BACKGROUND The postnatal period can be a challenging time for women, with mothers experiencing a ... more BACKGROUND The postnatal period can be a challenging time for women, with mothers experiencing a range of emotions. As a woman transitions to motherhood, she adjusts to a new sense of self and forms a new relationship with her infant. Becoming a mother is a complex cognitive and social process that is unique for each woman and is influenced and shaped by culture. The emerging mother-infant relationship is a significant factor in maternal well-being and infant development, with the bond between the mother and her baby being critical to the development of secure attachment. It has been recognized that the strength of this relationship is the main predictor of how well a child will do throughout life. There has been a global focus on the importance of the first 1000 days, with Australia identifying this as a national priority. Midwives are ideally placed to support mothers during the development of the mother-infant relationship, providing care through the early postnatal period, which...
Transition pedagogy has had a major impact on the first year experience for higher education stud... more Transition pedagogy has had a major impact on the first year experience for higher education students in Australia. Similarly, there has been a significant focus on transitioning students from their final year of study to employment. Considerably fewer studies have sought to understand the “middle child”; the years in between the first and final year of study. Staff at a metropolitan Australian university noticed an increase in students struggling with university life after the first year of their program, with students purposefully withdrawing from courses or their program entirely. This article reports on focus groups held with staff and feedback via a student survey. Findings suggest the challenges faced by students in second year are multi-faceted, and curriculum and delivery should be intentionally designed to support students through a series of transitions throughout the university journey.
This chapter focuses predominantly on the impact of the midwife-woman relationship. In this chapt... more This chapter focuses predominantly on the impact of the midwife-woman relationship. In this chapter, the intricacies of the women’s experiences of pregnancy and anticipation of birth are discussed and developed into a conceptual figure that illustrates their ambiguous approach to pain, the unknowable nature of birth, and the trust that women therefore placed in their own bodies. We further the argument that a focus on embodiment can provide a point of departure for contemporary attitudes to birth, discarding old dichotomies and embracing complexity. Drawing on contemporary childbirth literature, we reassert the centrality of the midwife’s role and approach to pain.
Background The sustainability of Australian rural maternity services is under threat due to curre... more Background The sustainability of Australian rural maternity services is under threat due to current workforce shortages. In July 2019, a new midwifery caseload model of care was implemented in rural South Australia to provide midwifery continuity of care and promote a sustainable workforce in the area. The model is unique as it brings together five birthing sites connecting midwives, doctors, nurses and community teams. A critical precursor to successful implementation requires those working in the model be ready to adopt to the change. We surveyed clinicians at the five sites transitioning to the new model of care in order to assess their organizational readiness to implement change. Methods A descriptive study assessing readiness for change was measured using the Organizational Readiness for Implementing Change scale (ORIC). The 12 item Likert scale measures a participant’s commitment to change and change efficacy. All clinicians working within the model of care (midwives, nurses ...
Background. Increasing intervention in birth continues to be a cause for concern and epidural ana... more Background. Increasing intervention in birth continues to be a cause for concern and epidural analgesia is an ever more common intervention. A major influence on rising intervention rates is the complex relationship society has with technology. Influenced by various political and cultural narratives, there has been a tendency to view technological advance as both neutral and superior in the human quest for progress. Aim. In this paper, the authors trace the dialectical relationship between culture and technology in order to investigate the way epidural analgesia is portrayed in the biomedical literature. Method. A purposeful literature search was conducted, with databases including CINAHL, MEDLINE, Scopus, Google Scholar, Academic Search Premier and thesis repositories. Relevant literature was identified and analysed using the analytic framework of critical discourse analysis and drawing on critical medical anthropology and Foucault’s discourse analysis. Findings. The biomedical lit...
Research suggests that the incidence of moral distress experienced by health professionals is sig... more Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting i...
International Journal of Environmental Research and Public Health
Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM); however,... more Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM); however, weight loss remains challenging in this population. In order to explore perceptions of T2DM risk, barriers to weight loss, and views of diet strategies in women with previous GDM, a cross-sectional online survey of n = 429 women in Australia aged ≥18 years with previous GDM was conducted. Opinions of intermittent energy restriction (IER) were of interest. Seventy-five percent of responders (n = 322) had overweight or obesity, and 34% (n = 144) believed they had a high risk of developing T2DM. Within the Theoretical Domains Framework, barriers to weight loss were prominently related to Environmental Context and Resources, Beliefs about Capabilities, and Behavioural Regulation. Exercising was the most tried method of weight loss over other diet strategies (71%, n = 234) and weight loss support by a dietician was appealing as individual appointments (65%, n = 242) or an online program (54%...
International Journal of Environmental Research and Public Health
Our objective was to describe the development and validation of a survey investigating barriers t... more Our objective was to describe the development and validation of a survey investigating barriers to weight loss, perception of diabetes risk, and views of diet strategies following gestational diabetes (GDM). The survey underwent three stages of development: generation of items, expert evaluation, and pilot testing. A content validation index (CVI) was calculated from expert responses regarding item relevance, coherence, clarity, and response options. Experts also responded to the domain fit of questions linked to the Theoretical Domains Framework (TDF). Pilot responders answered the survey and responded to review questions. Six experts in the field of nutrition, midwifery, psychology, or other health or medical research completed the expert review stage of the survey. In the pilot test, there were 20 responders who were women with previous GDM and who were living in Australia. The overall CVI from the expert review was 0.91. All questions except one received an I-CVI of >0.78 for...
BACKGROUND Shared decision making in pregnancy, labour, and birth is vital to woman-centred care ... more BACKGROUND Shared decision making in pregnancy, labour, and birth is vital to woman-centred care and despite strong evidence for the effectiveness of shared decision making in pregnancy care, practical uptake has been slow. DESIGN AND AIM This scoping review aimed to identify and describe effective and appropriate shared decision aids designed to be provided to women in the antenatal period to assist them in making informed decisions for both pregnancy and birth. Two questions guided the enquiry: (i) what shared decision aids for pregnancy and perinatal care are of appropriate quality and feasibility for application in Australia? (ii) which of these decision aids have been shown to be effective and appropriate for Aboriginal and Torres Strait Islander peoples, culturally diverse women, or those with low literacy? METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) was used to conduct the review. Five key databases and selected grey literature sources were examined. English language evidence from Australia, Europe, Canada, United Kingdom, New Zealand, and United States of America produced from 2009 was eligible for inclusion, checked against apriori inclusion criteria, and assessed for quality and usability using the International Patient Decision Aid Standards. RESULTS From a total of 5,209 search results, 35 sources of evidence reporting on 27 decision aids were included following title/abstract and full-text review. Most of the decision aids concerned decisions around birth (52%, n = =14) or antenatal screening 37% (n = =10). The quality of the decision aids was moderate to high, with most communicating risks, benefits, and choice pathways via a mix of Likert-style scales, quizzes, and pictures or graphs. Use of decision aids resulted in significant reductions in decisional conflict and increased knowledge. The format of decision aids appeared to have no effect on these outcomes, indicating that paper-based are as effective as video- or audio-based decision aids. Eleven decision aids were suitable for low literacy or low health literacy women, and six were either developed for culturally diverse groups or have been translated into other languages. No decision aids found were specific to Aboriginal and Torres Strait Islander peoples. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The 27 decision aids are readily adoptable into westernised healthcare settings and can be used by midwives or multidisciplinary teams in conjunction with women. Decision aids are designed to support women, and families to arrive at informed choices and supplement the decision-making process rather than to replace consumer-healthcare professional interaction. If given before an appointment, high quality decision aids can increase a woman's familiarity with medical terminology, options for care, and an insight into personal values, thereby decreasing decisional conflict and increasing knowledge.
Undergraduate midwifery programs across Australia have embedded simulation into their curriculum ... more Undergraduate midwifery programs across Australia have embedded simulation into their curriculum although there is limited but emerging evidence to support the use of simulation as an effective teaching strategy. The purpose of this study was to evaluate the impact that a simulated learning activity (insertion and management of a neonatal nasogastric tube), had on midwifery students' knowledge, confidence and skills post-simulation, and on completion of a clinical placement. A descriptive explorative study was undertaken in two phases. Phase 1: Midwifery students (n = 60) completed a purpose-designed questionnaire to assess their knowledge, confidence and skills, pre and post simulation. Phase 2: Students (n = 46) repeated the questionnaire to reassess their knowledge, confidence and skills after the completion of a neonatal nursery placement. The findings demonstrate that simulation is an effective learning strategy in an undergraduate midwifery program. Students' knowledge, confidence and skills increased significantly post-simulation activity (p0.001). A further increase in these areas was noted post-placement. Key aspects that contributed to student learning included; the demonstrators' level of knowledge, expertise and currency of practice, as well as the role the student assumes in the simulation activity.
Background: The Trans-Tasman Midwifery Education Consortium was established in 2017 to provide le... more Background: The Trans-Tasman Midwifery Education Consortium was established in 2017 to provide leadership and strategic direction to drive progressive, high quality, evidence-informed midwifery education. In 2018, the Consortium conducted a Delphi study to investigate the priorities facing midwifery education in Australia and New Zealand.
Objectives Weight loss after gestational diabetes (GDM) significantly reduces the risk of develop... more Objectives Weight loss after gestational diabetes (GDM) significantly reduces the risk of developing type 2 diabetes (T2DM) however weight loss is not easily achieved or maintained. The purpose of this survey was to examine knowledge of future risk of T2DM after GDM, barriers to weight loss and to identify diet strategies that these women feel might work for them. Opinions of intermittent energy restriction (IER) were of particular interest. Methods Australian women aged ≥18 years who ever had GDM were invited to participate in this cross-sectional online survey. The survey was developed by a dietitian using the Theoretical Domains Framework and underwent expert review (n = 6) and piloted (n = 20) prior to the final survey being run. Results There were 429 partial and 328 complete responses (age 37.2 ± 7.2 years, n = 429, years post GDM 4.9 ± 6.3 years, n = 428, BMI 30.9 ± 7.3 kg/m2n = 394). Overweight (n = 110) or obese (n = 200) responders mostly knew they were overweight and thre...
Selecting the most appropriate methodology for research as a doctoral student is one of the most ... more Selecting the most appropriate methodology for research as a doctoral student is one of the most important yet difficult decisions. Not only should the methodology suit the research question, it is important that it resonates with the philosophy of one’s discipline and produces needed results that will contribute to knowledge. Interpretative phenomenological analysis (IPA) is an approach to qualitative enquiry. IPA seeks to explore how individuals make sense of their major life experiences and is committed to the detailed study of each particular case before moving to broader claims. In the field of midwifery, midwives work with women throughout pregnancy, childbirth and the early postnatal period, offering individualized care based on the unique needs of each woman. IPA aligns with this women-centered philosophy as it offers a methodological approach that considers the individual in a local context. By capturing context specific situations, IPA allows broad-based knowledge to be co...
Resilience is considered a vital characteristic and has gained attention in midwifery practice an... more Resilience is considered a vital characteristic and has gained attention in midwifery practice and education. In particular, midwifery students face challenges during their education in both academic and clinical components of the program. There is need for greater understanding and strategies to develop resilience in the midwifery student population. The aim of this study is to gain insight into how midwifery students conceptualise resilience, and explore how education might support the development of resilience. A focus group was conducted as part of a broader study underpinned by a concept analysis methodology to explore the students understanding of resilience. Participants included six third year midwifery students from one university. Thematic analysis was used to analyse the data. Four key themes were identified. Resilience contextualised to midwifery was triggered by exposure to adversity; resilience was identified as the ability to bounce back and move forward, and was seen to be important for midwifery students. The concept of resilience appears to play an important role in student success. Evidence suggests resilience can be developed and education providers have a role to foster student's resilience. Findings offer strategies to strengthen resilient behaviour for the midwifery student population and provide a basis for further research.
This book examines the future of birthing practices, particularly by focusing on epidural analges... more This book examines the future of birthing practices, particularly by focusing on epidural analgesia in childbirth. It describes historical and cultural trajectories that have shaped the way in which birth is understood in Western, developed nations. In setting out the nature of epidural history, knowledge and practice, the book delves into related birth practices within the hospital setting. By critically examining these practices, which are embedded in a scientific discourse that rationalises and relies upon technology use, the authors argue that epidural analgesia has been positioned as a safe technology in contemporary maternity culture, despite it carrying particular risks. In examining alternative research the book proposes that increasing epidural rates are not only due to greater pain relief requirements or access but are influenced by technocratic values and a fragmented maternity system. The authors outline the way in which this epidural discourse influences how information is presented to women and how this affects their choices around the use of pain relief in labour.
Clinical placement is a core feature of Australian midwifery education programs, with clinical su... more Clinical placement is a core feature of Australian midwifery education programs, with clinical supervision acknowledged as a key component for student success. The aim of this study was to evaluate the clinical facilitation models in South Australia, specifically the quality of clinical supervision to facilitate learning, and key stakeholder satisfaction. A mixed method evaluation research design was used to compare three models of clinical facilitation for midwifery students undertaking clinical placement across five venues. Midwifery students (n = 174), across two universities completed an anonymous e-survey utilising the validated Clinical Placement Experience Questionnaire. Midwives (n = 149) across five venues completed an anonymous purpose-designed questionnaire on their experience providing clinical supervision to midwifery students and Clinical Facilitators (n = 8) representing three facilitation models completed a self-report e-diary for two weeks and engaged in a focus gro...
Women and birth : journal of the Australian College of Midwives, Jan 11, 2018
Exclusive breast milk provides complete nutrition for a baby's first six months of life. In A... more Exclusive breast milk provides complete nutrition for a baby's first six months of life. In Australia, breastfeeding initiation rates are high, however duration rates are low. Although numerous studies have explored the reasons behind low levels of breastfeeding, few have examined the experiences of women who maintain exclusive breastfeeding for the recommended six-month duration. This paper will present an in-depth, idiographic interpretation of first-time mothers' experience of exclusive breastfeeding for six months in Australia. Interpretative phenomenological analysis was used to explore how five new mothers understood their six-month exclusive breastfeeding journey. Face-to-face, semi-structured interviews were conducted retrospectively, transcribed in full, and analysed using the flexible seven-step approach of interpretative phenomenological analysis. Three higher-order themes were identified: (1) exclusive breastfeeding is a personal choice, (2) exclusive breastfeedi...
BACKGROUND The postnatal period can be a challenging time for women, with mothers experiencing a ... more BACKGROUND The postnatal period can be a challenging time for women, with mothers experiencing a range of emotions. As a woman transitions to motherhood, she adjusts to a new sense of self and forms a new relationship with her infant. Becoming a mother is a complex cognitive and social process that is unique for each woman and is influenced and shaped by culture. The emerging mother-infant relationship is a significant factor in maternal well-being and infant development, with the bond between the mother and her baby being critical to the development of secure attachment. It has been recognized that the strength of this relationship is the main predictor of how well a child will do throughout life. There has been a global focus on the importance of the first 1000 days, with Australia identifying this as a national priority. Midwives are ideally placed to support mothers during the development of the mother-infant relationship, providing care through the early postnatal period, which...
Transition pedagogy has had a major impact on the first year experience for higher education stud... more Transition pedagogy has had a major impact on the first year experience for higher education students in Australia. Similarly, there has been a significant focus on transitioning students from their final year of study to employment. Considerably fewer studies have sought to understand the “middle child”; the years in between the first and final year of study. Staff at a metropolitan Australian university noticed an increase in students struggling with university life after the first year of their program, with students purposefully withdrawing from courses or their program entirely. This article reports on focus groups held with staff and feedback via a student survey. Findings suggest the challenges faced by students in second year are multi-faceted, and curriculum and delivery should be intentionally designed to support students through a series of transitions throughout the university journey.
This chapter focuses predominantly on the impact of the midwife-woman relationship. In this chapt... more This chapter focuses predominantly on the impact of the midwife-woman relationship. In this chapter, the intricacies of the women’s experiences of pregnancy and anticipation of birth are discussed and developed into a conceptual figure that illustrates their ambiguous approach to pain, the unknowable nature of birth, and the trust that women therefore placed in their own bodies. We further the argument that a focus on embodiment can provide a point of departure for contemporary attitudes to birth, discarding old dichotomies and embracing complexity. Drawing on contemporary childbirth literature, we reassert the centrality of the midwife’s role and approach to pain.
Background The sustainability of Australian rural maternity services is under threat due to curre... more Background The sustainability of Australian rural maternity services is under threat due to current workforce shortages. In July 2019, a new midwifery caseload model of care was implemented in rural South Australia to provide midwifery continuity of care and promote a sustainable workforce in the area. The model is unique as it brings together five birthing sites connecting midwives, doctors, nurses and community teams. A critical precursor to successful implementation requires those working in the model be ready to adopt to the change. We surveyed clinicians at the five sites transitioning to the new model of care in order to assess their organizational readiness to implement change. Methods A descriptive study assessing readiness for change was measured using the Organizational Readiness for Implementing Change scale (ORIC). The 12 item Likert scale measures a participant’s commitment to change and change efficacy. All clinicians working within the model of care (midwives, nurses ...
Background. Increasing intervention in birth continues to be a cause for concern and epidural ana... more Background. Increasing intervention in birth continues to be a cause for concern and epidural analgesia is an ever more common intervention. A major influence on rising intervention rates is the complex relationship society has with technology. Influenced by various political and cultural narratives, there has been a tendency to view technological advance as both neutral and superior in the human quest for progress. Aim. In this paper, the authors trace the dialectical relationship between culture and technology in order to investigate the way epidural analgesia is portrayed in the biomedical literature. Method. A purposeful literature search was conducted, with databases including CINAHL, MEDLINE, Scopus, Google Scholar, Academic Search Premier and thesis repositories. Relevant literature was identified and analysed using the analytic framework of critical discourse analysis and drawing on critical medical anthropology and Foucault’s discourse analysis. Findings. The biomedical lit...
Research suggests that the incidence of moral distress experienced by health professionals is sig... more Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting i...
International Journal of Environmental Research and Public Health
Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM); however,... more Weight loss after gestational diabetes (GDM) reduces the risk of type 2 diabetes (T2DM); however, weight loss remains challenging in this population. In order to explore perceptions of T2DM risk, barriers to weight loss, and views of diet strategies in women with previous GDM, a cross-sectional online survey of n = 429 women in Australia aged ≥18 years with previous GDM was conducted. Opinions of intermittent energy restriction (IER) were of interest. Seventy-five percent of responders (n = 322) had overweight or obesity, and 34% (n = 144) believed they had a high risk of developing T2DM. Within the Theoretical Domains Framework, barriers to weight loss were prominently related to Environmental Context and Resources, Beliefs about Capabilities, and Behavioural Regulation. Exercising was the most tried method of weight loss over other diet strategies (71%, n = 234) and weight loss support by a dietician was appealing as individual appointments (65%, n = 242) or an online program (54%...
International Journal of Environmental Research and Public Health
Our objective was to describe the development and validation of a survey investigating barriers t... more Our objective was to describe the development and validation of a survey investigating barriers to weight loss, perception of diabetes risk, and views of diet strategies following gestational diabetes (GDM). The survey underwent three stages of development: generation of items, expert evaluation, and pilot testing. A content validation index (CVI) was calculated from expert responses regarding item relevance, coherence, clarity, and response options. Experts also responded to the domain fit of questions linked to the Theoretical Domains Framework (TDF). Pilot responders answered the survey and responded to review questions. Six experts in the field of nutrition, midwifery, psychology, or other health or medical research completed the expert review stage of the survey. In the pilot test, there were 20 responders who were women with previous GDM and who were living in Australia. The overall CVI from the expert review was 0.91. All questions except one received an I-CVI of >0.78 for...
BACKGROUND Shared decision making in pregnancy, labour, and birth is vital to woman-centred care ... more BACKGROUND Shared decision making in pregnancy, labour, and birth is vital to woman-centred care and despite strong evidence for the effectiveness of shared decision making in pregnancy care, practical uptake has been slow. DESIGN AND AIM This scoping review aimed to identify and describe effective and appropriate shared decision aids designed to be provided to women in the antenatal period to assist them in making informed decisions for both pregnancy and birth. Two questions guided the enquiry: (i) what shared decision aids for pregnancy and perinatal care are of appropriate quality and feasibility for application in Australia? (ii) which of these decision aids have been shown to be effective and appropriate for Aboriginal and Torres Strait Islander peoples, culturally diverse women, or those with low literacy? METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) was used to conduct the review. Five key databases and selected grey literature sources were examined. English language evidence from Australia, Europe, Canada, United Kingdom, New Zealand, and United States of America produced from 2009 was eligible for inclusion, checked against apriori inclusion criteria, and assessed for quality and usability using the International Patient Decision Aid Standards. RESULTS From a total of 5,209 search results, 35 sources of evidence reporting on 27 decision aids were included following title/abstract and full-text review. Most of the decision aids concerned decisions around birth (52%, n = =14) or antenatal screening 37% (n = =10). The quality of the decision aids was moderate to high, with most communicating risks, benefits, and choice pathways via a mix of Likert-style scales, quizzes, and pictures or graphs. Use of decision aids resulted in significant reductions in decisional conflict and increased knowledge. The format of decision aids appeared to have no effect on these outcomes, indicating that paper-based are as effective as video- or audio-based decision aids. Eleven decision aids were suitable for low literacy or low health literacy women, and six were either developed for culturally diverse groups or have been translated into other languages. No decision aids found were specific to Aboriginal and Torres Strait Islander peoples. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The 27 decision aids are readily adoptable into westernised healthcare settings and can be used by midwives or multidisciplinary teams in conjunction with women. Decision aids are designed to support women, and families to arrive at informed choices and supplement the decision-making process rather than to replace consumer-healthcare professional interaction. If given before an appointment, high quality decision aids can increase a woman's familiarity with medical terminology, options for care, and an insight into personal values, thereby decreasing decisional conflict and increasing knowledge.
Undergraduate midwifery programs across Australia have embedded simulation into their curriculum ... more Undergraduate midwifery programs across Australia have embedded simulation into their curriculum although there is limited but emerging evidence to support the use of simulation as an effective teaching strategy. The purpose of this study was to evaluate the impact that a simulated learning activity (insertion and management of a neonatal nasogastric tube), had on midwifery students' knowledge, confidence and skills post-simulation, and on completion of a clinical placement. A descriptive explorative study was undertaken in two phases. Phase 1: Midwifery students (n = 60) completed a purpose-designed questionnaire to assess their knowledge, confidence and skills, pre and post simulation. Phase 2: Students (n = 46) repeated the questionnaire to reassess their knowledge, confidence and skills after the completion of a neonatal nursery placement. The findings demonstrate that simulation is an effective learning strategy in an undergraduate midwifery program. Students' knowledge, confidence and skills increased significantly post-simulation activity (p0.001). A further increase in these areas was noted post-placement. Key aspects that contributed to student learning included; the demonstrators' level of knowledge, expertise and currency of practice, as well as the role the student assumes in the simulation activity.
Background: The Trans-Tasman Midwifery Education Consortium was established in 2017 to provide le... more Background: The Trans-Tasman Midwifery Education Consortium was established in 2017 to provide leadership and strategic direction to drive progressive, high quality, evidence-informed midwifery education. In 2018, the Consortium conducted a Delphi study to investigate the priorities facing midwifery education in Australia and New Zealand.
Objectives Weight loss after gestational diabetes (GDM) significantly reduces the risk of develop... more Objectives Weight loss after gestational diabetes (GDM) significantly reduces the risk of developing type 2 diabetes (T2DM) however weight loss is not easily achieved or maintained. The purpose of this survey was to examine knowledge of future risk of T2DM after GDM, barriers to weight loss and to identify diet strategies that these women feel might work for them. Opinions of intermittent energy restriction (IER) were of particular interest. Methods Australian women aged ≥18 years who ever had GDM were invited to participate in this cross-sectional online survey. The survey was developed by a dietitian using the Theoretical Domains Framework and underwent expert review (n = 6) and piloted (n = 20) prior to the final survey being run. Results There were 429 partial and 328 complete responses (age 37.2 ± 7.2 years, n = 429, years post GDM 4.9 ± 6.3 years, n = 428, BMI 30.9 ± 7.3 kg/m2n = 394). Overweight (n = 110) or obese (n = 200) responders mostly knew they were overweight and thre...
Selecting the most appropriate methodology for research as a doctoral student is one of the most ... more Selecting the most appropriate methodology for research as a doctoral student is one of the most important yet difficult decisions. Not only should the methodology suit the research question, it is important that it resonates with the philosophy of one’s discipline and produces needed results that will contribute to knowledge. Interpretative phenomenological analysis (IPA) is an approach to qualitative enquiry. IPA seeks to explore how individuals make sense of their major life experiences and is committed to the detailed study of each particular case before moving to broader claims. In the field of midwifery, midwives work with women throughout pregnancy, childbirth and the early postnatal period, offering individualized care based on the unique needs of each woman. IPA aligns with this women-centered philosophy as it offers a methodological approach that considers the individual in a local context. By capturing context specific situations, IPA allows broad-based knowledge to be co...
Resilience is considered a vital characteristic and has gained attention in midwifery practice an... more Resilience is considered a vital characteristic and has gained attention in midwifery practice and education. In particular, midwifery students face challenges during their education in both academic and clinical components of the program. There is need for greater understanding and strategies to develop resilience in the midwifery student population. The aim of this study is to gain insight into how midwifery students conceptualise resilience, and explore how education might support the development of resilience. A focus group was conducted as part of a broader study underpinned by a concept analysis methodology to explore the students understanding of resilience. Participants included six third year midwifery students from one university. Thematic analysis was used to analyse the data. Four key themes were identified. Resilience contextualised to midwifery was triggered by exposure to adversity; resilience was identified as the ability to bounce back and move forward, and was seen to be important for midwifery students. The concept of resilience appears to play an important role in student success. Evidence suggests resilience can be developed and education providers have a role to foster student's resilience. Findings offer strategies to strengthen resilient behaviour for the midwifery student population and provide a basis for further research.
This book examines the future of birthing practices, particularly by focusing on epidural analges... more This book examines the future of birthing practices, particularly by focusing on epidural analgesia in childbirth. It describes historical and cultural trajectories that have shaped the way in which birth is understood in Western, developed nations. In setting out the nature of epidural history, knowledge and practice, the book delves into related birth practices within the hospital setting. By critically examining these practices, which are embedded in a scientific discourse that rationalises and relies upon technology use, the authors argue that epidural analgesia has been positioned as a safe technology in contemporary maternity culture, despite it carrying particular risks. In examining alternative research the book proposes that increasing epidural rates are not only due to greater pain relief requirements or access but are influenced by technocratic values and a fragmented maternity system. The authors outline the way in which this epidural discourse influences how information is presented to women and how this affects their choices around the use of pain relief in labour.
Clinical placement is a core feature of Australian midwifery education programs, with clinical su... more Clinical placement is a core feature of Australian midwifery education programs, with clinical supervision acknowledged as a key component for student success. The aim of this study was to evaluate the clinical facilitation models in South Australia, specifically the quality of clinical supervision to facilitate learning, and key stakeholder satisfaction. A mixed method evaluation research design was used to compare three models of clinical facilitation for midwifery students undertaking clinical placement across five venues. Midwifery students (n = 174), across two universities completed an anonymous e-survey utilising the validated Clinical Placement Experience Questionnaire. Midwives (n = 149) across five venues completed an anonymous purpose-designed questionnaire on their experience providing clinical supervision to midwifery students and Clinical Facilitators (n = 8) representing three facilitation models completed a self-report e-diary for two weeks and engaged in a focus gro...
Women and birth : journal of the Australian College of Midwives, Jan 11, 2018
Exclusive breast milk provides complete nutrition for a baby's first six months of life. In A... more Exclusive breast milk provides complete nutrition for a baby's first six months of life. In Australia, breastfeeding initiation rates are high, however duration rates are low. Although numerous studies have explored the reasons behind low levels of breastfeeding, few have examined the experiences of women who maintain exclusive breastfeeding for the recommended six-month duration. This paper will present an in-depth, idiographic interpretation of first-time mothers' experience of exclusive breastfeeding for six months in Australia. Interpretative phenomenological analysis was used to explore how five new mothers understood their six-month exclusive breastfeeding journey. Face-to-face, semi-structured interviews were conducted retrospectively, transcribed in full, and analysed using the flexible seven-step approach of interpretative phenomenological analysis. Three higher-order themes were identified: (1) exclusive breastfeeding is a personal choice, (2) exclusive breastfeedi...
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Papers by Lois McKellar