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The aim of this research was to answer the research question “what is the midwifery care provided by midwives to women living in areas of high deprivation?” It has been identified that rates of stillbirth and neonatal death are significantly higher in women living in the most socioeconomically deprived areas of New Zealand. A potential contributory factor to these rates is the issue of access to, and engagement with, maternity services. Yet, little is known about the care midwives provide to women living in areas of socioeconomic deprivation.Using grounded theory methodology, a conceptual framework was developed from data analysis of 8 interviews undertaken with midwives between August 2000 and March 2001. Findings revealed a core category of “staying involved `because the need seems so huge.”’ Four further categories were identified: “Forming relationships with the wary,” “Giving `an awful lot of support,”’ “Remaining close by,” and “Ensuring personal coping.” Throughout, the midwives’ continued involvement with the woman ensured an optimal pregnancy outcome for both the woman and her new baby.The findings from this study inform the care provided by midwives who work with women living in areas of high deprivation and begin to address factors regarding access to, and engagement with, maternity services.

Background Woman-centred care is recognised as a fundamental construct of midwifery practice yet to date, there has been no validated tool available to measure it. This study aims to develop and test a self-report tool to measure woman-centred care in midwives. Methods A staged approach was used for tool development including deductive methods to generate items, testing content validity with a group of experts, and psychometrically testing the instrument with a sample drawn from the target audience. The draft 58 item tool was distributed in an online survey using professional networks in Australia and New Zealand. Testing included item analysis, principal components analysis with direct oblimin rotation and subscale analysis, and internal consistency reliability. Results In total, 319 surveys were returned. Analysis revealed five factors explaining 47.6% of variance. Items were reduced to 40. Internal consistency (.92) was high but varied across factors. Factors reflected the extent to which a midwife meets the woman’s unique needs; balances the woman’s needs within the context of the maternity service; ensures midwifery philosophy underpins practice; uses evidence to inform collaborative practice; and works in partnership with the woman. Conclusion The Woman-Centred Care Scale-Midwife Self Report is the first step in developing a valid and reliable tool to enable midwives to self-assess their woman-centredness. Further research in alternate populations and refinement is warranted.

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Background: The Midwifery Council of New Zealand requires that registered midwives are engaged in education as one aspect of demonstrating ongoing competence. Barriers to engagement include geographical isolation, inability of workplaces to release midwives, potential for the post-registration student to be unavailable to her Lead Maternity Care clients, and financial constraints associated with travel to where the study is offered. In New Zealand, the Otago Polytechnic postgraduate midwifery programme offers a range of clinically focussed and theoretical papers that are delivered at distance in a blended model, combining online learning with synchronous and asynchronous online discussion opportunities. This model enables midwives to up-skill and build "communities of practice" regardless of their physical location, with no resultant loss of availability to their community or workplace. Aim: This research aimed to explore midwives' perceptions of how their engagement in online postgraduate midwifery education had influenced their practice, potentially benefiting childbearing women in their care. Method: Following ethical approval, an online survey was sent to all midwives who were enrolled in postgraduate midwifery courses at Otago Polytechnic in the period 2012 to 2013. Data were collected in April 2014, from a survey that used a combination of Likert scales, yes/no responses, and provision for qualitative comments. Data were analysed using descriptive statistics and thematic analysis. Results: Fifty-five out of 117 (47%) surveys were returned. Midwife respondents practised across a range of settings from urban to remote rural locations, and midwifery care was provided at home and at primary, secondary and tertiary birth facilities. Respondents felt that participation in online postgraduate midwifery education had improved their knowledge base and their ability to practise in an evidence-informed way, and they felt connected to a community of practice in a virtual sense, gaining the benefits of support and encouragement from fellow learners and lecturers. They believed that the care they provided to women was enhanced because they had practice currency and could apply their knowledge to clinical situations with increased confidence. Conclusion: For these midwives, engagement in online postgraduate midwifery education informed their midwifery practice, and therefore the care that women received. Online postgraduate midwifery education enabled these midwives through its accessibility.