Providing rural and remote rural midwifery care: an 'expensive hobby'

Crowther, Susan

doi:10.12784/nzcomjnl52.2016.4.26-34

Cited by 18 publications

(23 citation statements)

References 12 publications

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“…The complex issues surrounding rural maternity care have been examined in some depth, most commonly in the context of exploring the difficulties in recruiting and retaining qualified maternity care specialists in rural and remote settings 2,10 . Among the challenges identified are the need to cover a small population over a large area 11 , issues around transfer times 4,12,13 and the maintenance of skills 4,[14][15][16] .…”

Section: Literature Reviewmentioning

confidence: 99%

“…The need to travel long distances takes a significant toll on midwives' time and influences the number of caseload numbers that can be taken on when compared to urban based practitioners 18 . This has financial implications where midwives are paid proportionately to the size of their caseload such as in the New Zealand system 10 . Working in relative isolation is not unusual given that General Practitioners (GPs), neonatal and obstetric services as well as secondary and tertiary facilities are located considerable distances away 11 .…”

Section: Literature Reviewmentioning

confidence: 99%

“…However, the need to engage in continuing professional education tends to be more difficult for those living in rural or remote areas. This is because the cost of travel to training/education courses, often held outside of the rural localities, added to which are the challenges of finding midwifery cover whilst out of the rural region when there are only a small group of practitioners covering a large area 2,15,16,21 . Organization of 'time away' requires rural midwives to have excellent networking and communication skills.…”

Section: Literature Reviewmentioning

confidence: 99%

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Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study

et al. 2019

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study

et al. 2019

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“…However, the need to be ready to expect the unexpected and the expectancy of challenge form the lived reality of rural midwifery practice. These challenges include: providing a service to a small but widely dispersed population (National Health Committee (NHC), 2010); issues related to remuneration (Crowther, 2016); engaging in continuing education (Tucker et al, 2005); and the distance of interface services impacting on transfer decisions such as GP and tertiary facilities (Munro et al, 2013;Tucker et al, 2005). Furthermore, travel demands have a significant impact on time availability, which has a bearing on realistic caseload size (Redshaw et al, 2012).…”

Section: Literature Reviewmentioning

confidence: 99%

‘Living the rural experience-preparation for practice’: The future proofing of sustainable rural midwifery practice through midwifery education

Kensington

Rankin

Gilkison

et al. 2018

Nurse Education in Practice

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Rural practice presents unique challenges and skill requirements for midwives. New Zealand and Scotland face similar challenges in sustaining a rural midwifery workforce. This paper draws from an international multi-centre study exploring rural midwifery to focus on the education needs of student midwives within pre-registration midwifery programmes in order to determine appropriate preparation for rural practice. The mixed-methods study was conducted with 222 midwives working in rural areas in New Zealand (n = 145) and Scotland (n = 77). Midwives' views were gathered through an anonymous online survey and online discussion forums. Descriptive analysis was used for quantitative data and thematic analysis was conducted with qualitative data. 'Future proofing rural midwifery practice' using education was identified as the overarching central theme in ensuring the sustainability of rural midwives, with two associated principle themes emerging (i) 'preparation for rural practice' and (ii) 'living the experience and seeing the reality'. The majority of participants agreed that pre-registration midwifery programmes should include a rural placement for students and rural-specific education with educational input from rural midwives. This study provides insight into how best to prepare midwives for rural practice within pre-registration midwifery education, in order to meet the needs of midwives and families in the rural context.

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“…These relationships are integral to maternity care [2–6] and are particularly pertinent in rural maternity care provision [7, 8]. This paper reports on an aspect of a larger study examining rural maternity experiences from a variety of professional and user experiences in New Zealand [9]. The theme of relationality resonated throughout the data of this study as a key component of safe care and is the focus of this paper.…”

Section: Introductionmentioning

confidence: 99%

Open, trusting relationships underpin safety in rural maternity a hermeneutic phenomenology study

Crowther

Smythe

2016

BMC Pregnancy Childbirth

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BackgroundThere are interwoven personal, professional and organisational relationships to be navigated in maternity in all regions. In rural regions relationships are integral to safe maternity care. Yet there is a paucity of research on how relationships influence safety and nurture satisfying experiences for rural maternity care providers and mothers and families in these regions. This paper draws attention to how these relationships matter.MethodsThis research is informed by hermeneutic phenomenology drawing on Heidegger and Gadamer. Thirteen participants were recruited via purposeful sampling and asked to share their experiences of rural maternity care in recorded unstructured in-depth interviews. Participants were women and health care providers living and working in rural regions. Recordings were transcribed and data interpretively analysed until a plausible and trustworthy thematic pattern emerged.ResultsThroughout the data the relational nature of rural living surfaced as an interweaving tapestry of connectivity. Relationships in rural maternity are revealed in myriad ways: for some optimal relationships, for others feeling isolated, living with discord and professional disharmony. Professional misunderstandings undermine relationships. Rural maternity can become unsustainable and unsettling when relationships break down leading to unsafeness.ConclusionsThis study reveals how relationships are an important and vital aspect to the lived-experience of rural maternity care. Relationships are founded on mutual understanding and attuned to trust matter. These relationships are forged over time and keep childbirth safe and enable maternity care providers to work sustainably. Yet hidden unspoken pre-understandings of individuals and groups build tension in relationships leading to discord. Trust builds healthy rural communities of practice within which everyone can flourish, feel accepted, supported and safe. This is facilitated by collaborative learning activities and open respectful communication founded on what matters most (safe positive childbirth) whilst appreciating and acknowledging professional and personal differences.

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Providing rural and remote rural midwifery care: an 'expensive hobby'

Cited by 18 publications

References 12 publications

Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study

Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study

‘Living the rural experience-preparation for practice’: The future proofing of sustainable rural midwifery practice through midwifery education

Open, trusting relationships underpin safety in rural maternity a hermeneutic phenomenology study

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