outcome was particularly significant for women with the highest level of social complexity. The qualitative analysis highlighted possible mechanisms for these findings that were related to access, interpreter services, education, information and choice, continuity of care, social, emotional and practical support and stigma, discrimination, and perceptions of surveillance. Women experienced substandard care when they were not in the presence of a known healthcare professional. Women described the benefits of seeing a known healthcare professional during pregnancy and particularly valued not having to repeat often difficult social and medical histories. They described feeling able to disclose difficult circumstances to a known and trusted midwife. Women in the hospital-based model described a lack of local, community support and had difficulty integrating into unfamiliar support services.
Conclusions Carefully considered place-based care with a focus on continuity can create safe spaces for women and identify their specific needs. The quantitative data highlighted interesting relationships between all community-based models of care and neonatal outcomes that require further testing in future research. The identification of specific mechanisms will allow those developing maternity services to structure models of care around local need without losing the core aspects that lead to improved outcomes.
Mothers Mood Study: women’s and midwives’ experiences of perinatal mental health and service provision
Perinatal mental health, Women
Background: Existing research on poor perinatal mental health largely focuses on recognition and treatment of postnatal depression. Consequently, there is a need to explore antenatal mental health. Aim: To assess poor mental health prevalence in pregnancy, its relationship to sociodemographic characteristics, self-efficacy and perceived support networks. To understand experiences and barriers preventing women with mental health problems from receiving help and explore midwives’ understanding of their role.
Method: Questionnaires were completed by women in early pregnancy. A subset identified to have mental health problems, were interviewed in late pregnancy to explore their experiences and barriers to receiving care. Midwives completed questionnaires exploring their experiences of supporting women with mental health problems and focus groups further discussed the issues raised.
Results: Amongst participants (n=302), the Edinburgh Postnatal Depression Scale (EPDS) identified 8.6%, and the Generalised Anxiety Disorder Assessment (GAD-7) 8.3%, with symptoms of depression or anxiety respectively. Low self-efficacy (p=0.01) and history of previous mental health problems (p<0.01) were most strongly associated with anxiety or depression. Thematic analysis of interviews with women (n=20) identified three themes: ‘past present and future’; ‘expectations and control’; and ‘knowledge and conversations’. Questionnaires were completed by 145 midwives. The three themes identified from the focus groups with midwives were: ‘conversations’; ‘it’s immensely complex’; and ‘there’s another gap in their care’.
Conclusion: Prevalence rates of anxiety and depression amongst women in early pregnancy were found to be similar to those reported in the literature. Low self-efficacy and previous poor mental health were significant predictors of anxiety and depression. Continuity and more time at appointments were suggested by midwives and women to improve discussions regarding mental health. Midwives were keen to support women but lacked knowledge and confidence. Consistent reference was made to the need for training regarding the practical aspects of supporting women’s mental health.
Determinants of late stillbirth Auckland 2006-2009
Stillbirth, Epidemiology, New Zealand
Stillbirth is a devastating and too common outcome of pregnancy; globally there are approximately three million deaths after 28 weeks‟ gestation every year. In New Zealand, as in other high income countries, more than 1 in 200 babies die before birth, and around 1 in 300 die in the last three months of pregnancy. During the mid twentieth century there was a dramatic decline in the rate of stillbirth, however this improvement has not been sustained in recent years. Previous studies have identified certain causes and risk factors for late stillbirth, but over a third of the deaths remain unexplained. The current variation in the rate of stillbirths both across and within high income countries suggests that it is possible to make further improvements in stillbirth rates. We hypothesised that there would be modifiable, but as yet unidentified risk factors for late stillbirth. The Auckland Stillbirth Study was the first case control study to select women with ongoing pregnancies as gestation matched controls. This study found that the disparity in rates of late stillbirth in women from different ethnicities in New Zealand could be attributed to associated factors such as high parity, high body mass index and social deprivation. Regular utilisation of antenatal care was found to be protective, and women who attended at least 50% of recommended antenatal visits had a lower risk of stillbirth compared to those who did not. Antenatal identification of sub-optimal fetal growth was found to be a possible aspect of the benefit of regular antenatal attendance. Maternal perception of fetal movements was also identified as an area of importance, with women who perceived their baby's movements to decrease in the last two weeks of the pregnancy being at greater risk of experiencing a stillbirth. In addition this study found an association between maternal sleep practices and risk of late stillbirth. Most strikingly, the study found that women who went to sleep on their left side on the last night (prior to stillbirth/interview) were half as likely to experience a late stillbirth compared to women who went to sleep in any other position. This study has added a New Zealand perspective to the existing literature on certain known risk factors for late stillbirth (such as high body mass index). It has also identified novel factors that present new possibilities for further research and for the potential for future reductions in the incidence of late stillbirth.
Twitter: @TabibM2
A Different Way of Being The Influence of a Single Antenatal Relaxation Class on Maternal Psychological Wellbeing and Childbirth Experience An Exploratory Sequential Mix-Method Study
Relaxation, Perinatal Psychological Wellbeing, Childbirth Experience, Antenatal Education
Background: Perinatal mental health problems are prevalent, have a wide range of adverse effects on the mother and her child, and are predictors of negative childbirth experiences. Therefore, improving perinatal mental health is a global public health priority and developing services that could promote it must be a priority for maternity services. There is growing evidence that antenatal education incorporating hypnosis or guided imagery techniques may have the potential to promote perinatal mental health and positive childbirth experiences. However, high-quality research in the field is lacking. Aim and objectives: This study aimed to explore the influence of a single 3- hour Antenatal Relaxation Class (ARC), incorporating theory on childbirth physiology, hypnosis and guided imagery, on maternal psychological wellbeing and childbirth experiences. The objectives of the study were to: a) identify the aspects of maternal psychological wellbeing and childbirth experiences that may be influenced by ARC, b) understand ‘why’ and ‘how’ any influence may occur, c) identify the factors that may mitigate the influence of ARC during labour and birth, and d) test the significance of any influence over time.
Methods: The study took an exploratory sequential mixed-method approach. In the initial qualitative phase, a purposive sample of 17 women and 9 birth partners participated in either individual (8 women) or joint (9 women and their birth partners) semi-structured in-depth interviews. The data were analysed using descriptive qualitative and reflexive thematic analysis. The follow up quantitative phase was a prospective longitudinal cohort study that used surveys to further examine childbirth experiences and measure psychological wellbeing in a sample of 91 women at three time points: pre-class, post-class, and post-birth.
Findings: Attending ARC was associated with increased childbirth self-efficacy, reduced fear of childbirth and state and trait anxiety, as well as improved mental wellbeing. These changes were significant and lasted over time, until after the birth. Attitudes towards childbirth changed after attendance at ARC, which motivated wide use of relaxation techniques as a self-care behaviour during pregnancy, labour, birth and beyond. Use of relaxation techniques was perceived to positively influence women’s childbirth experiences and choices including a decline in choice of epidural use for labour pain. The efficacy of the learned techniques in the management of labour pain, however, depended on the ‘birth space’ which encompassed the physical environment, interactions with birth attendants and the clinical picture of the experience.
Conclusion: Incorporating theory on childbirth physiology, hypnosis and guided imagery in childbirth education can enhance perinatal psychological wellbeing and childbirth experiences. Providing relevant education for birth practitioners may contribute to a salutogenic model of childbirth care in which practitioners can facilitate childbirth education as well as a birth space that is conducive to experiencing an altered state of consciousness as a health promoting state.
Unsafe Abortion and Unsupervised Births: Understanding the Challenges of Pregnancy and Childbirth in the Rural Highlands of Papua New Guinea
Unsafe Abortion, Unsupervised Births, Access to Care
Papua New Guinea (PNG) has one of the highest maternal mortality ratios in the world. Postpartum haemorrhage and sepsis related to childbirth and unsafe abortion are the leading causes of death. In PNG around 60% of women give birth unsupervised. This study was conducted the Eastern Highlands of PNG and used a mixed methods approach. This thesis is divided into two themes: unsafe abortion and community experiences and perceptions of pregnancy and childbirth; and describes a community-based intervention to improve maternal health outcomes. Unsafe abortion to end an unwanted pregnancy resulting in severe, acute morbidity was identified among young women presenting to the Eastern Highlands Provincial Hospital. Compared to those women who presented following a spontaneous abortion, those presenting following an induced abortion were significantly more likely to be younger, unmarried and a student (either at school or university). Obtained illegally, misoprostol was the most frequently used method to end pregnancy. Despite knowledge relating to complications that can occur during childbirth, many women continued to give birth, unsupervised in the community. Women faced numerous challenges in accessing care, particularly during childbirth. The implementation of a community-based package of interventions, providing clean birth kits and misoprostol for self-administration was feasible and highly acceptable in this setting. Through review of the findings identified in this thesis, one key factor emerged that influenced maternal health outcomes: access to health care. This key factor underpins the uptake of appropriate health care for two vulnerable groups of women: women with poorly timed pregnancies; and women during pregnancy and childbirth.
Competence and expertise in physiological breech birth
Physiological breech birth, Competence, Delphi, Grounded theory
This doctoral thesis by prospective publication aims to provide pragmatic, evidence-based guidance for the development and evaluation of physiological breech skills and services within the context of contemporary maternity care. The research uses multiple methods to explore development of professional competence and expertise. While skill and experience are acknowledged in multiple national guidelines as important safety factors in vaginal breech birth, prior to this research no guidance existed about how skill and experience should be defined, developed and evaluated. The thesis begins with an integrative review of the efficacy of current breech training methods, highlighting a lack of evidence associating any training methods with improved outcomes for breech births. Following this are two papers reporting the results of a Delphi consensus technique study involving a panel of breech experienced obstetricians, midwives and service user representatives. The first outlines standards of competence, training components and volume of experience recommended to achieve competence and maintain proficiency in upright breech birth. The second outlines principles of practice for physiological breech birth, rooted in relationship and response, and divergent from medicalised practices based on prediction and control. Following this is a grounded theory paper exploring the deliberate acquisition of breech competence among midwives and obstetricians with moderate upright breech experience. The paper reports a theoretical model that can inform development of breech teams and training programmes. The final paper reports a mixed methods analysis of data from the Delphi and grounded theory studies concerning breech expertise. The results present a model of generative expertise, underpinned by affinity, flexibility and relationship, which may function to increase the availability and safety of vaginal breech birth. Each paper is followed by critical analysis and reflection. The thesis ends with a discussion of the implications for practice and research in light of the overall body of work.
The Use of Telemetry to Monitor the Fetal Heart during Labour: A mixed methods study
Labour, telemetry, wireless monitoring, Control
Background: Wireless fetal heart rate monitoring (telemetry) is increasingly being used by maternity units in the UK. Guidelines from the National Institute for Health and Care and Excellence recommend that telemetry is offered to any woman who needs continuous monitoring of the fetal heart in labour. There is no contemporary evidence on the use of telemetry in the UK.
Aims: To gather in-depth knowledge about the experiences of women and midwives using telemetry to monitor the fetal heart in labour and to assess any impact that the use of telemetry may have on clinical outcomes, mobility in labour or control and satisfaction.
Study design: A convergent parallel mixed methods design was chosen.
Methods: Qualitative methods included in-depth interviews with 10 women, 2 partners, 12 midwives and one student midwife from two NHS Trusts in the Northwest of England. A constructivist grounded theory methodology was employed for this phase and used both purposive and theoretical sampling. All interviews were audio-recorded and transcribed verbatim. The quantitative phase recruited 161 women from both sites and compared clinical outcome and mobility data from 74 women who used telemetry during labour and 87 women who had conventional wired monitoring. Women also were asked to complete a questionnaire in the postnatal period on control and satisfaction during labour and birth. Questionnaire data was analysed from 128 women, 64 who used telemetry and 64 who had conventional wired monitoring. Both sets of data were integrated to give an overall broad understanding of telemetry use.
Findings: The grounded theory core category was ‘Telemetry: A Sense of Normality’ and was described by three sub-categories. ‘Being Free’ described women being more mobile when using telemetry in labour and experiencing greater feelings of control, normality, and support. Telemetry also increased dignity for women as they were able to use the bathroom independently and with ease. ‘Enabling and facilitating’ described midwives facilitating the use of telemetry, encouraging mobility and using midwifery skills including caring for women in a birth pool. ‘Culture and Change’ described the different maternity unit cultures and how this impacted on the use of telemetry. Telemetry was viewed as increasing choice and equity for women with more complex pregnancies. Within the quantitative phase there was no difference in the aggregate scores for either the Perceived Control in Childbirth (PCCh) scale or the Satisfaction with Childbirth (SWCh) scale. Sub-group analysis found that women who used telemetry for the majority of the time the fetus was continuously monitored in labour scored a higher aggregate score for perceived control during labour (mean ± SD; 5.3 ±0.8 telemetry vs. 4.9 ± 0.9 wired, p = 0.047). Mobility data found that women using telemetry spentmore time off the bed in labour and adopted more upright positions for birth.
Conclusions: Both qualitative and quantitative findings confirmed that women were more mobile in labour when using telemetry to monitor the fetal heart and integrated findings also found that telemetry increased feelings of control in labour. The use of telemetry had a positive impact on women who required continuous monitoring in labour and engendered a sense of normality for both women and midwives. The use of telemetry contributes to humanising birth for women requiring more complex care in labour and birth.
Keeping the balance: promoting physical activity and healthy dietary behaviour in pregnancy
Motivational Interviewing, Self Determination Theory, Behaviour Change, Pregnancy
Gaining large amounts of weight during pregnancy may contribute to development of obesity and is associated with poor outcomes. Therefore managing gestational weight gain is important to reduce the risk of complications. This thesis aims to explore clinical and personal management of gestational weight gain and to discover how pregnant women can be best supported to maintain physical activity and healthy dietary behaviours. This is achieved through a programme of research comprising three related studies. Study One explored the antenatal clinical management of weight and weight gain through one-to-one interviews with Antenatal Clinical Midwifery Managers across Wales (n=11). Findings showed wide variation in management of weight from unit to unit. Although midwives believed pregnancy to be a perfect opportunity to encourage healthier behaviours, many identified barriers preventing them discussing weight with women. In Study Two semi-structured interviews with pregnant women (n=15) investigated views on personal weight management during pregnancy. Again pregnancy was seen as an ideal time to improve health behaviours due to a perceived increase in motivation and many women identified specific goals. However, in the face of various barriers, it was apparent that the motivation which initially identified healthy lifestyle goals was unable to sustain this behaviour throughout the pregnancy. Finally Study Three looked at the feasibility and acceptability of a midwife-led intervention informed by the two preliminary studies. The ‘Eat Well Keep Active’ intervention programme designed to promote healthy eating and physical activity in pregnant women (n=20) was based upon the Self Determination Theory framework for enhancing and maintaining motivation and utilised motivational interviewing. Results indicated that the intervention was received well by participants who reported that it positively influenced their health behaviours. The ‘Eat Well Keep Active’ programme may be a suitable intervention to encourage and facilitate women to pursue a healthier lifestyle throughout their pregnancy.
An investigation of subsequent birth after Obstetric Anal Sphincter Injury
OASI, Perineal Trauma, Subsequent birth
Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth with a reported average worldwide incidence of 4%-6%. They are a recognised major risk factor for anal incontinence resulting in concern amongst women who sustain such injuries when considering the most suitable mode of birth in a subsequent pregnancy. This thesis contains three studies; a systematic review and meta-analysis of the published literature exploring the impact of a subsequent birth and it’s mode on bowel function and/or QoL for women with previous OASIS, a follow-up study on the long-term effects of OASIS on bowel function and QoL and finally a prospective cohort study of women with previous OASIS to assess the impact of subsequent birth and its mode on change in bowel function. The work in this thesis demonstrated an increase in incidence of bowel symptoms in women with previous OASIS over time and that short-term bowel symptoms were significantly associated with bowel symptoms and QoL. This thesis also showed that the mode of subsequent birth was not significantly associated with bowel symptoms or QoL and for women with previous OASIS who have normal bowel function and no anal sphincter disruption a subsequent vaginal birth is a suitable option.
Home » Blog » Dissertation » Topics » Nursing » Midwifery » Midwifery Dissertation Topics List (30 Examples) For Your Research
Mark Dec 14, 2019 Jun 5, 2020 Midwifery , Nursing No Comments
As a student, if you are finding Midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on new and emerging concepts and ideas. You can choose any of the […]
As a student, if you are finding midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on the new and emerging concepts and ideas.
You can choose any of the give topic for your research in midvfery and our team can offer quality dissertations according to your requirements.
Emerging trends in midwifery and obstetrical nursing.
Modern trends of the N education in midwives and modern methods in practical training.
The impact of delayed umbilical cord clamping after birth.
How the cell-free DNA screening is helpful in identifying genetic problems in the baby?
Limiting interventions during low-risk labor.
The concept of cost containment in healthcare deliver.
The importance of family centred care and natural childbirth environment.
An interpretive research on the disparity between women’s expectations and experience during childbirth.
Systematic literature review on the extrauterine life management focusing on lung functions in new born.
To analyse the role of perinatal care to pregnant women.
Studying the treatment alternatives for urogenital infections in rural women.
Conducting a systematic review on how midwifery students plan their career.
Strategies adopted by midwives to advise pregnant women about nutritional values and healthy food consumption.
Studying the impact of Hepatitis B in pregnant women.
Analysing how frequent miscarriages are linked with higher anticardiolip antibodies.
Studying the relationship between perinatal mortality rates and physical activity levels.
How can nurses recommend preventive strategies to avoid sexual transmission of Zika virus to new born?
Evaluating the attitude of women related to the implementation of basic immunisation programs in village.
Analysing the modern trends of the education in midwives and new methods in practical training.
To study the advance trends in gynaecology and obstetrics.
The role of midwives in saving the lives of unborn foetus.
Exploring the global trends in nursing and midwifery education.
Analysing the role of optimal midwifery decision-making during second-stage labour.
To study the integration of clinical reasoning into midwifery practice.
A literature review on labouring in water.
Exploring the experiences of mothers in caring for children with complex needs.
An ethnography of independent midwifery in Asian countries.
To explore the perceptions of control in midwifery assisted childbirth.
Analysing the decision-making between nurse-midwives and clients regarding the formulation of a birth plan.
The role of Vitamin D supplementation during pregnancy .
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Yang, Zhihui 1 ; Li, Xinxin 2 ; Lin, Huanhuan 2 ; Chen, Fanfan 2 ; Zhang, Lili 1 ; Wang, Ning 1
1 PR China Southern Centre for Evidence-based Nursing and Midwifery Practice: A JBI Centre of Excellence, Guangzhou City, Guangdong Province, PR China
2 School of Nursing, Southern Medical University, Guangzhou City, Guangdong Province, PR China
Correspondence: Ning Wang, [email protected]
The authors declare no conflict of interest.
This systematic review aims to investigate and synthesize qualitative evidence related to midwifery students’ perceptions and experiences of learning in clinical practice.
Midwifery students are required to develop strong competencies during pre-registration education for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education.
This proposed review will consider qualitative studies that have explored midwifery students’ perceptions and experiences of learning in clinical practice in all degrees. The search will be limited to English-language published and unpublished studies to the present.
This review will follow the JBI approach for qualitative systematic reviews. A three-stage search will be conducted to include published and unpublished literature. Databases to be searched include PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, American Nurses Association, Google Scholar, ProQuest Dissertation & Theses, and Index to Theses in Great Britain and Ireland. Identified studies will be screened for inclusion in the review by two independent reviewers. Any disagreements will be resolved through discussion. Data will be extracted using a standardized tool. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be used to inform midwifery education.
PROSPERO CRD42020208189
Due to strong advocacy for improved health and safety of pregnant women and their babies globally, many countries have made significant progress in increasing the proportion of pregnant women who give birth at health care facilities. 1 However, such effort has not led to the expected level of reduction in maternal and newborn mortality and stillbirths, 2 which can be caused by inadequacies in the quality of care provided in the health care facilities. 3
The delivery of quality and safe midwifery practice requires that health professionals develop strong competencies and high-level accountabilities. Evidence shows that well educated, regulated, and licensed midwives are associated with improved quality of care and rapid and sustained reduction in maternal or neonatal morbidity and mortality. 4 Pre-registration education is an important stage for midwifery students to develop the fundamental professional knowledge, skills, and judgment essential for their future practice. Clinical practice programs as a significant component of midwifery education provide a valuable opportunity for midwifery students to build hands-on capabilities that integrate with classroom theories, and to be socialized into their chosen profession. 5 Specifically, it helps students develop the required professional competencies for registration and ideas about their career preference, as well as smoothly transit to their future career. 6,7 It has been found that education undertaken through clinical placements provides up to 50% of the learning experience for students in pre-registration midwifery courses. 8
Midwifery refers to “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum throughout pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life.” 9 (p.1130) Midwifery practice involves a wide scope of care activities that are undertaken to pursue the overall well-being of pregnant women. This includes providing continuous support to the women during their antenatal, intrapartum, and postpartum periods, being responsible for conducting births, caring for the newborns, and preventing and managing complications in pregnancy and childbirth. 10 These require that midwives are highly competent in undertaking various work tasks in partnership with the women and to cope with the complex and dynamic nature of the practice environments. 11 To face such challenging learning requirements, midwifery students can become frustrated when they first enter a practice setting. Literature shows that student health professionals often face challenges and experience a high level of stress during their clinical placements, 12,13 and midwifery students experience more stress compared to students in other professions. 14,15 Research has found that the midwifery students’ clinical stress was either due to their low confidence in undertaking care and a fear of making mistakes, or their relationships with clinical educators and colleagues. 16 Negative clinical experiences perceived by the student midwives can pose a potential threat to their effective learning and recognition of their future professional career. 17-19
As a key part of successful midwifery education, a well-designed practice program with a supportive environment is essential for fostering students’ confidence and passion to pursue a future midwifery career and for building competencies for entry to their registrations. 7,20 Students’ perceptions and experiences about their clinical learning are considered a hallmark of quality education. 21 While there is a growing body of knowledge reported in the literature about these elements, a systematic aggregation of such evidence should identify implications for the educational and clinical faculties to develop appropriate and effective clinical training strategies and provide required support to the students. Our literature search has identified three reviews about student professionals’ learning experiences; however, these reviews have focused on the learning experiences of undergraduate nursing rather than midwifery students, 22 a setting other than clinical placements, 23 or the relationship between workplace culture and the practice experience. 24 This review addresses a gap in the literature by aggregating evidence about midwifery students’ perceptions and experiences of learning in clinical settings. The ultimate aim is to improve midwifery educators’ understanding of their students’ clinical experiences.
What are the perceptions and experiences of midwifery students’ learning in clinical practice?
Participants.
This review will consider qualitative studies that focus on midwifery students’ perceptions and experiences of learning in clinical practice settings. There will be no limitation regarding age, gender, grade or year, or ethnicity of participants.
The phenomena of interest will be midwifery students’ perceptions and experiences of learning in clinical practice settings.
This review will consider studies conducted in any settings identified as a clinical practice, including clinical placement or internship, in acute care, community care, or simulated learning environments.
This review will consider English-language qualitative studies that describe the perceptions and experiences of midwifery students in their clinical practice. These studies will focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, and action research. Qualitative data from mixed method studies will also be included.
The proposed systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. 25 The review has been registered in PROSPERO (CRD42020208189).
The search strategy aims to locate both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of PubMed will be undertaken followed by analysis of the text words contained in the titles and abstracts, and of the index terms used to describe the articles. This preliminary search in PubMed will be used to develop a search strategy for this review that will include other databases. A second search using identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. A sample search strategy for PubMed is detailed in Appendix I. There is no date limit for the studies included in this review.
The databases to be searched for published studies include: MEDLINE (PubMed), Science Direct, Web of Science, EBSCO (CINAHL), and EBSCO (PsycINFO). The search for unpublished literature will include Google Scholar, American Nurses Association, ProQuest Dissertation & Theses Database, and Index to Theses in Great Britain and Ireland.
Following the search, all identified citations will be collated and uploaded into EndNote v.9 (Clarivate Analytics, PA, USA) and duplicates removed. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant studies will be retrieved in full and their citation details will be imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI; JBI, Adelaide, Australia). 26 The full text of selected citations will be assessed in detail against the inclusion criteria by the two independent reviewers. Reasons for exclusion of full-text studies that do not meet the inclusion criteria will be recorded and reported in the systematic review. Any disagreements that arise between the reviewers at each stage of the study selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final systematic review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. 27
Papers selected for retrieval will be assessed by the two independent reviewers for methodological quality prior to inclusion in the review using the standard JBI critical appraisal checklist for qualitative research. 25 Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Authors of primary studies will be contacted with questions on missing information or if clarification is needed. The results of the critical appraisal will be reported in narrative form, as well as in a table. All studies, regardless of the results of their methodological quality, will undergo data extraction and synthesis.
Qualitative data will be extracted from studies included in the review by the two independent reviewers using the standardized JBI qualitative data extraction tool for qualitative evidence (JBI SUMARI). The data extracted will include specific details about the participants, context, geographical location, study methods, and the phenomena of interest relevant to the review question and specific objectives. Findings will be verbatim extractions of the authors’ analytic interpretations, along with relevant illustrations. Each finding will be assigned a level of validity or credibility. Findings will be described as “unequivocal” or “credible,” as recommended in the JBI Manual for Evidence Synthesis . 25 All “unsupported” findings will be excluded from the review. Any disagreements relating to credibility that arise between the reviewers will be resolved through discussion or by a third reviewer.
Qualitative research findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach. 28 This will involve aggregation or synthesis of findings to generate a set of statements that represents the aggregation, through assembling and categorizing these findings on the basis of similarity in meaning. These categories will then be subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. The categories and synthesized findings will be agreed by discussion among the reviewers to ensure they support the meaning of the data. Where textual pooling is not possible, the findings will be presented in narrative form.
The final synthesized findings will be graded according to the ConQual 29 approach for establishing confidence in the output of qualitative research synthesis and presented in a Summary of Findings. The Summary of Findings includes the major elements of the review and details how the ConQual score is developed. Included in the Summary of Findings will be the title, population, phenomena of interest, and context for the specific review. Each synthesized finding from the review will then be presented along with the type of research informing it, score for dependability and credibility, and the overall ConQual score.
The library staff at Southern Medical University for their guidance and support on literature retrieval.
Medline (pubmed).
Search conducted August 2020
clinical practice; experience; midwifery students; perception; qualitative research
Choosing a topic, developing your search strategy, carrying out your search, saving and documenting your search, formulating a research question, critical appraisal tools.
So you have been asked to complete a literature review, but what is a literature review?
A literature review is a piece of research which aims to address a specific research question. It is a comprehensive summary and analysis of existing literature. The literature itself should be the main topic of discussion in your review. You want the results and themes to speak for themselves to avoid any bias.
The first step is to decide on a topic. Here are some elements to consider when deciding upon a topic:
Once you have decided on a topic, it is a good practice to carry out an initial scoping search.
This requires you to do a quick search using LibrarySearch or Google Scholar to ensure that there is research on your topic. This is a preliminary step to your search to check what literature is available before deciding on your question.
The research question framework elements can also be used as keywords.
It is important to remember that databases will only ever search for the exact term you put in, so don't panic if you are not getting the results you hoped for. Think about alternative words that could be used for each keyword to build upon your search.
Build your search by thinking about about synonyms, specialist language, spellings, acronyms, abbreviations for each keyword that you have.
Inclusion & Exclusion Criteria
Your inclusion and exclusion criteria is also an important step in the literature review process. It allows you to be transparent in how you have ended up with your final articles.
Your inclusion/exclusion criteria is completely dependent on your chosen topic. Use your inclusion and exclusion criteria to select your articles, it is important not to cherry pick but to have a reason as to why you have selected that particular article.
Once you have thought about your keywords and alternative keywords, it is time to think about how to combine them to form your search strategy. Boolean operators instruct the database how your terms should interact with one another.
Boolean Operators
Don't forget the more ORs you use the broader your search becomes, the more ANDs you use the narrower your search becomes.
One of the databases you will be using is EBSCOHost Research Databases. This is a platform which searches through multiple databases so allows for a comprehensive search. The short video below covers how to access and use EBSCO.
A reference management software will save you a lot of time especially when you are looking at lots of different articles.
We provide support for EndNote and Mendeley. The video below covers how to install and use Mendeley.
Consider using a research question framework. A framework will ensure that your question is specific and answerable.
There are different frameworks available depending on what type of research you are interested in.
Population - Who is the question focussed on? This could relate to staff, patients, an age group, an ethnicity etc.
Intervention - What is the question focussed on? This could be a certain type of medication, therapeutic technique etc.
Comparison/Context - This may be with our without the intervention or it may be concerned with the context for example where is the setting of your question? The hospital, ward, community etc?
Outcome - What do you hope to accomplish or improve etc.
Sample - as this is qualitative research sample is preferred over patient so that it is not generalised.
Phenomenon of Interest - reasons for behaviour, attitudes, beliefs and decisions.
Design - the form of research used.
Evaluation - the outcomes.
Research type -qualitative, quantitative or mixed methods.
All frameworks help you to be specific, but don't worry if your question doesn't fit exactly into a framework.
There are many critical appraisal tools or books you can use to assess the credibility of a research paper but these are a few we would recommend in the library. Your tutor may be able to advise you of others or some that are more suitable for your topic.
Critical Appraisal Skills Programme (CASP)
CASP is a well-known critical appraisal website that has checklists for a wide variety of study types. You will see it frequently used by practitioners.
Understanding Health Research
This is a brand-new, interactive resource that guides you through appraising a research paper, highlighting key areas you should consider when appraising evidence.
Greenhalgh, T. (2014) How to read a paper: The basics of evidence-based medicine . 5 th edn. Chichester: Wiley
Greenhalgh’s book is a classic in critical appraisal. Whilst you don’t need to read this book cover-to-cover, it can be useful to refer to its specific chapters on how to assess different types of research papers. We have copies available in the library!
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Home » Ideas » Nursing Dissertation Topics » Here Is The List Of Best Midwifery Dissertation Topics Ideas
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Writing a strong dissertation is a crucial first step toward academic achievement in the field of midwifery. Dissertation Help Services UK provides students with vital assistance in this process by helping them choose subjects that are relevant to the changing field of maternity and newborn health.
The search for the greatest midwifery dissertation themes is both thrilling and difficult because there are so many intriguing possibilities for investigation, ranging from cutting-edge childbirth education techniques to the complexities of maternal healthcare.
Our help strives to motivate and direct budding midwifery scholars toward effective research initiatives through critical thought and incisive analysis. We enable students to make significant contributions to the improvement of healthcare practices in the field by matching academic goals with the changing demands of midwifery practice.
Like the many options for nursing, there are many exciting options for nursing dissertation topics in the UK just waiting to be explored. The midwifery profession offers many research opportunities, from exploring acute maternal health practices to examining the social impact of childbirth education.
Our dedicated staff is committed to supporting students at every stage of their academic career, providing valuable guidance and expertise to facilitate the selection of a thesis topic. Our staff are committed to supporting learners on this learning journey, providing valuable advice and knowledge to help them choose the topical topics that best go with their learning aims and objectives.
Please contact us with any queries or difficulties you may be having. We promise to help and assist you with deep research and are always welcome to suggestions for dissertation themes.
Our experts are here to help you build a dissertation topic that matches your academic goals, such as maternal health, infant care, or childbirth education, regardless of your specific interest in midwifery. Please feel free to email or message us in real time or fill out the form on this page for fresh topics in the midwifery domain.
The aim is to effectively utilise midwifery methods and to improve maternal health outcomes in Sub-Saharan Africa.
This study’s aim is to assess and contrast midwifery outcomes and practices in urban and rural Southeast Asia.
The aim is to identify the strategies applied to improve midwifery education and training in North America to maintain the changing medical demands.
This study aims to evaluate how midwifery may help nations in South Asia reduce maternal death rates.
The aim is to improve cultural competency in the provision of care for Native American people by midwifery.
This study’s main aim is to examine and make comparisons between midwifery practices and results in urban and rural Southeast Asian areas.
This study aims to compare home deliveries overseen by midwifery in various European nations.
The aim is to offer culturally appropriate midwifery care while upholding Indigenous populations’ cultural traditions in Oceania.
This study aims to examine how midwifery in Latin Amaerican nations may help ensure safe pregnancies and provide prenatal care.
The aim of study is to analyse midwifery treatment practices in Southeast Asian nations to empower young mothers.
The aim is to evaluate midwifery’s contributions to decreasing preterm deliveries in North America.
The aim of the research is to contrast how midwives operate in Western European nations when dealing with maternal psychological health difficulties.
The aim is to offer varied populations in South American nations culturally appropriate midwifery treatment.
The aim is to examine the effects of midwife-led water deliveries in Australia on mother and neonate outcomes.
The aim of this study is to identify the role of midwifery and the challenges it faces in providing care in humanitarian settings, notably in Middle Eastern refugee camps.
This study aims to examine how midwifery in Eastern Asian nations can support and care for new moms at home after giving birth.
The aim is to analyse the role of midwifery in telehealth services to intensify maternity care access in rural parts of Africa.
The aim of this study is to examine how midwifery can accompany LGBTQ+ families in North America throughout pregnancy and delivery by offering them culturally appropriate support.
The aim is to identify the role of reproductive health education programs for teenagers in Southeast Asian nations.
The aim is to assess the contribution of midwifery to global health programs focused on improving maternity care in underdeveloped nations.e.
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Literature review.
This scoping review was conducted according to the Preferred Reporting Items for Scoping Reviews, as outlined by the Joanna Briggs Institute (Aromataris and Munn, 2020). A priori protocol was...
This systematic review was conducted to identify tools that have been developed to evaluate breastfeeding knowledge and practice among nursing and midwifery students. The review followed the Preferred...
A systematic review is the best approach to determine the most effective intervention/treatment in clinical decision-making (Harvey and Land, 2017). This method follows explicit, rigorous and...
For this narrative review, PubMed was searched to identify key articles published between 2019 and 2024 investigating egg consumption during pregnancy, breastfeeding and/or infancy. The following...
The PICO mnemonic (Stern et al, 2014) was used to identify key words and develop the research question: what can midwives in England learn from studies exploring the experiences of autistic women in...
Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess the results of previous research to derive conclusions about that body of research (Haidich, 2010)....
This review was carried out to determine if the use of carbetocin in low- and middle-income countries would reduce the risk of postpartum haemorrhage, and associated morbidity and mortality, in...
The electronic search was carried out in September 2022, using the population/problem/patient, intervention, comparison, outcome and study design strategy. The primary source of literature was online...
A preliminary search of the Cochrane Library, CINAHL, and MEDLINE databases was undertaken to identify articles relating to the topic. Search terms or text words contained in titles, abstracts and...
An integrative review was considered suitable for this study, as this methodology allows inclusion of data from all types of literature to fully answer review questions (Whittemore and Knafl, 2005;...
This study was developed based on Arskey and O'Malley's (2005) scoping review methodology. According to this framework, there are six stages: (1) identifying the research question, (2) identifying...
Searches of key databases (CINAHL, MEDLINE, EMBASE, EMCARE) were conducted using a search strategy developed in collaboration with the local NHS library service (Table 1). Known researchers in this...
Showing 1 to 12 of 63 results
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EccentricaGallumbits · 30/09/2009 12:02
Things I like Normal birth Water Art Placentas Knitting. TIA.
The role of the knitted placenta in art.
also there has to have been at least 10 research papers already done on said subject.
Homebirth - is it an unacknowledged feminist stance against the male-dominated hegemony of the obstetric unit? !!
Then you might like threads about this subject:
Aha...that's where my idea comes unstuck I suspect
...and knitting
Antenatal preparation and mode of birth? I thankfully escaped a dissertation, but sometimes wonder, if I had to...then shudder, and have a cup of tea.
Can't you do your own research? If I wasn't so lazy and could motivate myself to do my dissertation I'd want to do some research. I was thinking about doing research on partnerss feelings about the birth. But then I realised I wouldn't have enough time for Mn'ing and decided to stick at a diploma.
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Breech presentation in pregnancy and the demise of knowledgeable clinicians available to assist with vaginal birth.
who the bloody hell thought it would be a good idea to do this to myself? am sorely tempted to jack it in and go back to nursing.
not enough time / energy for primary research. Has to be literature review. Breech is tempting. Perhaps something about whether nurses make better midwives or not. spirituality ad birthing? but what focus?
Do women need spiritual care from midwives? Spirituality, midwifery and childbirth in the UK?
Spirituality of midwives and its impact on maternal care Does midwives' experience of water-assisted birth affect their attitudes towards it? (could you manage a questionnaire as well as a literature review?) Like the 'Does previous nursing training affect midwives' practice?' idea.
Im a mental health nurse (with interest in perinatal mental health). I did my dissertation on Post Traumatic Stress Disorder following childbirth. Quite a few 'recent' (from 1994) papers out there.
Or what about ante natal care in prisons?
Still haven't decded. I really don't want to do something tat will traumatise me for the next 10 months so things like PTSD, emergencies and cappitity while interesting are out. I'm wondering about language used by midwives / medical peeps, whether women mind us talking bollocks a different language? whether women have jargo or medical / professional terms explained? and if it makes a difference to their experience? what do you think?
how about hypnosis & birth? there's some research going on in Adelaide at the moment Think the language issue a good one... interesting how rhetoric is used to manipulate choices ie get women so afraid they will agree to whatever medics want.
EccentricaGallumbits I'm being a bit cheeky (hijack) but can I just ask you, your a nurse, yes? Did you train as a nurse with midwifery in mind to do after initial nurse training, and do you think that it has benefited you by doing the nurse training first? Sorry lots of questions it's just I have started an access course to do nursing/midwifery....slightly undecided which pathway and am applying now to uni's. Any advice would be amazing......
pnd incidence related to birth experience Or, is it helpful to tell women they are not in labour until 2cm dilated?
cultural issues, esp as affecting women who are displaced, like asylum seekers? tho' might be a bit traumatic. I'd like a quick hijack, too- having a midlife crisis and considering long term dream of mw training? good idea or not?
well can you knit your own stretchy cervix and birth canal?
Hokay. Hijackers! I did always have an incling to do midwifery. I did nursing first because a. there was a nursing campus near me and the DDs were littler so less travelling. b. direct entry midwifery is hellishly competetive to get into so thought nursing might give me a leg up on the way (it did) c. I wasn't completely sure about the midwifery so thought having nursing as a base would be a good start because you an do lots of stuff, specialisms, etc from it. I am very glad I did nursing first because I actually love nursing, just don't like the crappy beurocracy that goes with it. not that midwifery is any different in that way but there are other options and a different supervision system. The nursing bit does help hugely when actually working in maternity. You have a more rounded view of medicine, surgery, physiology, pain, communication, psychology, sociology etc etc. However that's not to say that all that stuff isn't covered in the 3 year course. I think it just helps being more practiced in it before you start. If you do consider the nursey bit first then it may be useful checking with local universities if they do the 18 month conversion because lots don't and you may have to commute miles. And finally perfect for a midlife crisis career change. I have to say that. Thanks for suggestions. keep them coming. Am liking the decision making angle to the language thingy.
and yes. i have been known to knit uteri
hellishly competitive have to say I made a rather fine placenta out of felt with dressing gown cord covered with tights as umbilical cord (when I was nct teacher) I had this idea that 'visual' aids should be homely, would be more empowering...so...if you have knitted a uterus, what about something on women's understanding of physiology, how that relates to their exp of labour? prob no primary research on this tho. love your name btw.
(yes, hijacking again) Just wondering how you managed studying nursing with little children. i am considering a nursing degree but don't know how on earth i would make time for my 4 kids!?
post-traumatic stress incidence following instrumental delivery and impact on postnatal depression and/or bonding with baby
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MIDIRS is here to allow all midwives, student midwives, Maternity Support Workers (MSWs) or any health professional caring for women, babies and their families during pregnancy, birth and the postnatal period, worldwide, to share their knowledge and experiences to improve practice and outcomes. We are dedicated to helping you learn, grow and share from the start of your midwifery training all the way through your career.
We welcome original contributions from new, aspiring, or established writers, and our author guidelines will tell you everything you need to know about submitting your work to us.
Before you submit an article, please read the guidelines carefully. Unfortunately, we are unable to accept or review articles that do not adhere to the guidelines.
The Editor reserves the right to revise material or to return it to the author for amendments before accepting it for publication. We also reserve the right to amend material during production in accordance with house style and the demands of space and layout. Copyright of original articles published in MIDIRS belongs to MIDIRS.
For informal inquiries, questions or support with your submission please contact the MIDIRS Editor: Sara Webb at: [email protected] .
Find out more about writing original articles for MIDIRS Midwifery Digest below:
Listen to our very first podcast episode on writing for publication here . Read the transcript here .
A journal article should be written in a different style from that of an academic essay. Aim for a clear, readable and accessible style. If this is the first time you have submitted an article to a journal it may help to ask a colleague or tutor to read it.
As you write, ask yourself:
Please check your writing carefully for accuracy and ambiguity. A final edit, prior to submission, is essential to check spelling and remove any unnecessary words or phrases. You may find it helpful to look at past issues of MIDIRS to get an idea of the journal’s overall style and focus. The editorial team reserves the right to edit any article. Your article will be sent to you to check in its final form shortly before publication.
For informal inquiries, questions or support with your submission please contact the MIDIRS Editor: Sara Webb at [email protected].
Download the advice on writing for MIDIRS here.
Advancing Clinical Practice - (Reflective Practice/ Work experience / Service evaluation / Clinical Governance & Safety)
We welcome contributions about clinical practice, such as reflection on practice, personal experiences, service evaluation and clinical governance/safety. We are particularly interested in current issues, new developments, controversial topics, and would like articles that share experiences to help others advance their practice and/or challenge clinical practice.
Guidelines - Advancing Clinical Practice
• Maximum of 2500 words including in-text references and the reference list. • 100-word summary of the article, positioned at the start of the paper. • Statement of permissions obtained if appropriate • Reference list positioned at the end – maximum of 20 references . • Maximum of three tables/illustrations
Research – Primary (audits / RCTs / Cohort studies) or Secondary (Literature reviews / Systematic reviews / Modified systematic reviews)
We welcome submissions on primary and secondary research. We are keen to encourage submissions from any research undertaken as part of a higher education course, such as a dissertation or essay. Occasionally, the larger pieces of work may need to be split into two related papers.
Research articles are a maximum 3500 words including in-text references, tables/figures and the reference list.
Guideline - Primary Research (audits / RCTs / Cohort studies)
• Abstract - 350 word maximum o Objective o Methods o Results o Conclusion • Main paper o Introduction State the objectives of the work and provide an adequate background, avoiding a detailed literature survey or a summary of the results. o Methods A brief but clear outline of the methodology, making clear the study setting, the sample, the hypothesis (where relevant) and the reason for the chosen method. Please provide information of ethical approvals granted and particular ethical considerations in your study. Please provide details of funding, if appropriate. o Results Results should be clear and concise. Results/findings consistent with your chosen methodology. Tables and graphs may be used – maximum of three in total . o Discussion Relate your findings to focus their relevance to midwifery practice. Also include a brief statement of limitations of the research, and implications for practice and future research. o Conclusion A concise conclusion to include implications for future practice/research. • Statement of permissions obtained if appropriate. • Reference list - maximum of 25 references.
Guideline - Secondary Research (Literature reviews / Systematic reviews / Modified systematic reviews)
• Abstract - 350 word maximum o Objective o Methods o Results o Conclusion • Main paper o Introduction State the objectives of the work and provide an adequate background, avoiding a detailed literature survey or a summary of the results. o Methods A brief but clear outline of the methodology, to include search strategy, inclusion/exclusion criteria, study selection, quality appraisal, reflexivity (if applicable), data extraction and analysis methods. Please provide details of funding, if appropriate. o Results/Findings Results should be clear and consistent with your chosen methodology. Tables and graphs may be used – maximum of three in total. o Discussion Relate your findings to focus their relevance to midwifery practice. Also include a brief statement of limitations of the research, and implications for practice and future research. o Conclusion A concise conclusion to include implications for future practice/research. • Statement of permissions obtained if appropriate. • Reference list - maximum of 25 references.
Viewpoint/Discussion pieces
We welcome shorter reflective pieces that will encourage reflection and discussion. These articles may be clinical, descriptive, narrative or reflective pieces. We are keen for pieces that look at historical practices and experiences and how they relate to current services/guidelines, or for comparison of clinical practices across countries.
Viewpoint/Discussion pieces are a maximum of 1000 words including in-text references and the reference list.
For inclusion with your submission: • 100-word summary of the article, positioned at the start of the paper. • Main body of article. Tables/illustrations can be included - maximum of three tables/illustrations in total • Statement of permissions obtained if appropriate. • Reference list - maximum of 25 references .
De-mystifying Research!
To encourage advancement, understanding and adoption of research into daily midwifery practice, MIDIRS welcome pieces that discuss and critique a particular published piece of research. These will help the reader gain a greater understanding of how to critique research, while also gaining knowledge about the specific research study being discussed.
We also request submission of ‘Research guides’ that explain research and statistic methodologies in an easy to understand format. These can be published in a series or as a one off piece.
Word count for these types of articles will be dependent on the content/topic.
Please contact MIDIRS Editor, Sara Webb to discuss if you are interested in publishing such work: [email protected] .
Guideline/Report reviews
We encourage reviews of local, national and international guidelines/reports that have implications directly or indirectly for midwives. Such commentaries will help our readers to understand what reports mean for midwifery practice and to place report recommendations into context.
Download the article types here.
Author information: you will need to provide the following information:
Submitting Author • Preferred title • Name • Role • Workplace • Contact author email(This is usually the submitting author) • Twitter or Instagram handle (if applicable).
Co-Author(s) • Preferred title • Name • Role • Workplace
Main body article as described in the types of article, adhering to the following house style:
• Font and formatting: o Use Arial font, size 12. o Use 1.5 line spacing. o Headings and sub-headings in bold, further sub-headings in italic. o If you have included boxes of writing (possibly as extras or illustrative comments), please ensure these appear as text within the article (with borders, if you wish) rather than as separate items; this is to ensure they are easily accessible for our editorial team, but also so that the text is included in the word count. o When using abbreviations or acronyms in the text, always show the term or the name of the organisation in full the first time it is used in the text. For example: lower segment caesarean section (LSCS); National Institute for Health and Care Excellence (NICE). Thereafter, just use the abbreviation, ‘LSCS’, ‘NICE’ etc.
• References: o The chosen style for citing references is Harvard. Using this style, authors are named in the text with the publication year of their work shown in brackets after their name(s). o All references, regardless of the format they take, (whether they are journal articles, books, book chapters etc) should be listed alphabetically at the end of your paper. o Use authors’ initials as they appear in the article/publication but do not leave spaces between them. For foreign names, refer to Medline for the correct citation style. o Do not use commas between author names and initials in the reference list: Duff E (2003) not Duff, E (2003). o When referencing papers with different number of authors:
When referencing papers with different number of authors:
One author:
In the text: In a study by Duff (2003) it was concluded that…
In the reference list : Duff E (2003). Millennium development goals: where are the goalkeepers? MIDIRS Midwifery Digest 13(3):319-20.
Two authors:
In the text: When citing two authors, names should be linked by “&”: In a study by Hey & Hurst (2003) it was concluded that…
In the reference list: Hey M, Hurst K (2003). Antenatal screening: why do women refuse? RCM Midwives Journal 6(5):216-20.
Three authors or more:
In the text: Show the name of the first author only, and follow this by the phrase ‘et al’. Thompson et al (1997) conclude that…
In the reference list: All the authors names are included in the reference list.
• Tables and graphs A maximum of three tables and/or graphs are allowed for all types of article. Each one is equivalent to 200 words so please remember this and include these into your total word count: eg, One table or graph = 250 words, one table and one graph/ two tables = 500 words, etc.
• Images We welcome the addition of illustrations as they enhance articles. Please ensure that pictures, photos, diagrams, etc. are sent as VERY HIGH RESOLUTION jpegs or pdf attachments in addition to showing their placement in the article. Please clearly indicate in the text where the images are to be placed. Please ensure that the APPROPRIATE PERMISSIONS ARE OBTAINED and these are clearly stated next to the image.
• Illustrations Please provide good quality photographs (high res jpegs at a size of 1MB), diagrams or illustrations to go with your article. If you want to use or adapt illustrations from another source, it is your responsibility to obtain written permission to reproduce the material and to credit it accordingly. Photographs need the permission of both the photographer and all subjects within the pictures. Please submit all photos, diagrams and other illustrations as high res jpegs or pdfs separately, clearly highlighting where in the article it should go.
Confidentiality
Please be aware of issues of confidentiality. You may require permission from individuals/institutions discussed in your article. We reserve the right to anonymise where appropriate before publication.
All material is accepted for publication as an original article on the understanding that it has not been published before and is not due for publication elsewhere. The copyright of all material accepted for publication lies with the Publisher, MIDIRS. Whilst welcoming all contributions MIDIRS does not offer payment for unsolicited articles.
Promotion of products or services
We cannot include references to private companies, products or services. If you are writing as owner or employee of a company, brand names etc. will be changed to be more generic. Where a further resources section is included, this is designed to provide sources of information to the reader, not to list or promote products, companies or even particular books. Charities can appear, at our discretion, within the further resources, but only alongside a variety of alternatives, usually based in the NHS or equivalent.
Download the submission guidelines for MIDIRS here.
We recently supported the Bangladesh Midwifery Society on how to write for an academic publication.
Listen to the our very first podcast episode on writing for publication here .
In order for you to share your publication please see below:
1. Academic institute repository
MIDIRS publications can be deposited in your academic library repository after a three-month embargo period from the date of publication. Your institute librarian can email us to request this deposit: [email protected]
2. Personal/organisational sharing
Immediate sharing – front page
Upload an image of the front page of your article on a website/social media together with a link to the MIDIRS Midwifery Digest page on our website.
T hree-month embargo – full article
If you wish to share the full article this is subject to a three-month embargo from the date of publication. Please attach the following link statement: MIDIRS retains the copyright of this article
Download the copyright information about sharing your MIDIRS Digest article.
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Topic:1 Adolescence care. Research Aim: Focus on comprehensive medical, psychological, physical, and mental health assessments to provide a better quality of care to patients. Topic:2 Alcohol Abuse. Topic:3 Birth Planning. Topic:4 Community midwifery.
List of Best Research Topics in Midwifery 2024. Topic 1: Analysing the Ways to Hold Safe Childbirth by Adopting Preventive Measures: A Checklist Tool to Reduce Infant and Maternal Mortality. Topic 2: Evaluating the Prospects of Midwifery: Learning from the Past Experiences and Recent Developments for Childbirth and Mortality Rate in the UK.
Finding the best midwifery dissertation topics is a challenging job for students. To overcome this issue, Assignment Desk experts have prepared this blog. It will provide you with all relevant information on how to choose midwifery dissertation ideas, some good topics to choose from, and how to start writing your dissertation.. As a midwifery student, you will be required to write your ...
More Midwifery Dissertation Topics. In light of the above guidance, students can choose any topic from the following given midwifery dissertation topics. The impact of maternal obesity on birth outcomes. The use of midwife-led continuity of care models in maternity care. The role of midwives in promoting breastfeeding.
List of Midwifery Dissertation Topics For 2023. Midwives have been around for decades. Modern medicine does not change the role of midwives, however, their main role is still the same which is to care for and comfort expectant mothers during childbirth. Midwives are trained specialists who are responsible to take care of pregnant women, new ...
Midwifery Dissertation Topics With Research AimTopic:1 Adolescence care.Topic:2 Alcohol Abuse.Topic:3.Topic:4 Community midwifery.Topic:5 Contraception.Topic:6. ... Midwifery: Dissertation (40 credits) In this module you'll critically review literature to answer a research question, ...
Henderson, Ciara(Trinity College Dublin. School of Nursing & Midwifery. Discipline of Nursing, 2023) This thesis showcases an interdisciplinary and comprehensive exploration of perinatal death in Ireland through the nineteenth and twentieth centuries. Employing a social constructionist approach, this study questions the ...
The midwifery dissertation topics should aim to explain the profession in depth. It should define the focal point rather than going off track. Try to enhance your basic knowledge to understand the subject better. Knowledge is a core element because, without it, you cannot write and develop your thought process. You can even refer to midwifery ...
Here are 150+ broad trending dissertation topics in midwifery research: The impact of midwifery-led care on maternal and neonatal outcomes. Cultural competency in midwifery practice. Addressing health disparities in maternal and infant health. The role of midwives in promoting breastfeeding initiation and duration.
Dissertations on Midwifery. Midwifery is a health profession concerned with the care of mothers and all stages of pregnancy, childbirth, and early postnatal period. Those that practice midwifery are called midwives. View All Dissertation Examples.
63 Best Midwifery Dissertation Topics. Whenever you search "midwifery dissertation topics," you expect to find expert recommendations for top grades.Even professionals sometimes need a hand to find the best project ideas. Also, students who seek help in finding topics have a high chance of scoring better grades than those who find their research questions independently.
Improving Maternal Health: The Safe Childbirth. Checklist as a Tool for Reducing Maternal Mortality. and Morbidity. Julius Dohbit, Vetty Agala, Pamela Chinwa-Banda, Betty Anane-Fenin, Omosivie ...
Midwifery is about dealing with people and being near in the most significant periods of their lives. Thus, your midwifery dissertation should be devoted to some acute problems that midwives and their patients might face. Be specific and do not pick broad issues to discuss in your midwifery dissertation. Even if the issue you have chosen seems ...
Doctoral Thesis Collection. This midwifery PhD thesis collection is an exciting new initiative for the RCM. The aim of the collection is to provide a platform for midwives to showcase their academic work, and to inspire and support midwives who are considering or who are currently undertaking further academic study. Additionally, the collection ...
Topic With Mini-Proposal (Paid Service) Undergraduate: £30 (250 Words) Master: £45 (400 Words) Doctoral: £70 (600 Words) Along with a topic, you will also get; An explanation why we choose this topic. 2-3 research questions. Key literature resources identification. Suitable methodology with identification of raw sample size, and data ...
To access the repository, please enrol on the Undergraduate Dissertations Moodle site . All examples on the repository received a mark of 2:1 or above. Examples are available from a number of subject areas, including Business and Management, Dental Technology and Health and Social Care. We welcome further submissions from academic staff.
tion for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education. Inclusion criteria ...
A literature review is a piece of research which aims to address a specific research question. It is a comprehensive summary and analysis of existing literature. The literature itself should be the main topic of discussion in your review. You want the results and themes to speak for themselves to avoid any bias.
Looking for midwifery dissertation topics and ideas? Here you can find the best dissertation topics on midwifery to get high grades.
Impact of the midwife-led care model on mode of birth: a systematic review and meta-analysis. A systematic review is the best approach to determine the most effective intervention/treatment in clinical decision-making (Harvey and Land, 2017). This method follows explicit, rigorous and...
Hokay. Hijackers! I did always have an incling to do midwifery. I did nursing first because. a. there was a nursing campus near me and the DDs were littler so less travelling. b. direct entry midwifery is hellishly competetive to get into so thought nursing might give me a leg up on the way (it did) c.
Midwifery Dissertation Ideas - Free download as PDF File (.pdf), Text File (.txt) or read online for free. The document discusses getting help with midwifery dissertation topics. It states that writing a dissertation in midwifery can be an overwhelming task that requires extensive research and understanding. It then introduces HelpWriting.net as a service that provides expert assistance to ...
For informal inquiries, questions or support with your submission please contact the MIDIRS Editor: Sara Webb at: [email protected]. Find out more about writing original articles for MIDIRS Midwifery Digest below: Why you should write for MIDIRS Midwifery Digest. Watch on.