Creating Guardians of Physiologic Birth: The Development of an Educational Initiative for Student Midwives in the Netherlands

Abstract

Women want positive birth experiences with high quality maternity care that is neither too much, too soon, nor too little, too late. Research confirms the effectiveness of midwifery care, and the midwifery approach to birth as physiologic may counter the upward trend of the unnecessary medicalization of birth. The role of guardian of physiologic birth is seen as central to midwifery practice; however, medical hegemony has led to the subordination of midwives, which inhibits them in fulfilling the role as guardian of physiologic birth. Learning to become powerful advocates of physiologic birth creates midwives able to speak up for effective, evidence-based maternity care and challenge the unnecessary use of obstetric intervention. Midwifery education has a role to fulfil in molding midwives who are able to assume this role. This brief report describes the development of an educational prototype aimed at increasing student midwife agency as an advocate of physiologic birth. This was done using rapid prototyping (RP) methodology, in which important stakeholders gave input and feedback during the educational design and development process. Input from stakeholders led to the inclusion of persuasive communication strategies and discussion and debate as teaching methodologies in order to increase student midwife agency to argue for physiologic birth. Reflective evidence-based practice, using the Optimality Index-Netherlands, allowed students to reflect on their practice while providing a framework for discussion. Working with the RP methodology allowed for the development of a prototype that reflected the needs of midwifery stakeholders and was mindful of material and human resources.

Why Women in Ethiopia Give Birth at Home? A Systematic Review of Literature

“…Regarding developed countries, the efforts to change the misconception about childbirth as a condition that requires immediate and continuous medical interventions is strong. [36][37][38] Even the World Health Organization is calling, through its intrapartum care guideline, for de-medicalization of childbirth unless there are medically proven indicators. 8 In recent years, several studies are questioning the benefit of secondary and tertiary institutions as an optimum place for labour and delivery.…”

Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-St

“…Students´awareness of the main obstacles for a humanized childbirth (L1), is a critical point to start taking into account values such as woman's emotional state, beliefs, sense of dignity and autonomy in their future professional practice, in order to achieve the goal of promoting a positive childbirth experience (Behruzi, Hatem, Fraser, et al, 2010a;Wagner, 2001). A number of studies have been published in the last decade that explore incorporating specific competencies or pedagogical interventions in medical, nursing or midwifery study programs (Arzuaga & Cummings, 2016;Cooksey, 2010;Cummings et al, 2015;Daboval et al, 2014Daboval et al, , 2019Drake, 2016;Garbarino et al, 2019;Hall & Mitchell, 2016;Persson et al, 2018;Pilkenton et al, 2015;Shakartzi et al, 2018;Thompson et al, 2019;Yin et al, 2018). Most of these studies are surveys conducted among education experts and program directors, with particular attention to training needs in relation to dignity, respect (Hall & Mitchell, 2016;Yin et al, 2018) and perinatal mental health (Garbarino et al, 2019).…”

“…The quality of the interpersonal interaction with women at childbirth is another of the main factors included in CAVE-st (L2). Poor interpersonal interaction has been presented as one of the main risk factors for posttraumatic stress disorder after childbirth (Fenech & Thomson, 2014), being advisable the inclusion in the perinatal training programs of competencies regarding the development of personal agency skills, persuasive and convincing communication skills, debate and discussion skills and reflexive practice as critical educational contents (Thompson et al, 2019). On the other hand, knowing to what extent the students are prepared to meet the expectations and cultural needs of women at childbirth (L3) highlights the possible effectiveness of training programs in the development of women centered maternities (Cooksey, 2010).…”

The Students' Attitudes Towards Women'S Childbirth Experience - Development and Validation of a Questionnaire for Health Sciences Students (Cave-St)

“…A number of studies have been published in the last decade that explore incorporating speci c competencies or pedagogical interventions in medical, nursing or midwifery study programs to improve the quality of woman-professional interactions during the perinatal period (18,19,(28)(29)(30)(20)(21)(22)(23)(24)(25)(26)(27). Most of these studies are surveys conducted among education experts and programme directors, with particular attention to training needs in relation to dignity, respect (27,30) and perinatal mental health (20).…”