Changes in midwives' attitudes to their professional role following the implementation of the midwifery development unit

Turnbull, Deborah; Reid, Margaret; McGinley, Marisa; Shields, Noreen

doi:10.1016/0266-6138(95)90025-x

Cited by 51 publications

(25 citation statements)

References 4 publications

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“…Increased satisfaction resulting from a perception of higher feelings of autonomy and enhanced continuity of care has also been demonstrated in other settings (14,15). In a study evaluating midwives' attitudes toward their role after moving to a midwifery‐run unit, autonomy and continuity of care were the best predictors of midwife satisfaction (15).…”

Section: Discussionmentioning

confidence: 83%

Single Room Maternity Care: The Nursing Response

Janssen

Harris

Soolsma

et al. 2001

Birth

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Section: Discussionmentioning

confidence: 83%

Single Room Maternity Care: The Nursing Response

Janssen

Harris

Soolsma

et al. 2001

Birth

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“…The Attitudes to Professional Role scale was used to assess job satisfaction (Turnbull, Reid, McGinley, & Sheilds, 1995). It assesses professional satisfaction, professional support, client interaction and professional development.…”

Section: Methodsmentioning

confidence: 99%

A programme for the prevention of post-traumatic stress disorder in midwifery (POPPY): indications of effectiveness from a feasibility study

Slade

Sheen

Collinge

et al. 2018

European Journal of Psychotraumatology

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Background: Midwives can experience events they perceive as traumatic when providingcare. As a result, some will develop post-traumatic stress disorder (PTSD), with adverse implications for their mental health, the quality of care provided for women and the employing organizations. POPPY (Programme for the prevention of PTSD in midwifery) is a package of educational and supportive resources comprising an educational workshop, information leaflet, peer support and access to trauma-focused clinical psychology intervention. A feasibility study of POPPY implementation was completed. Objective: This study aimed to identify potential impacts of POPPY on midwives’ understandingof trauma, their psychological well-being and job satisfaction. Method: POPPY was implemented in one hospital site. Before taking part in the POPPY workshop (T1) midwives (N = 153) completed self-report questionnaires, which measured exposure to work-related trauma, knowledge and confidence of managing trauma responses, professional impacts, symptoms of PTSD, burnout and job satisfaction. Measures were repeated (T2) approximately 6 months after training (n = 91, 62%). Results: Midwives’ confidence in recognizing (p = .001) and managing early traumaresponses in themselves and their colleagues significantly improved (both p < .001). There was a trend towards reduced levels of PTSD symptomatology, and fewer midwives reported sub clinical levels of PTSD (from 10% at T1 to 7% at T2). The proportion of midwives reporting high and moderate levels of depersonalization towards care was reduced (33% to 20%) and midwives reported significantly higher levels of job satisfaction at T2 (p < .001). Reductions in self-reported stress-related absenteeism (12% to 5%), long-term changes to clinical allocation (10% to 5%) and considerations about leaving midwifery (34% to 27%) were identified. Conclusions: In conclusion, POPPY shows very positive potential to improve midwives’ mental health and the sensitivity of care they provide, and reduce service disruption and costs for trusts. Large-scale longitudinal evaluation is required.

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“…It is possible that the continuity inherent in caseload midwifery and potential for lower intervention childbirth would improve midwife satisfaction [18-21]; however studies in the UK and Australia have reported problems with the widespread implementation and organisation of models that promote continuity of carer. Issues for midwives include high and unsustainable workloads, personal costs (impinging on family life) [22,23]; and burnout and stress [24].…”

Section: Introductionmentioning

confidence: 99%

COSMOS: COmparing Standard Maternity care with One-to-one midwifery Support: a randomised controlled trial

McLachlan

Forster

Davey

et al. 2008

BMC Pregnancy Childbirth

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BackgroundIn Australia and internationally, there is concern about the growing proportion of women giving birth by caesarean section. There is evidence of increased risk of placenta accreta and percreta in subsequent pregnancies as well as decreased fertility; and significant resource implications. Randomised controlled trials (RCTs) of continuity of midwifery care have reported reduced caesareans and other interventions in labour, as well as increased maternal satisfaction, with no statistically significant differences in perinatal morbidity or mortality. RCTs conducted in the UK and in Australia have largely measured the effect of teams of care providers (commonly 6–12 midwives) with very few testing caseload (one-to-one) midwifery care. This study aims to determine whether caseload (one-to-one) midwifery care for women at low risk of medical complications decreases the proportion of women delivering by caesarean section compared with women receiving 'standard' care. This paper presents the trial protocol in detail.Methods/designA two-arm RCT design will be used. Women who are identified at low medical risk will be recruited from the antenatal booking clinics of a tertiary women's hospital in Melbourne, Australia. Baseline data will be collected, then women randomised to caseload midwifery or standard low risk care. Women allocated to the caseload intervention will receive antenatal, intrapartum and postpartum care from a designated primary midwife with one or two antenatal visits conducted by a 'back-up' midwife. The midwives will collaborate with obstetricians and other health professionals as necessary. If the woman has an extended labour, or if the primary midwife is unavailable, care will be provided by the back-up midwife. For women allocated to standard care, options include midwifery-led care with varying levels of continuity, junior obstetric care and community based general medical practitioner care. Data will be collected at recruitment (self administered survey) and at 2 and 6 months postpartum by postal survey. Medical/obstetric outcomes will be abstracted from the medical record. The sample size of 2008 was calculated to identify a decrease in caesarean birth from 19 to 14% and detect a range of other significant clinical differences. Comprehensive process and economic evaluations will be conducted.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN012607000073404.

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Changes in midwives' attitudes to their professional role following the implementation of the midwifery development unit

Cited by 51 publications

References 4 publications

Single Room Maternity Care: The Nursing Response

Single Room Maternity Care: The Nursing Response

A programme for the prevention of post-traumatic stress disorder in midwifery (POPPY): indications of effectiveness from a feasibility study

COSMOS: COmparing Standard Maternity care with One-to-one midwifery Support: a randomised controlled trial

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