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At least 19 recordsLinked to original sources
PubMed1991

Midwife/client relationship: midwives' perspectives.

This study set out to explore midwives' understanding of the factors which affected the development of a therapeutic relationship with clients. A qualitative approach was adopted for the study to avoid placing predetermined categories upon midwives' perceptions. Because of the qualitative nature of the study in-depth interviews were conducted to allow midwives to explore in depth their perceptions of the research topic. Themes identified within the interview data indicated conflicting needs/interests which in turn seemed to cause dilemmas for the midwives interviewed. It seemed appropriate therefore to take the data analysis one step further by utilising dilemma analysis. Consideration of the situations in which the midwives experienced 'good' or 'poor' relationships revealed a complex picture of the factors affecting relationships with clients. Four main issues were identified: the nature and value of the midwives' role; recognition of authority/autonomy in practising this role; emotional involvement with clients; and maintaining personal integrity. From dilemma analysis of the data it appears that when midwives were successful in managing these issues then the relationship became 'special' and therapeutic for clients. Mismanagement of these issues in contrast led to dilemmas which then inhibited development of meaningful relationships between the midwives and clients. In view of the fact that clients and midwives value this 'special' relationship a case is made for midwives to be prepared educationally to manage effectively issues which are raised in their everyday practice. Only then will the midwife/client relationship become therapeutic.

Clinical Nursing Research↗
PubMed1989

Variations between midwives regarding administration of obstetrical analgesia.

Variations among 32 midwives involved in a total of 1578 deliveries were studied regarding attitudes to and use of obstetrical analgesia. Relevant data were obtained from the register of the maternity department of a Swedish regional hospital. This was complemented with information about the midwives' attitudes to pharmacological pain relief in labour and delivery, collected by means of a mailed questionnaire. Variations between midwives (range), expressed as percentages of each midwife's total number of deliveries, were considerable: epidural block (EDA), 9-48%; Pethidine, 0-41%; Entonox (N2O/O2), 8-62%; pudendal block (PDB), 11-71%. Midwives working on night-shift used less EDA, but more pethidine, than their day-shift colleagues. 59% of all the midwives were critical of current levels of obstetrical use of analgesics in Sweden, while 41% felt the level to be about right. Night-shift midwives were rather more critical than day-shift midwives. Midwives critical of current levels of obstetric medication used EDA and PDB less often than their more enthusiastic colleagues, but the difference was not statistically significant. On the other hand, critical midwives used more Pethidine (p less than 0.05) and also more Entonox than their less critical colleagues, though again the difference was statistically non-significant.

Anesthesia, Obstetrical↗
PubMed2026

Exploring the perceptions, experiences, and behaviours that nurses and midwives face in relation to sleep: A systematic review of qualitative evidence.

BACKGROUND: The importance of sleep for nurses and midwives is increasingly being recognised. Poor sleep is known to have negative impacts on physical health, mental wellbeing, and work performance. This has prompted efforts to promote and support staff sleep. However, further efforts are needed to understand how nurses and midwives consider and manage sleep to ensure that meaningful and effective interventions are adopted and sustained. AIMS: This review of qualitative evidence aims to examine nurses' and midwives' perceptions, experiences, and behaviours around sleep. METHODS: This review followed JBI's systematic meta-aggregative approach including development of an a priori protocol. A systematic search of six electronic databases (MEDLINE, Embase, Emcare, PsycINFO, CINAHL, and Scopus) was undertaken to identify qualitative studies that examine nurses' and midwives' perceptions, experiences, and behaviours related to sleep. The search was conducted on the 10th of October 2024. Study selection, quality appraisal, data extraction, and synthesis followed JBI approaches and the ConQual approach was used to report assessment of synthesised findings. RESULTS: Thirty-three studies were included for review, and 245 findings were aggregated into 24 categories and nine synthesised findings related to the perceptions, behaviours, and experiences. While sleep was perceived as important, poor sleep was often understood as an expected and inevitable part of the job and that there was a need to always be awake to provide continual care. Experiences influencing sleep related to personal circumstances and work-related factors, as well as professional training and institutional practices. A range of behaviours, including planning time to sleep, using sleep aids, modifying the sleep environment, and altering daytime behaviours were also described. CONCLUSION: This review identified a range of perceptions, behaviours, and experiences that may influence the sleep of nurses and midwives which are vital to supporting individual and workforce wellbeing and safe, effective clinical practice. Insights from this review can be used to better understand nurses' and midwives' relationship with sleep and to develop and enhance targeted sleep interventions and programs that aim to promote and support healthy sleep among nurses and midwives. Open Science Framework Registration: 10.17605/OSF.IO/F32UM.

Humans↗
PubMed1992

Antenatal care of low risk obstetric patients by midwives. A randomised controlled trial.

OBJECTIVES: To assess the practicality, acceptability to patients and salary costs of the antenatal care of low risk obstetric patients by midwives. DESIGN: A randomised controlled trial. SETTING: The antenatal clinic at Westmead Hospital, a teaching hospital of the University of Sydney in western Sydney. PATIENTS: From January 1989 until November 1990, 89 women booking for full antenatal care at Westmead Hospital and classified as low risk were randomly allocated to one of two groups. Group 1 (43 patients) had their antenatal care provided by registered midwives. Group 2 (46 patients) had their antenatal care provided by an obstetrician (either Visiting Medical Officer or Staff Specialist) in a routine hospital antenatal clinic. INTERVENTIONS: Patients in the midwives' clinic were seen by an obstetrician at their first visit to the antenatal clinic and again at 30 weeks and at 40 weeks. MAIN OUTCOME MEASURES: These were the salary costs of each clinic and the patients' levels of satisfaction. Maternal and neonatal indicators, delivery details and analgesic requirements were also considered. These indicators were planned before data collection commenced. RESULTS: The major differences found were a 28% to 68% salary cost saving and that patients cared for by midwives showed appreciation of the continuity of care and information given at the midwives' clinic. CONCLUSIONS: The care of low risk obstetric patients by midwives in a midwives' clinic showed salary cost savings and high patient acceptance.

Continuity of Patient Care↗
PubMed1990

Private midwives: a new approach to family planning service delivery in Ghana.

Data on 134 private sector midwives who were educated and trained in family planning service delivery by the Ghana Registered Midwives' Association (GRMA) showed that, for most, the course was the first they had received since qualifying as a midwife. Four out of five of the new family planning clients served by these midwives were first time contraceptive users. Approximately 9% of the clients were men, most of whom requested condoms. While delivering women is still the main function of the maternity homes, it is clear that family planning services have come to represent an important element of the health care the midwives provide. A follow-up study of family planning acceptors found extremely encouraging continuation rates. In addition, a survey of the women that the midwives had delivered showed that the contraceptive prevalence rate among these women was higher than the national rate. Providing family planning services through private sector midwives has been shown to be a very successful approach in Ghana, and one that has the potential to become a pillar of the nation's overall family planning delivery programme. As several other countries in Africa also have active private sector health networks, this approach holds promise far beyond its initial success in Ghana.

Adolescent↗
PubMedDate not supplied

Prescriptive authority and nurse-midwives.

The purpose of this paper is to provide an overview of issues relevant to the question of prescriptive authority for nurse-midwives. Nurse-midwives can be held liable for prescriptive competency as evidenced by the American College of Nurse-Midwives' statements, physician delegation of prescribing privileges, and recent court rulings. Despite this liability, nurse-midwives are denied legally sanctioned authority if they are not granted prescriptive privilege by specific legislation. This discussion concludes with a position in favor of direct prescriptive authority, regulated by boards of nursing, for all nurse-midwives in order to remove unnecessary restrictions to the practice of an important member of the health-care team.

Drug Prescriptions↗
PubMedDate not supplied

Findings of the 1990 Annual American College of Nurse-Midwives Membership Survey.

The 1990 Annual ACNM Membership Survey was conducted by the Division of Research for the purpose of obtaining current information about certified nurse-midwives (CNMs) who were members of ACNM. Of the 2,899 surveys sent, 1,992 surveys were returned from 1,877 CNMs and 115 student nurse-midwives (a response rate of 68.7%). The mean age of the CNMs was 41.8 years. Most were female (97.9%) and white (95.3%); 85.1% were active members and 6% were life members of ACNM. The CNMs had been employed in nurse-midwifery-related employment a mean of 8.5 years. The greatest proportion were in clinical nurse-midwifery practice attending births (64.2%). An additional 10.0% were in clinical nurse-midwifery practice not attending births. Experienced nurse-midwives employed full-time reported a mean annual income of $45,229 and being on-call 71.4 hours per week. New nurse-midwives employed full-time reported a mean annual income of $40,504 and being on-call 59.6 hours per week. Most nurse-midwives employed full-time were salaried (57.4%), whereas most CNMs working part-time were paid based on the number of hours worked (49.7%).

Adult↗
PubMed1992

Testing for HIV in the antenatal clinic: the views of midwives.

Self administered questionnaires were given to 34 midwives, who regularly counsel parturient women about the HIV antibody test, to investigate their attitudes to the test being offered in the antenatal clinic. Most of the midwives felt that testing should not be compulsory and that the test should be offered to all pregnant women who ask for it, not only those in recognized risk groups. Most also felt that women should be told the results of the test and that it should not be the midwives aim to increase the number of women having the test. Most felt that all midwives should counsel about the test but would like health advisers, GPs and obstetricians to be involved also. They also felt that they did not have sufficient knowledge in some areas to counsel particularly with regard to the practical and psychological implications of being HIV positive. This has implications in terms of the provision of adequate pre-test counselling for all pregnant women as an improvement in counselling services requires an allocation of finances, e.g. for training of midwives, which may be seen as unnecessary in areas of low seroprevalence. Further discussion and debate of these issues is required.

AIDS Serodiagnosis↗
PubMed1992

The role of the village midwives in antenatal care services in the Sudan.

A study was conducted to assess the obstetric care coverage provided by the Sudanese village midwives. Mothers and village midwives, from four villages were interviewed using structured questionnaires. A total of 130 mothers who had delivered within 6 months were included in the study. Seventy per cent of these mothers contacted the village midwives at least once during their pregnancy. The average attendance was 3.8 antenatal contacts per mother. Seventy-one per cent of those who contacted the village midwives did so during the first half of pregnancy. Half of these mothers were seen in the village midwife's own home and only 20 per cent were in the mothers' homes. The village midwife attended 76 per cent of the deliveries, 11 per cent were attended by the traditional birth attendants, and the remainder delivered in hospital. The village midwives demonstrated reasonable standard of knowledge and competence in various aspects of antenatal care, history taking, examination, and selection of cases for referral. They lack adequate support and supervision, and supplies of drugs such as iron, folic acid, and chloroquine tablets.

Adolescent↗
PubMed1989

Characteristics of traditional midwives and their beliefs and practices in rural Bangladesh.

This study has analyzed the characteristics, beliefs and practices of midwives in rural Bangladesh. The midwives were mainly above age 30, married or widowed, and illiterate. Most of them learned their midwifery from informal sources such as female relatives or neighbours. Often, during pregnancy, childbirth, and post-partum period, midwives imposed dietary restriction on the mothers. Similarly, devices used in the cutting of the umbilical cord and placenta were not properly sterilized and potentially dangerous substances were applied at the navel after cutting the umbilical cord or placenta. There was a practice of withholding breast-feeding up to 3 days after the birth of a child. However, there were also some beliefs or practices among the midwives that could be regarded as based on scientific understanding such as the practice of cutting the umbilical cord by boiled razor blade or the belief that child death could occur from tetanus caused by the unsterilized device used in the cutting of the umbilical cord.

Bangladesh↗
PubMedDate not supplied

Use of precautions by nurse-midwives to prevent occupational infections with HIV and other blood-borne diseases.

A questionnaire was designed with these objectives: (1) to determine the frequency and type of adverse exposures experienced by certified nurse-midwives (CNMs); (2) to determine the extent to which CNMs used recommended precautions to prevent such incidents; and (3) to identify the sources used for obtaining information on AIDS. The questionnaire was mailed to all CNMs with the exception of associate and student members of the American College of Midwives. A response rate of 1,784/2,963 (60.2%) was obtained. These midwives reported frequent exposures to blood and body fluids. Sixty-five percent reported being soaked to the skin with blood or amniotic fluid; 50.7% had face-splashes with blood or amniotic fluid; and 24.0% experienced one or more needlestick(s). Only 55.1% reported using Universal Precautions (UP). Interference with the midwife-client relationship was identified most frequently as the reason for not using UP. Strategies need to be developed for midwives that will increase the use of UP and minimize the frequency of adverse exposures, while maintaining a caring midwife-client relationship.

Acquired Immunodeficiency Syndrome↗