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Midwifery Dissertation Topics

Published by Owen Ingram at January 3rd, 2023 , Revised On August 16, 2023

There have been midwives around for decades now. The role of midwives has not changed much with the advent of modern medicine, but their core function remains the same – to provide care and comfort to pregnant women during childbirth.

It is possible to be a midwife in the healthcare industry, but it is not always a rewarding or challenging career. Here are five things you didn’t know about midwifery nursing to help you decide if it could be the right career choice for you.

The profession of midwifery involves caring for women and newborns during pregnancy, childbirth, and the first few days following birth. Registered nurses are trained with four additional years of education along with major research on methods involve in midwifery and writing on midwifery dissertation topics, while midwives provide natural health care for mothers and children.

As a midwife, your role is to promote healthy pregnancies and births while respecting women’s rights and dignity. Midwives provide care to patients at every stage of life, from preconception to postpartum, family planning to home delivery to breastfeeding support.

Important Links: Child Health Nursing Dissertation Topics , Adult Nursing Topics , Critical Care Nursing Dissertation Topics . These links will help you to get a broad experience or knowledge about the latest trends and practices in academics.

Midwifery Is A Good Fit for the Following:

● Those who want to work with women, especially those at risk of giving birth in a hospital setting. ● Those who enjoy helping people and solving problems. ● Those who like to be creative and solve complex problems. ● Those who want to help others and make a difference in their lives.

Midwifery is a career with many benefits for both the midwife and the baby. They are well-trained and experienced in caring for pregnant women and newborns and often have access to the exceptional care that other nurses may not have.

Midwifery Dissertation Topics With Research Aim

Topic:1 adolescence care.

Research Aim: Focus on comprehensive medical, psychological, physical, and mental health assessments to provide a better quality of care to patients.

Topic:2 Alcohol Abuse

Reseasrch Aim: Closely studying different addictions and their treatments to break the habit of drug consumption among individuals.

Topic:3 Birth Planning

Research Aim: Comprehensive birth planning between parents discussing the possible consequences of before, between, and after labour.

Topic:4 Community midwifery

Research Aim: Studying different characters in community midwifery and the midwife’s role in providing care for the infant during the early days of the child’s birth.

Topic:5 Contraception

Research Aim: Understand the simplicity of contraception to prevent pregnancy by stopping egg production that results in the fertilization of egg and sperm in the later stages.

Topic:6 Electronic fetal monitoring

Research Aim: In-depth study of electronic fetal monitoring to track the health of your baby during the womb, record construction per minute, and make a count of your baby’s heart rate.

Topic:7 Family planning

Research Aim: Importance to follow the basic rhythm methods for the couple to prevent pregnancy and use protection during the vaginal sex to plan a family without fertility treatments.

Topic:8 Foetal and newborn care

Research Aim: Expansion of the maternal-fetal and newborn care services to improve the nutritional quality of infants after delivery during their postnatal care time.

Topic:9 Foetal well being

Carefully tracking indications for the rise in heart rate of the fetal by weekly checkups to assess the overall well-being of the fetal.

Topic:10 Gender-based violence

Research Aim: Studying the consequences of male desire for a child that results in gender-based violence, harming the child’s physical and mental health.

Topic:11 Health promotion

Research Aim: Working on practices that help in controlling the amount of pollution of people, taking care of their overall health, and improving quality of life through adapting best health practices.

Topic:12 High-risk pregnancy

Research Aim: Calculating the ordinary risks of a high-risk pregnancy and how it affects a pregnant body resulting in a baby with poor health or any by-birth diseases, increasing the chance for complications.

Topic:13 HIV infection

Research Aim: Common causes of HIV infection and their long-term consequences on the body’s immune system. An in-depth study into the acquired immunodeficiency and the results leading to this.

Topic:14 Human Rights

Creating reports on human rights and their link with the freedom of thought, conscience, religion, belief, and other factors.

Topic:15 Infection prevention and control

Research Aim: Practices for infection prevention and control using efficient approaches for patients and health workers to avoid harmful substances in the environment.

Topic:16 Infertility and pregnancy

Research Aim: Evaluating the percentage of infertility and pregnancy, especially those facing no prior births, and who have high chances of infertility and pregnancy complications.

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Midwives are nurses who provide continuous support to the mother before, during, and after labour. Midwives also help with newborn care and educate parents on how to care for their children.

How Much Do Midwives Make?

The salary of a midwife varies depending on the type of work, location, and experience of the midwife. Midwives generally earn $132,950 per year. The average annual salary for entry-level midwives is $102,390.

The minimum requirement for becoming a midwifery nurse is a bachelor’s degree in nursing, with the option of pursuing a master’s degree.

An accredited educational exam can also lead to certification as a nurse-midwife (CNM). The American College of Nurse-Midwives (ACNM) enables you to practice independently as a midwife.

There are many pros and cons to working as a midwife. As a midwife, you have the following pros and cons:

Midwives have the opportunity to help women during one of the most memorable moments in their lives.
Midwives can positively impact the health of mothers and their children.
Midwives can work in many hospitals, clinics, and homes.
In midwifery, there are many opportunities for continuing education and professional development.
You will often have to work nights and weekends, which can be mentally draining.
You will have to travel a lot since most births occur in hospitals or centres in different areas.
You will have to deal with stressors such as complex patients and uncooperative families.
You will be dealing with a lot of pain, so you need to be able to handle it without medication or other treatment methods.

A career in midwifery is a great fit for those with a passion for health and wellness, an interest in helping people, and a desire to work in a supportive environment.

It is important to become involved in your local midwifery community if you are contemplating a career in midwifery – the best source of learning is your major research work, along with writing a lengthy thesis document on midwifery dissertation topics that will submit to your university to progress your midwifery career.

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How to find midwifery dissertation topics.

To find midwifery dissertation topics:

Explore childbirth challenges or trends.
Investigate maternal and infant health.
Consider cultural or ethical aspects.
Review recent research in midwifery.
Focus on gaps in knowledge.
Choose a topic that resonates with your passion and career goals.

Dissertations on Midwifery

Midwifery is a health profession concerned with the care of mothers and all stages of pregnancy, childbirth, and early postnatal period. Those that practice midwifery are called midwives.

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Latest Midwifery Dissertations

Including full dissertations, proposals, individual dissertation chapters, and study guides for students working on their undergraduate or masters dissertation.

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Relationship Between Pregnancy, Childbirth and IPV

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Theses and Dissertations

Black midwives for black mothers: ameliorating racial disparities in the quality of maternal healthcare.

Kimberly Navarro Follow

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women disproportionately experience lower quality PNC, the overall improvement in the quality of PNC is likely to yield high benefits for Black women. This study sought to identify and give perspective to the unique challenges that Black women experience in the maternal healthcare system. Findings show that Black mothers who had home births with a race-concordant midwife experienced excellent quality of care. For Black home-birthing mothers in this study, PNC and childbirth were normalized at home, PNC was accessible, mother led, consistent, encouraging, and supportive, good quality, emotionally fulfilling and peaceful, personalized, race-concordant, and with family involvement, which made mother feel well prepared for birth. Findings from this study highlight the importance of race-concordant midwifery care for Black mothers to experience high quality care. Black midwives in this study demonstrated the provision of high-quality midwifery care to Black mothers. These findings may help inform clinical practice for the maternal care of Black women. Advocating for Black women to receive high-quality PNC, promoting race-concordant midwifery care and diversity midwifery are essential in the fight to ameliorate racial disparities in maternal health. Policies that support further research into maternal healthcare for Black women, promote midwifery care and diversity in midwifery, like the Black Maternal Health Momnibus, are instrumental to improve maternal health outcomes for Black women.

Library of Congress Subject Headings

Maternal health services; Mothers--Mortality--Women, Black; Pregnancy--Women, Black; Midwife and patient--Women, Black

Date of Award

School affiliation.

Graduate School of Education and Psychology

Department/Program

Degree type.

Dissertation

Degree Name

Faculty advisor.

Kfir Mordechay

Recommended Citation

Navarro, Kimberly, "Black midwives for Black mothers: ameliorating racial disparities in the quality of maternal healthcare" (2023). Theses and Dissertations . 1346. https://digitalcommons.pepperdine.edu/etd/1346

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Midwifery students’ perceptions and experiences of learning in clinical practice: a qualitative review protocol

Yang, Zhihui 1 ; Li, Xinxin 2 ; Lin, Huanhuan 2 ; Chen, Fanfan 2 ; Zhang, Lili 1 ; Wang, Ning 1

1 PR China Southern Centre for Evidence-based Nursing and Midwifery Practice: A JBI Centre of Excellence, Guangzhou City, Guangdong Province, PR China

2 School of Nursing, Southern Medical University, Guangzhou City, Guangdong Province, PR China

Correspondence: Ning Wang, [email protected]

The authors declare no conflict of interest.

Objective:

This systematic review aims to investigate and synthesize qualitative evidence related to midwifery students’ perceptions and experiences of learning in clinical practice.

Introduction:

Midwifery students are required to develop strong competencies during pre-registration education for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education.

Inclusion criteria:

This proposed review will consider qualitative studies that have explored midwifery students’ perceptions and experiences of learning in clinical practice in all degrees. The search will be limited to English-language published and unpublished studies to the present.

Methods:

This review will follow the JBI approach for qualitative systematic reviews. A three-stage search will be conducted to include published and unpublished literature. Databases to be searched include PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, American Nurses Association, Google Scholar, ProQuest Dissertation & Theses, and Index to Theses in Great Britain and Ireland. Identified studies will be screened for inclusion in the review by two independent reviewers. Any disagreements will be resolved through discussion. Data will be extracted using a standardized tool. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be used to inform midwifery education.

Systematic review registration number:

PROSPERO CRD42020208189

Introduction

Due to strong advocacy for improved health and safety of pregnant women and their babies globally, many countries have made significant progress in increasing the proportion of pregnant women who give birth at health care facilities. 1 However, such effort has not led to the expected level of reduction in maternal and newborn mortality and stillbirths, 2 which can be caused by inadequacies in the quality of care provided in the health care facilities. 3

The delivery of quality and safe midwifery practice requires that health professionals develop strong competencies and high-level accountabilities. Evidence shows that well educated, regulated, and licensed midwives are associated with improved quality of care and rapid and sustained reduction in maternal or neonatal morbidity and mortality. 4 Pre-registration education is an important stage for midwifery students to develop the fundamental professional knowledge, skills, and judgment essential for their future practice. Clinical practice programs as a significant component of midwifery education provide a valuable opportunity for midwifery students to build hands-on capabilities that integrate with classroom theories, and to be socialized into their chosen profession. 5 Specifically, it helps students develop the required professional competencies for registration and ideas about their career preference, as well as smoothly transit to their future career. 6,7 It has been found that education undertaken through clinical placements provides up to 50% of the learning experience for students in pre-registration midwifery courses. 8

Midwifery refers to “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum throughout pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life.” 9 (p.1130) Midwifery practice involves a wide scope of care activities that are undertaken to pursue the overall well-being of pregnant women. This includes providing continuous support to the women during their antenatal, intrapartum, and postpartum periods, being responsible for conducting births, caring for the newborns, and preventing and managing complications in pregnancy and childbirth. 10 These require that midwives are highly competent in undertaking various work tasks in partnership with the women and to cope with the complex and dynamic nature of the practice environments. 11 To face such challenging learning requirements, midwifery students can become frustrated when they first enter a practice setting. Literature shows that student health professionals often face challenges and experience a high level of stress during their clinical placements, 12,13 and midwifery students experience more stress compared to students in other professions. 14,15 Research has found that the midwifery students’ clinical stress was either due to their low confidence in undertaking care and a fear of making mistakes, or their relationships with clinical educators and colleagues. 16 Negative clinical experiences perceived by the student midwives can pose a potential threat to their effective learning and recognition of their future professional career. 17-19

As a key part of successful midwifery education, a well-designed practice program with a supportive environment is essential for fostering students’ confidence and passion to pursue a future midwifery career and for building competencies for entry to their registrations. 7,20 Students’ perceptions and experiences about their clinical learning are considered a hallmark of quality education. 21 While there is a growing body of knowledge reported in the literature about these elements, a systematic aggregation of such evidence should identify implications for the educational and clinical faculties to develop appropriate and effective clinical training strategies and provide required support to the students. Our literature search has identified three reviews about student professionals’ learning experiences; however, these reviews have focused on the learning experiences of undergraduate nursing rather than midwifery students, 22 a setting other than clinical placements, 23 or the relationship between workplace culture and the practice experience. 24 This review addresses a gap in the literature by aggregating evidence about midwifery students’ perceptions and experiences of learning in clinical settings. The ultimate aim is to improve midwifery educators’ understanding of their students’ clinical experiences.

Review question

What are the perceptions and experiences of midwifery students’ learning in clinical practice?

Inclusion criteria

Participants.

This review will consider qualitative studies that focus on midwifery students’ perceptions and experiences of learning in clinical practice settings. There will be no limitation regarding age, gender, grade or year, or ethnicity of participants.

Phenomena of interest

The phenomena of interest will be midwifery students’ perceptions and experiences of learning in clinical practice settings.

This review will consider studies conducted in any settings identified as a clinical practice, including clinical placement or internship, in acute care, community care, or simulated learning environments.

Types of studies

This review will consider English-language qualitative studies that describe the perceptions and experiences of midwifery students in their clinical practice. These studies will focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, and action research. Qualitative data from mixed method studies will also be included.

The proposed systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. 25 The review has been registered in PROSPERO (CRD42020208189).

Search strategy

The search strategy aims to locate both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of PubMed will be undertaken followed by analysis of the text words contained in the titles and abstracts, and of the index terms used to describe the articles. This preliminary search in PubMed will be used to develop a search strategy for this review that will include other databases. A second search using identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. A sample search strategy for PubMed is detailed in Appendix I. There is no date limit for the studies included in this review.

The databases to be searched for published studies include: MEDLINE (PubMed), Science Direct, Web of Science, EBSCO (CINAHL), and EBSCO (PsycINFO). The search for unpublished literature will include Google Scholar, American Nurses Association, ProQuest Dissertation & Theses Database, and Index to Theses in Great Britain and Ireland.

Study selection

Following the search, all identified citations will be collated and uploaded into EndNote v.9 (Clarivate Analytics, PA, USA) and duplicates removed. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant studies will be retrieved in full and their citation details will be imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI; JBI, Adelaide, Australia). 26 The full text of selected citations will be assessed in detail against the inclusion criteria by the two independent reviewers. Reasons for exclusion of full-text studies that do not meet the inclusion criteria will be recorded and reported in the systematic review. Any disagreements that arise between the reviewers at each stage of the study selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final systematic review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. 27

Assessment of methodological quality

Papers selected for retrieval will be assessed by the two independent reviewers for methodological quality prior to inclusion in the review using the standard JBI critical appraisal checklist for qualitative research. 25 Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Authors of primary studies will be contacted with questions on missing information or if clarification is needed. The results of the critical appraisal will be reported in narrative form, as well as in a table. All studies, regardless of the results of their methodological quality, will undergo data extraction and synthesis.

Data extraction

Qualitative data will be extracted from studies included in the review by the two independent reviewers using the standardized JBI qualitative data extraction tool for qualitative evidence (JBI SUMARI). The data extracted will include specific details about the participants, context, geographical location, study methods, and the phenomena of interest relevant to the review question and specific objectives. Findings will be verbatim extractions of the authors’ analytic interpretations, along with relevant illustrations. Each finding will be assigned a level of validity or credibility. Findings will be described as “unequivocal” or “credible,” as recommended in the JBI Manual for Evidence Synthesis . 25 All “unsupported” findings will be excluded from the review. Any disagreements relating to credibility that arise between the reviewers will be resolved through discussion or by a third reviewer.

Data synthesis

Qualitative research findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach. 28 This will involve aggregation or synthesis of findings to generate a set of statements that represents the aggregation, through assembling and categorizing these findings on the basis of similarity in meaning. These categories will then be subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. The categories and synthesized findings will be agreed by discussion among the reviewers to ensure they support the meaning of the data. Where textual pooling is not possible, the findings will be presented in narrative form.

Assessing certainty in the findings

The final synthesized findings will be graded according to the ConQual 29 approach for establishing confidence in the output of qualitative research synthesis and presented in a Summary of Findings. The Summary of Findings includes the major elements of the review and details how the ConQual score is developed. Included in the Summary of Findings will be the title, population, phenomena of interest, and context for the specific review. Each synthesized finding from the review will then be presented along with the type of research informing it, score for dependability and credibility, and the overall ConQual score.

Acknowledgments

The library staff at Southern Medical University for their guidance and support on literature retrieval.

Appendix I: Search strategy

Medline (pubmed).

Search conducted August 2020

Cited Here |
PubMed | CrossRef
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clinical practice; experience; midwifery students; perception; qualitative research

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Home » Blog » Dissertation » Topics » Nursing » Midwifery » Midwifery Dissertation Topics List (30 Examples) For Your Research

Midwifery Dissertation Topics List (30 Examples) For Your Research

Mark Dec 14, 2019 Jun 5, 2020 Midwifery , Nursing No Comments

As a student, if you are finding Midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on new and emerging concepts and ideas. You can choose any of the […]

As a student, if you are finding midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on the new and emerging concepts and ideas.

You can choose any of the give topic for your research in midvfery and our team can offer quality dissertations according to your requirements.

A list Of midwifery dissertaton topics

Emerging trends in midwifery and obstetrical nursing.

Modern trends of the N education in midwives and modern methods in practical training.

The impact of delayed umbilical cord clamping after birth.

How the cell-free DNA screening is helpful in identifying genetic problems in the baby?

Limiting interventions during low-risk labor.

The concept of cost containment in healthcare deliver.

The importance of family centred care and natural childbirth environment.

An interpretive research on the disparity between women’s expectations and experience during childbirth.

Systematic literature review on the extrauterine life management focusing on lung functions in new born.

To analyse the role of perinatal care to pregnant women.

Studying the treatment alternatives for urogenital infections in rural women.

Conducting a systematic review on how midwifery students plan their career.

Strategies adopted by midwives to advise pregnant women about nutritional values and healthy food consumption.

Studying the impact of Hepatitis B in pregnant women.

Analysing how frequent miscarriages are linked with higher anticardiolip antibodies.

Studying the relationship between perinatal mortality rates and physical activity levels.

How can nurses recommend preventive strategies to avoid sexual transmission of Zika virus to new born?

Evaluating the attitude of women related to the implementation of basic immunisation programs in village.

Analysing the modern trends of the education in midwives and new methods in practical training.

To study the advance trends in gynaecology and obstetrics.

The role of midwives in saving the lives of unborn foetus.

Exploring the global trends in nursing and midwifery education.

Analysing the role of optimal midwifery decision-making during second-stage labour.

To study the integration of clinical reasoning into midwifery practice.

A literature review on labouring in water.

Exploring the experiences of mothers in caring for children with complex needs.

An ethnography of independent midwifery in Asian countries.

To explore the perceptions of control in midwifery assisted childbirth.

Analysing the decision-making between nurse-midwives and clients regarding the formulation of a birth plan.

The role of Vitamin D supplementation during pregnancy .

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Best Midwifery Dissertation Topics Ideas & Examples

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List of Midwifery Dissertation Topics and Tips for Choosing the Best One

Are you a student in the UK studying midwifery and finding it hard to pick a dissertation topic? You are not alone. Many students struggle when it comes to selecting a topic for their midwifery dissertation. If you’re looking for midwifery dissertation topics , midwifery research topics , or midwifery dissertation examples , this guide is for you.

Choosing a topic for your dissertation might feel overwhelming, but with the right guidance, it doesn’t have to be. Let’s break down what midwifery is and why it’s so important. Then, we’ll share some helpful tips to make selecting a topic easier for you.

What is Midwifery?

Midwifery is a special part of healthcare that focuses on looking after women during pregnancy, labor, and after they give birth. Midwives help care for the newborn and provide support to the mother. They also offer general healthcare to women, including family planning, gynecological exams, and care during menopause.

When studying midwifery in the UK, students often need to write a dissertation on a specific topic in this field.

Tips for Choosing Midwifery Dissertation Topics

Picking the right topic for your dissertation is very important. You want to choose a topic that is not only interesting but also useful for improving healthcare for mothers and their babies. Here are some tips to help you pick the best midwifery dissertation topic:

Pick an Important Topic Make sure your topic focuses on something important in midwifery. Your dissertation should highlight serious issues that mothers and newborns face, especially in the UK.
Be Specific Don’t choose a topic that’s too broad. Focus on a specific issue in midwifery, like a particular stage of pregnancy or a health problem that is common for mothers.
Expand Narrow Topics If your topic feels too small, don’t worry. You can always expand it by adding more research or looking at it from different angles.
Look at Traditional Topics Check out some classic midwifery dissertation topics to see what has been written about before. This will help you understand what has already been covered and where you can add something new.
Choose a Topic That Helps Your topic should aim to improve the healthcare system for mothers and children. Look for research topics in midwifery that could help make things better in real life.
Build Your Knowledge Before you choose your topic, make sure you have a good understanding of midwifery. The more you know, the easier it will be to pick a strong topic.

Midwifery Dissertation Examples

Looking at midwifery dissertation examples can give your ideas about how to structure your own work. You can find research topics in midwifery PDFs online to see how other students have tackled their dissertations. This can be helpful for seeing what types of research have already been done and where there might be gaps for you to explore.

Hot Topics in Midwifery for Your Dissertation

To help you get started, here are some hot topics in midwifery that could be great for your dissertation:

Exploring how midwifery care can help reduce the risk of maternal deaths during childbirth.
Investigating how trained midwives can save lives in countries with limited access to healthcare.
Exploring how midwives are essential in managing and preventing severe bleeding after childbirth, a leading cause of maternal deaths.
Examining how improved midwifery education and training have contributed to lowering maternal mortality rates worldwide.
Looking at how midwives are prepared to handle obstetric emergencies that often lead to maternal deaths if not properly managed.
Understanding how midwives provide critical care in rural areas where hospitals and doctors are less accessible, and how this impacts maternal mortality rates.
Studying how midwives provide consistent care throughout the entire pregnancy, birth, and postpartum period, reducing the risk of complications.
Investigating how midwives can detect and manage preeclampsia, a major cause of maternal deaths, through early intervention and monitoring.
Analyzing how community-based midwives help lower maternal mortality by providing accessible and affordable care to women in underserved regions.
Exploring the impact of midwifery-led birth centers on maternal health outcomes compared to hospital-based births.
Looking at the role midwives play in shaping healthcare policies aimed at improving maternal health and reducing mortality rates.
Examining how midwives provide specialized care to teenage mothers, reducing the risks of complications that can lead to maternal death.
Investigating specific safe delivery techniques employed by midwives to prevent common complications that cause maternal mortality.
Exploring how midwives help in detecting and treating infections during and after childbirth, preventing sepsis, a significant cause of maternal deaths.
Studying how regular antenatal checkups provided by midwives can identify risks early and prevent maternal deaths.
Investigating how midwives handle high-risk pregnancies, which are more likely to lead to maternal mortality if not managed properly.
Examining how teamwork between midwives and obstetricians leads to better outcomes for mothers, particularly in high-risk situations.
Looking at how trained midwives ensure safe home births, reducing the risks that can lead to maternal mortality during unsupervised deliveries.
Exploring how midwives are working to improve maternal health in indigenous populations, where maternal mortality rates tend to be higher.
Investigating how midwives provide critical care to women in conflict zones and disaster areas, where maternal mortality is often higher.
Examining how midwives identify and manage cases of obstructed labor, preventing complications that could otherwise lead to maternal mortality.
Understanding the importance of mental health care for pregnant women and how midwives can provide essential support.
Investigating the benefits and risks of water births compared to traditional birthing methods.
Examining how midwives encourage natural births and the impact of these practices on mother and baby.
Comparing the outcomes of midwife-led births with those led by obstetricians.
Exploring how technology like telemedicine is being used by midwives to provide care, especially in rural areas.
Looking at how midwives support women with high-risk pregnancies and improve outcomes.
Analyzing the growing trend of home births and the role of midwives in ensuring safety and care.
Understanding how midwives provide essential family planning services and advice on contraception.
Investigating the specific needs of teenage mothers and how midwives can offer tailored care.
Examining how midwives help new mothers with breastfeeding and care during the first weeks after birth.
Studying the strategies midwives use to recognize and help women suffering from postpartum depression.
Exploring how midwives provide care to women from different cultural backgrounds and address unique needs.
Analyzing how midwives include and support fathers during pregnancy, birth, and postpartum care.
Investigating the impact of midwifery on preventing newborn deaths and improving infant health.
Looking at how midwives provide care in remote areas and what innovations are helping them reach more women.
Understanding how midwives handle preterm births and the specific care required for these babies and mothers.
A historical perspective on how midwifery has changed and adapted over the centuries.
Examining how midwives are trained to handle emergencies during childbirth and the role they play in such situations.
Looking ahead at emerging trends in midwifery, such as increasing demand for personalized care, and the challenges midwives will face.
Midwives’ descriptions and perceptions of pregnant women with problems of substance abuse .

Prenatal Care

Understanding how midwives help expectant mothers adopt good habits for a healthy pregnancy.
Evaluating how well prenatal education programs prepare parents for childbirth and baby care.
Identifying challenges and solutions for different cultures to access necessary prenatal care.
Exploring how midwives track the growth and health of the baby during pregnancy.
How midwives help manage conditions like diabetes or hypertension during pregnancy.
Understanding why starting prenatal care early is crucial for both mother and baby.
Examining how midwives guide expectant mothers in maintaining a healthy weight throughout pregnancy.
Exploring how midwives provide advice on diet and nutrition for a healthy pregnancy.
Investigating how midwives help manage stress to ensure a healthier pregnancy.
Understanding how regular appointments with midwives contribute to a healthy pregnancy outcome.

Postpartum Care

Exploring strategies midwives use to support new mothers in the weeks following childbirth.
Examining the impact of postpartum depression on a mother’s health and well-being.
Investigating the advantages of midwives visiting new mothers at home for support.
Understanding the role of midwives in supporting recovery after a C-section.
How midwives offer mental and emotional support to help new parents adjust.
Exploring why continuous care after birth is crucial for the mother’s health.
Understanding how midwives assist with physical recovery and changes after giving birth.
Examining how midwives help new mothers overcome challenges with breastfeeding.
Identifying how midwives handle issues like infections or excessive bleeding after birth.
Providing new parents with essential information and support on caring for their newborn.

Labor and Delivery

Exploring various pain management techniques used by midwives during labor.
Investigating how different settings and conditions impact the labor process.
Understanding how midwives work to minimize the number of C-sections performed.
Examining how midwives support natural birthing methods and their benefits.
How midwives handle unexpected complications that arise during labor.
Exploring how midwives provide physical and emotional support during labor.
Investigating how different labor positions can affect the birthing process.
Understanding the benefits of having a midwife present throughout the entire labor.
Exploring the practice of water births and its advantages for both mother and baby.
How midwives help parents understand and prepare for the childbirth experience.

Maternal Health

Addressing how to ensure every woman has access to necessary maternal health services.
Examining how proper nutrition affects the health of expectant and new mothers.
Investigating worldwide initiatives aimed at lowering the number of maternal deaths.
Understanding how economic and social conditions impact a mother’s health during pregnancy and childbirth.
Exploring how midwives help manage chronic illnesses to ensure safe pregnancies.
Understanding how frequent health check-ups help detect and prevent complications.
Strategies to enhance maternal health care in areas with limited resources.
Investigating the effects of stress on maternal health and how midwives can help manage it.
How midwives track and support a mother’s health after childbirth.
Exploring new developments in maternal health care and how they improve outcomes for mothers.

Neonatal Care

How midwives help ensure successful breastfeeding for newborns in the neonatal unit.
Investigating the critical role midwives play in emergency situations involving newborns.
Exploring how skin-to-skin contact benefits newborns and the role of midwives in promoting it.
Strategies midwives use to support newborns as they transition from the womb to the outside world.
Understanding how routine tests performed by midwives help detect health issues early.
How midwives care for and support premature infants in the neonatal unit.
Examining how midwives diagnose and treat jaundice in newborns.
Addressing how midwives provide care to newborns in settings with limited resources.
How midwives facilitate and encourage bonding between parents and their newborns.
Assessing various practices used in neonatal care and their outcomes.

Women’s Health

Exploring different midwifery-led approaches to overall women’s health care.
Investigating how midwives provide care and education related to sexual and reproductive health.
Addressing cultural barriers and how midwives support women with sensitive health concerns.
Understanding how midwives help women navigate and manage symptoms of menopause.
Exploring how midwives provide preventive care to maintain women’s health.
Investigating the role of midwives in diagnosing and managing hormonal issues.
Examining how midwives support women with PCOS and related health issues.
Exploring how midwives help women with issues like heavy periods or irregular cycles.
How midwives incorporate various therapies and practices to enhance women’s health.
Addressing how midwives provide tailored care for women with unique health conditions.

Family Planning

How midwives help individuals make informed decisions about contraception.
Understanding how midwives support and offer care for abortion services.
Exploring challenges faced by rural communities in accessing family planning and how midwives address them.
How midwives educate patients about different birth control methods and their effectiveness.
Investigating how midwives provide support and care following an abortion.
Exploring how midwives educate young people about reproductive health and planning.
How midwives correct common misconceptions about contraception and family planning.
Examining how midwives assist couples in understanding and managing fertility.
Identifying obstacles to delivering effective contraceptive services and how midwives overcome them.
Assessing how midwives help with the use of long-term contraceptive solutions like implants or IUDs.

Midwifery Education and Training

How hands-on simulation training enhances midwifery education.
Exploring new approaches to teaching midwifery skills and knowledge.
How mentoring programs support midwifery students in their professional growth.
Examining how ongoing learning and professional development benefit midwives.
Investigating the effectiveness of online courses and resources for midwifery students.
How specialized training prepares midwives for emergencies and complex cases.
Understanding how real-world clinical experiences enhance midwifery education.
Exploring how competency-based approaches improve midwifery training outcomes.
How learning alongside other healthcare professionals’ benefits midwifery practice.
Examining how advanced simulation tools improve the training experience for midwifery students.

Midwifery Ethics and Legal Issues

Understanding the challenging ethical issues faced by midwives and how they navigate them.
Exploring how laws and regulations vary for midwifery practice around the world.
Investigating how legal challenges affect midwifery practice and patient care.
Examining how midwives handle patient confidentiality and informed consent.
How midwives address ethical concerns when working with at-risk groups.
Understanding how professional organizations support midwives in legal matters.
Exploring how midwives respect patient choices while following best practice guidelines.
Investigating how midwives manage potential conflicts of interest in their work.
Understanding the legal implications of midwifery decisions during emergencies.
Examining how emerging technologies impact ethical practices in midwifery.

Mental Health in Pregnancy and Childbirth

Exploring how common mental health issues are for pregnant women and their impact.
Understanding how midwives help women cope with traumatic childbirth experiences.
How midwives assist with mental health challenges that arise after childbirth.
Investigating how midwives identify and treat mental health conditions during pregnancy and postpartum.
Exploring preventive measures midwives can take to reduce the risk of postpartum depression.
How midwives offer care to women with existing mental health issues during pregnancy.
Examining how maternal mental health affects both the mother and baby’s health.
Exploring successful programs and strategies for supporting mental health in pregnancy.
How midwives help manage stress and anxiety to promote a healthier pregnancy.
Understanding how mental health support can be incorporated into standard midwifery care.

Integrative Medicine in Midwifery Practice

Exploring how midwives incorporate alternative treatments alongside traditional care.
Investigating the use of herbal remedies and their impact on pregnancy and childbirth.
Understanding how midwives respect and incorporate cultural traditions into care.
Examining how acupuncture and massage therapies benefit pregnant women and their labor experiences.
Exploring how practices like yoga and mindfulness are used to support pregnant women.
Understanding the effects of essential oils and aromatherapy on pregnancy and childbirth.
Investigating the role of vitamins and supplements in supporting maternal and fetal health.
Assessing the use of homeopathic treatments in midwifery practice.
How midwives blend conventional and alternative approaches for comprehensive care.
Examining how combining different medical approaches affects overall birth outcomes.

Technology in Midwifery

Exploring the role of remote consultations in improving access to midwifery services.
Investigating how apps help with tracking pregnancy progress and health management.
Examining how artificial intelligence aids in early detection and management of pregnancy-related conditions.
Exploring how devices like fitness trackers and monitors contribute to better health management.
Understanding how new technologies improve the labor and delivery experience.
Examining how VR and simulation are used for training midwifery students and professionals.
How digital records improve the efficiency and accuracy of midwifery care.
Investigating how virtual communities provide support and information for pregnant women and new parents.
Exploring how digital tools aid in the support and monitoring of new mothers after childbirth.
Understanding the ethical issues related to using technology in midwifery practice.

LGBTQ+ Inclusive Care

Exploring how LGBTQ+ individuals experience maternity care and the challenges they face.
Examining how training helps midwives provide inclusive and affirming care to LGBTQ+ patients.
Strategies for midwives to create welcoming spaces for LGBTQ+ individuals during childbirth.
How midwives cater to the specific health needs of LGBTQ+ people during pregnancy.
Understanding the importance of using inclusive language and practices in midwifery.
How midwives support diverse family structures and needs during pregnancy and childbirth.
Addressing and reducing instances of discrimination in maternity care settings.
Exploring how midwives address mental health issues specific to LGBTQ+ patients.
Investigating the legal and ethical considerations when providing care to LGBTQ+ patients.
How to create and implement policies that ensure inclusive care for LGBTQ+ individuals in maternity settings.

Midwifery is a noble profession with a lot of growth potential. There could be more thought-provoking nursing dissertation topics for research in this field. Interested in further details, call us for more Midwifery Dissertation topics.

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Choosing the right midwifery dissertation topic is a key step in completing your degree. By focusing on important and specific issues, you can make your dissertation stand out and contribute to improving healthcare for mothers and babies in the UK. Whether you’re looking at midwifery research topics or exploring a midwifery dissertation example , the most important thing is to choose a topic that you are passionate about and that can make a difference.

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Department : Health Sciences Credit value : 40 credits Credit level : H Academic year of delivery : 2023-24 See module specification for other years: 2022-23

Module will run

Occurrence	Teaching period
A	Autumn Term 2023-24

Module aims

To provide the student with the opportunity to study an area of midwifery practice in depth, demonstrate critical reasoning and application of theory to practice.

Module learning outcomes

This module will enable the student to:

Critically review in depth the research literature related to their chosen topic of study.
Critically evaluate a range of theoretical and philosophical dimensions in order to contextualise their study.
Integrate relevant theoretical concepts with reflections on experience.
Critically reflect on the application of evidence based guidelines to practice in their chosen area of study.
Present a major study, which demonstrates critical thought and the ability to synthesise knowledge from a range of appraised sources.

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	100

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Written feedback for summative assessment is provided on the standard proforma, within the timescale specified in the programme handbook.

Indicative reading

Aveyard, H. & Sharp, P. (2017) A beginners guide to evidence based practice (3rd ed). Maidenhead: Open University Press
Aveyard, H., Sharp, P. & Woolliams, M (2015) A beginners guide to critical thinking and writing in health and social care (2nd ed). Maidenhead: Open University Press
Becker, L. (2015) Writing successful reports and dissertations . London: SAGE Publications Ltd
Cottrell, S. (2014) Dissertations and project reports. Basingstoke: Palgrave Macmillan
Cottrell, S. (2017) Critical thinking skills. (3rd ed) . Basingstoke: Palgrave Macmillan
Wickham, S. (2015) 101 Tips for planning, writing and surviving your dissertatio n. www.sarawickham.com
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Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth

Lucy Lewis 1 , 2 ,
Yvonne L. Hauck 1 , 2 ,
Janice Butt 2 ,
Chloe Western 2 ,
Helen Overing 2 ,
Corrinne Poletti 2 ,
Jessica Priest 2 ,
Dawn Hudd 3 &
Brooke Thomson 1

BMC Pregnancy and Childbirth volume 18 , Article number: 249 ( 2018 ) Cite this article

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There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic.

This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts.

The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance.

Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth.

Conclusions

Peer Review reports

The provision of water immersion for labour and birth is facilitated by midwives working within low risk midwifery-led models of care who are deemed competent to provide this method of birth [ 1 , 2 ]. The concept of competence is often aligned with confidence [ 3 ], but distinguishing between these two concepts is important as they are not always synonymous. A midwife may be a competent waterbirth practitioner having met all the professional competency requirements, but becoming confident is an individual journey that is dependent upon trust in clinical guidelines, presence of peer support and the challenge of achieving consistent exposure to waterbirth [ 4 ]. Additionally, midwives with extensive experience of conventional birth on land may be challenged to unlearn old skills and develop new practices required for water immersion in labour and birth. Whilst midwives working within low risk continuity of care models where physiological birth was the norm, researchers concluded that a supportive culture assisted in the development of their confidence, irrespective of clinical experience [ 4 ].

Individual midwives can act as gate keepers to water immersion which is more likely to be accepted into an organisation’s culture when it is supported by midwifery managers and championed by experienced waterbirth practitioners [ 5 ]. These champions can mentor midwives who wish to achieve waterbirth competency [ 5 ]. In this situation, mentors may not always be the most senior midwives who have extensive experience with conventional birth on land. Caution is recommended to recognise and consider ways to minimise the possible hierarchical tensions that may occur when experienced midwives are mentored by junior midwives who have achieved waterbirth competency [ 4 ]. Indeed, promoting and sustaining change in midwives’ waterbirth practice can be challenging. A study, undertaken in the United Kingdom (UK), utilised problem solving workshops to identify interventions that could develop and sustain a waterbirth culture. These interventions included: publishing monthly waterbirth statistics; setting a target of 100 waterbirths per annum; keeping portable birthing pools partially inflated; and appointing a waterbirth champion. Co-ordinators were able to positively influence midwifery practice through social support which was found to be pivotal in relation to developing and sustaining a waterbirth culture [ 6 ].

Access to immersion in water for labour and birth is reliant on both the care provider and the policies and procedures that guide clinical practice. Policies and guidelines in relation to water immersion for birth in Australia usually reflect the organisation’s interpretation of the current literature [ 7 ]. Additionally, more evidence is required around the effect of immersion in water on neonatal morbidity [ 1 , 8 , 9 ] and management of the third stage of labour [ 7 ]. A literature review exploring midwives concerns around waterbirth [ 10 ] identified three clinical issues (neonatal water aspiration and neonatal and maternal infection and thermo-regulation) and two practice issues (midwives skills and education and emergency procedures around maternal collapse). The clinical issues were not evidence based and the practice issues could ‘be addressed by appropriate policy, guidelines and practice’ [ 10 ]. Other work exploring how a convenience sample of 249 Australian midwives utilised normal birth guidelines, found that although the majority (90%) were aware that specific guidelines existed, only 71% reported routinely using them to guide their clinical practice [ 11 ].

It has been suggested that the waterbirth environment nurtures woman-centred care by facilitating shared decision making and perceptions of control around their care [ 8 ]. However, recent Australian research found some midwives perceive waterbirth policies and guidelines can limit their scope to facilitate water immersion and did not always support women’s informed choice [ 12 ].

There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. To address this gap in evidence and build our knowledge around this topic, our intention was to obtain a contemporary overview of midwives' experience of their education, knowledge and practice around immersion in water for labour or birth in Western Australia (WA).

The specific aim of this WA study was to assess Midwifery Group Practice (MGP) and Community Midwifery Program (CMP) midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth. This mixed method study was performed in two sequential phases. Phase one incorporated a cross sectional design and examined midwives' perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire; 34 midwives were invited to participate. Phase two employed a qualitative descriptive design to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth; two focus groups were held.

Mixed methods were utilised to provide in-depth knowledge [ 13 , 14 ] relating to the education, knowledge and practice around immersion in water for labour or birth. This methodology offers researchers using quantitative methods the opportunity to utilise qualitative research to gain deeper understanding of the investigated phenomenon [ 15 ]. Utilising this two phase mixed methodology provided a more informative, constructive and thorough integration of the research results, building on the links between methods rather than within methods [ 15 ]. We envisaged being able to utilise both numbers and words would give greater insight into the bigger picture around midwives' experience of their education, knowledge and practice around immersion in water for labour or birth.

Participants and setting

The study was performed at the sole tertiary public maternity hospital in WA, which has approximately 5200 births annually. Women can labour and birth in the tertiary maternity hospital’s Labour Ward and Birth Suite or the Family Birth Centre (an adjacent building within the hospital grounds).

Perinatal data collected in 2016, by King Edward Memorial Hospital (KEMH) in WA confirmed that 5% (228 of 4402) of infants ≥37 weeks gestation were born immersed in water. Currently WA and South Australia are the only Australian states with state-wide policies and guidance supporting immersion in water for labour and birth, although waterbirth is available in every state and territory [ 16 , 17 ]. In WA midwives are guided by state-wide clinical waterbirth guidelines [ 16 ]. Between August and November 2016 we invited the 34 midwives who provided care for women who opted to use water for labour and/or birth to participate. Throughout the study, women choosing to labour and/or birth in water were cared for by midwives working within two publically funded services: the MGP and CMP. These low risk continuity of care models [ 18 ] are ideally suited to provide care for women who labour and/or birth in water, as this model facilitates a shift from high risk obstetric-led care to low risk midwifery-led care [ 18 , 19 ]. Both the MGP and CMP operate their services (antenatal, intrapartum and postnatal care) from the Family Birth Centre (FBC) with the CMP also providing antenatal, intrapartum and postnatal care to women in their homes and local community clinics. In these midwifery care models, a primary midwife is supported by a small team of midwives who provide continuity of care 24 h a day throughout pregnancy, birth and up to two weeks post birth. Perinatal data collected in 2016 at KEMH confirmed MGP and CMP midwives birthed 16% (813 of 5189) of all women at KEMH. Although, no women received immersion in water for labour and birth in the tertiary maternity hospital’s Labour Ward and Birth Suite throughout the duration of the study, in the last two weeks of the study the tertiary maternity hospital agreed that immersion in water for labour and birth could be facilitated in their main Labour and Birth Suite.

Recruitment and data collection

Midwives were invited to participate in the study through an information letter and in-house designed questionnaire (Additional file 1 ), both of which were sent to their workplace mobile phone. Midwives who did not want to complete the online questionnaire were given the option to complete a hard copy and return it to the research team by placing it in a locked box situated in the FBC. Returning a completed questionnaire was deemed implied consent. Ethics approval was gained from the Women and Newborn Health Service Ethics Committee (Approval Number 2016103QK) at the study centre.

The questionnaire was validated through a review process with an expert panel involving a midwifery educator and three midwives who had experience caring for women who had birthed in water. Feedback from the panel resulted in changes to questions around being competent to facilitate water immersion for labour or birth and actively promoting this birth choice for labour and birth. This question was divided into two questions, one focused upon labour and another concerning birth.

The aim of the questionnaire was to examine midwives' perceptions of education, knowledge and practice around immersion in water for labour. Midwives were asked about: their employment status (if they worked in the MGP or CMP and how long they had been working as a midwife and facilitating water immersion for labour or birth); their education (training undertaken to facilitate immersion in water for labour or birth and number of births required to develop waterbirth confidence); their practice (two factors they would discuss with women in relation to water immersion for labour or birth); their confidence caring for women immersed in water for labour and birth (in the first, second and third stages of labour); their enjoyment facilitating immersion in water for labour and birth; whether they actively promote water immersion for labour and birth; and their interpretation of four scenarios around antenatal, early labour, birth and third stage clinical care. The scenarios required a written response, were scored and were based on information relating to the state-wide clinical waterbirth guidelines [ 16 ]. It was decided to give midwives completing the questionnaire a website link to the state-wide guidelines [ 16 ], in the information letter accompanying the questionnaire. By providing a website link to this guidance, we were examining how midwives interpreted and applied the guidance in their clinical practice. In relation to confidence and enjoyment, midwives were asked to place a cross on a 10 cm line (where zero was ‘not confident’ or ‘does not enjoy’ and 10 was ‘very confident’ or ‘enjoys’), to quantify their perceptions on the continuum from zero to ten.

An item was included at the end of the questionnaire (phase one) inviting midwives to participate in a focus group to discuss their experiences around immersion in water for labour or birth. The first author conducted the two focus groups. Observations were documented by the fourth author in the form of field notes. Each focus group lasted approximately 45 min. The focus groups were held at the study centre in an interview room that was convenient to all interested midwives. Prior to commencing the focus group, midwives were reminded that their privacy would be maintained by issuing each of them a unique identifier; the discussions linked to an individual’s identity should ‘remain in the room’; and that the focus group would be audio recorded. All midwives verbally consented to these conditions.

The final questions for the focus groups (Additional file 2 ) were based around the results from phase one, with two questions being developed: question one asked ‘What contributes to your enjoyment of waterbirth?’ Two prompts were utilised for this question. The first one addressed the promotion of natural birth and the second was around supporting women’s choice. Question two asked ‘Are there any issues with waterbirth?’ One prompt was utilised around the issue of exploring which stage of labour midwives found most challenging.

Data analysis

Phase one: quantitative data.

Each of the four clinical scenarios was allocated a maximum score according to whether a midwife correctly identified key aspects of clinical practice based on the state-wide clinical waterbirth guidelines [ 16 ]. Four members of the research team independently scored each scenario. The team then met to compare scores. Any disagreement in relation to the scores was discussed and a consensus reached by referring back to the data.

Means, and interquartile ranges were used to summarise continuous data (such as the scores for each scenario). Frequency distributions were used to summarise categorical data (such as feeling equipped to facilitate waterbirth following training). Statistical software (SPSS version 22) was used for analysis.

Phase two: Qualitative data

Transcribed focus groups were subjected to thematic analysis [ 20 ] by five members of the research team, who analysed a cross-section of transcripts and field notes ensuring each data source was reviewed by at least two members [ 21 ]. Analysis required the research team to become submerged in the data. Transcripts and field notes were deconstructed enabling the research team to identify patterns, similarities and themes from the midwives’ words or sentences [ 13 , 20 , 21 ]. The team met weekly over three months to negotiate, clarify and refine the themes. Any disagreements on interpretation were negotiated by referring back to the data. All the researchers were clinical or academic midwives, with varying experiences of facilitating immersion in water for labour or birth. As a process of member checking, preliminary themes were presented to five midwife participants who confirmed agreement with the themes.

Table 1 summarises the midwives’ perception of their education, knowledge and practice around immersion in water for labour and birth. A total of 29 (85%) out of a potential 34 midwives returned a questionnaire. The mean time midwives were qualified was 162 months (13 years and 5 months), with the mean time midwives had been facilitating waterbirth being 83 months (eight years and 9 months). Most (59%; n = 17) midwives worked in the MGP. The majority (93%; n = 27) of midwives used the WA state-wide clinical guidelines for waterbirth [ 16 ] for their education and training, with 90% ( n = 26) accessing the E-learning package developed by the study hospital’s education department. Following waterbirth training, 93% ( n = 27) felt equipped to facilitate waterbirth with the mean number of waterbirths required to facilitate confidence being seven.

On a scale of 0 to 10 (where zero was ‘not confident’ and 10 was ‘very confident’), midwives were very confident caring for women in water during the first stage of labour (mean score of 10). They were also confident caring for women in the second stage (mean score of 9) and third stage of labour (mean score of 8). The mean score in relation to confidence using the emergency evacuation to get the woman out of the bath was eight. On a scale of 0 to 10 (where zero was ‘does not enjoy’ and 10 was ‘enjoys’), midwives enjoyed facilitating immersion in water and birth, obtaining a mean score of 10. Finally, mean scores for the antenatal, early labour, birth and third stage of labour scenarios indicated midwives were practicing according to the WA state-wide clinical guidelines for waterbirth [ 16 ].

Two focus groups comprising of seven and five midwives were performed. Findings are presented with supportive quotes in italics from the midwives. For confidentiality a pseudo-name was allocated to each midwife.

Caring for women who labour or birth in water

Exploration of what midwives enjoyed about caring for women who labour or birth in water revealed three distinctive themes: instinctive birthing; woman-centred atmosphere; and undisturbed space (Table 2 ).

Instinctive birthing

The theme ‘instinctive birthing’ described how midwives perceived labouring or birthing in water nurtured an instinctive birthing behaviour led by the woman. Anna reflected ‘ You absolutely see the hormones that promote labour take over. You know labour progresses better and the woman relaxes into labour ’. Noreen agreed; they ‘ Really feel what the body is able to do and how birth feels ’, whilst Kate described how she perceived water enabled her to trust a woman’s ability to instinctively birth:

I think they progress really well. I don’t do many vaginal exams, but they are getting in [the water] and they are well established, they are fully before you know it and they don’t push early. Like sometimes with their first grunt the heads on view…They’re not asking for epidurals, they’re not asking for gas.

Jasmine agreed with Kate’s sentiments: ‘ Because you can’t see as the vagina is submerged, the first sign she needs to push is she’s pushing ’ whilst Anna summarised her experience was that ‘ They’re more likely to reach down and lift the baby up themselves ’.

Woman-centred atmosphere

The theme ‘woman-centred atmosphere’ described a labour and birth environment which was woman centred, calm, peaceful and relaxed. Initially midwives discussed how labouring and birthing in water empowered women. Jacquie noted ‘ I feel women have more control ’. Anna agreed suggesting she thought it was to do with power stating ‘ The woman holds more of the power in labour ’. Noreen continued the discussion ‘ the thing is society brings up pictures of women with somebody doing it [the birth] for them, there is a cultural thing of having somebody delivering the baby whilst [with water] there is themselves and their body ’. Bonnie reflected on Noreen’s comments suggesting water promoted a change in the woman’s demeanour ‘ You can see the change in the woman’s face and in her body when she gets in the water, it’s nice and relaxed ’. Beth agreed water ‘ Promotes the environment to be quiet and peaceful ’. Jacquie thought this may be because ‘ The space between contractions is very different from a land birth, they are very much more focused on their breathing and calmer ’. Whilst Noreen shared how a woman’s relaxed state affected the care she gave ‘ You know it’s all relaxed and you can concentrate more on the signs, the natural signs of a woman giving birth ’ . Sophie agreed ‘ It’s so calming for the women. I think it relaxes them which then relaxes us ’.

Undisturbed space

The theme ‘undisturbed space’, described how water creates an undisturbed space where access to the woman is mediated by the water. Jasmine noted that ‘ If you’re in the bath people knock and they stay out, they leave you alone. As far as society is concerned, it’s not acceptable to walk into the room when someone’s in the bath. If someone’s in lithotomy, fine ’. Kerry reflected it also had an impact on how safe the woman felt. ‘ Especially for the women who have a sexual abuse history, they feel safer in the water, they feel like you can’t get at them ’. The topic of safety led to a discussion around privacy with Olivia commenting that ‘ It’s [‘water] their ‘own space and you have to really reach into their space, rather than them being poked and prodded [with a land birth]’. Dorothy agreed stating ‘ It’s more undisturbed ’. Kerry continued ‘ Even though you can see beneath the water and everything, I think for them it just feels, more private under the water ’. Kate reflected on her experiences by recounting a scenario ‘ A woman that came back to the waterbirth study day and spoke about when she got in [the pool] there was a real sense of privacy, even though she had nothing on, the water was like a veil ’. Baily also remarked on how the ‘dynamics’ of a labour in water effects the partner ‘ I get a sense they quite like it too, because they are able to just sit and observe and hold that silent still place…my experience is that even men feel quite comfortable in that space ’.

The challenges midwives experienced with waterbirth

Analysis of the focus group transcripts exploring the question ‘are there any issues with waterbirth’ revealed that issues highlighted by the midwives were perceived as challenges. Two themes were identified: learning through reflection and facilities required to support waterbirth.

Learning through reflection

The theme ‘learning through reflection’ illustrates how midwives learnt by documenting and then reflecting on the clinical challenges encountered during their day to day clinical practice around water immersion for labour and birth. Kerry shared ‘ I didn’t used to but since we’ve been doing group practice… when you look at your records you can see most of them are waterbirths ’. Olivia continued ‘ I don’t remember all of the waterbirths…I’ve got a little book that I just pop them in ’. Kate reflected on her colleagues comments sharing she did not keep records of each waterbirth and that her confidence caring for women in water ‘ took a long time. I’ve probably done, I don’t know over 150 now ’. Kate went on to explain why ‘ You had to flex the head and then move the hand and then sweep the perineum, it was really hands on. But that’s how we were taught. So to move to totally hands off [waterbirth] where you’re not even poised is challenging ’. Olivia agreed with Kate’s sentiments describing a waterbirth scenario where ‘ I remember taking over from somebody else and it was a hypno-birth and so there was no talking…it was a good learning experience ’.

To illustrate, the topic of learning through clinical experience led to a discussion around placental cord snapping. Bonnie shared ‘ I’ve had a few cord snaps now. Like quite a few issues, but it hasn’t changed my feeling of how to perform waterbirth because I know it’s going to be fine and we just deal with it as it comes ’. Kerry empathised, supporting Bonnie by acknowledging ‘ I think a lot of midwives get anxious even though they may pretend they don’t get anxious about waterbirths. They want to get the baby out as fast as possible. But I think if you make them [the women] aware you don’t just yank it [the baby up]… you need to check how long it [the cord] is before you can go yanking’ .

Facilities required to support waterbirth

The theme ‘facilities required to support waterbirth’ related to ensuring waterbirth facilities were suitable, available and accessible for women and identified challenges relating to the provision of infrastructure around waterbirth. Jasmine stated:

If we want this option [waterbirth] open for all women then we need to provide the facilities for that to happen. I have an issue with it being inequitable at the moment. The Birth Centre has the birth pool and blow up pools that are free of charge whilst clients [women] in the main hospital and CMP have to pay and hire their own…how come one group of clients under the same public system get it for nothing and the other group have to pay?

Sophie was also concerned by the rollout of waterbirths to the main hospital but her frustration was around the referral process. ‘ When waterbith was approved in the main hospital…I had a patient come over and say ‘I want a waterbirth but they [the main hospital] won’t facilitate one for me over there and they’ve told me to come to the Birth Centre and I was quite surprised ’. Whilst Kate’s sentiments concerned the content of the waterbirth guidelines. ‘ When it [the waterbirth guideline] was first developed we didn’t have telemetry and now we do. So I think waterbirth telemetry needs to be incorporated into the guideline’ . Other midwives did not appear sure of how often in-service needed to be provided in relation to emergency management, pool evacuation and assessment of blood loss. There was debate between midwives in relation to how often these drills should be performed. Dorothy confirmed ‘ In the CMP we have to do like a quiz, you know we put the blood in the water every six months and estimate it ’. Whilst Jacquie confirmed ‘ We do up a calendar [of available professional development sessions]’ and it was up to individuals to ensure their development was up to date.

This mixed methods study enabled us to explore midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth in WA. Quantitative analysis found the majority of midwives felt equipped following waterbirth training to facilitate labour and birth in water, with scenario responses indicating midwives were practicing according to the WA state-wide guidance. Additionally, midwives were confident and enjoyed caring for women who used water immersion. Qualitative exploration of what midwives enjoyed about caring for women who used water immersion for labour and/or birth revealed three distinctive themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Whilst exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth. Our discussion will focus on what waterbirth offers midwives.

Labouring and birthing in water is centred around the philosophy that pregnancy and birth are normal life events [ 19 ]. The importance of sustaining a waterbirth culture highlighted by these WA midwives aligns with the belief that maintaining low risk birth cultures is essential to meet the needs of healthy, low risk women through recognition and respect of midwives’ contribution [ 22 ]. Midwives in this study were experts in their field, who had been qualified for a mean of 13 years and five months and facilitating waterbirth for a mean of eight years and nine months; similar to other research [ 6 ]. During the study it was agreed that immersion in water for labour and birth could be facilitated in the tertiary Labour and Birth Suite. We suggest this expertise will be integral in relation to supporting midwives in the tertiary Labour and Birth Suite to become skilled waterbirth practitioners. Indeed, an action research study introducing a problem solving waterbirth workshop with UK midwives and their co-ordinators positively affected change in waterbirth practice and was recognised for its potential shift toward normalising low risk midwifery care [ 6 ].

Midwives are guided by the International Confederation of Midwives (ICM) Position Statement on ‘keeping birth normal’ [ 23 ] which asserts that midwives are advocates and experts in low risk childbirth. The ICM acknowledges that ‘women should have access to midwifery-led care, one-to-one support, including the choice of a home birth and immersion in water’ [ 23 ] which aligns with the international recommended pathway towards evidence based respectful maternity care [ 24 ]. Utilising immersion for labour and/or birth provides midwives with an opportunity to facilitate this experience for women.

The theme of ‘learning through reflection’ articulated by the midwives supports the ICM Philosophy of Midwifery Care [ 25 ] ensuring competent midwifery care is informed and guided by continuous education. The association between workplace learning and competence was confirmed in a Japanese study with nurse/midwives who related learning through reflection to their self-reported competence [ 26 ]. Differences were noted based upon level of experience whereby learning from feedback and training were associated with competence for more experienced clinicians compared to learning through practice and from others for self-reported competence for those with less experience [ 26 ]. Fittingly, the Australian national competency standards for the midwife [ 27 ] present domains around the provision of woman-centred care, with one domain suitably entitled ‘reflective and ethical practice’. Midwives in this study reinforce the relevance of this domain in their practice as both the clinical scenarios and focus group findings illustrated they valued having the ability and skills to analyse and reflect in, on and about practice to ultimately maintain clinical competence and confidence. In short, when care is provided by midwives who are educated [ 28 , 29 ], regulated [ 21 , 30 ] and provide respectful evidence based care [ 24 ], the outcomes are improved for women and their infants [ 1 , 24 , 28 , 29 ]. The midwives in this study adhered to these principles empowering women to realise their potential to birth, though the medium of water.

Strengths and limitations

Although the quantitative methods employed provided limited scope to explore the wide range of experiences midwives in our study encountered caring for women who laboured and/or birthed in water, they did provide the research team with an objective starting point for further exploration of specific aspects of the questionnaire [ 21 , 30 ]. For example, utilising a question for the focus groups gleaned from a phase one question asking midwives to score their enjoyment facilitating immersion in water for labour and birth, gave us the opportunity to contextualise what they enjoyed; providing a connection between the quantitative and qualitative components that could not be answered by mono-methods alone. By utilising both numbers and words to explore this topic [ 14 , 15 ], the qualitative and quantitative components became cohesively integrated, producing research findings around midwives enjoyment which were greater than the sum of individual parts of the research [ 31 ]. This approach exposed the importance of instinctive birthing; woman-centred atmosphere; and undisturbed space.

Midwives in this study were self-selected from the MGP and CMP midwives based within the sole tertiary public maternity hospital in WA. Providing midwives with a website link to the WA state-wide waterbirth guidelines may have influenced their responses. This was a self-assessment of competence which is a subjective aptitude. The research would have been strengthened by comparing the midwives responses to their actions. Participating midwives may have been motivated and confident in their waterbirth practice. The sample of midwives included in phase one was small and may not be representative of all midwives who provide care for women who labour and/or birth in water. We acknowledge these factors could have had an impact in relation to the findings and should be considered when interpreting transferability of the findings to other settings.

This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are an integral component in relation to supporting and sustaining a waterbirth culture. Midwives in this WA study were both competent and confident and enjoyed caring for women who used water immersion. Perhaps this was because the medium of water not only empowered women to realise their potential, but also themselves.

Abbreviations

Community Midwifery Program

Family Birth Centre

International Confederation of Midwives

King Edward Memorial Hospital

Midwifery Group Practice

United Kindgom

Western Australia

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Acknowledgements

We would like to thank King Edward Memorial Hospital for providing funding for the research staff and the midwives for graciously sharing their experiences.

The research was not supported by a research grant. King Edward Memorial Hospital provided funding for the research staff to undertake and complete the project with no role in study design, data collection, analysis, interpretation and writing the manuscript.

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We had assured the midwives participating in the study we would maintain their confidentiality and privacy. As there 29 midwives in this study, we were not able to make their supporting data available as we felt their identity may be compromised.

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Lucy Lewis, Yvonne L. Hauck & Brooke Thomson

Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, 6008, Australia

Lucy Lewis, Yvonne L. Hauck, Janice Butt, Chloe Western, Helen Overing, Corrinne Poletti & Jessica Priest

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All authors read and approved the final version of the manuscript. LL was responsible for the proposal, ethics approval development of the data collection tool/questions and coordination of the study. For the quantitative data she assisted data entry into SPSS. She also performed the quantitative data analysis. For the qualitative data she ran the focus groups and participated in thematic analysis. She drafted the article and was responsible for the final editing which incorporated the team member’s comments. YH assisted LL with the proposal and ethics approval and development of the data collection tool. For the qualitative data she participated in the thematic analysis. She assisted LL with the drafting of the article. JB assisted with development of the data collection tool/questions and made comments on the final article. CW assisted with the coordination of the study. For the qualitative data she assisted with the focus groups. She made comment on the final article. HO participated in thematic analysis. She made comment on the final article. CP participated in thematic analysis. She made comment on the final article. JP participated in thematic analysis. She made comment on the final article. DH assisted with coordination of the study. She made comment on the final article. BT contributed and approved the final article.

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Correspondence to Lucy Lewis .

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Ethics approval and consent to participate.

Ethics approval was gained from the Women and Newborn Ethics Committee (Approval Number 2016103QK) at the study centre. Returning a completed questionnaire was deemed implied consent. An item was also included at the end of the questionnaire inviting midwives to participate in a focus group to discuss their experiences around immersion in water for labour or birth. Prior to commencing the focus group midwives were reminded that their privacy would be maintained by issuing each of them a unique identifier; the discussions linked to an individual’s identity should ‘remain in the room’; and that the focus group would be audio recorded. All midwives verbally consented to these conditions.

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Lewis, L., Hauck, Y.L., Butt, J. et al. Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth. BMC Pregnancy Childbirth 18 , 249 (2018). https://doi.org/10.1186/s12884-018-1823-0

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Challenges in day-to-day midwifery practice; a qualitative study from a regional referral hospital in Dar es Salaam, Tanzania

Hanna strømholt bremnes.

a Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

Åsil Kjøl Wiig

Muzdalifat abeid.

b Department of Obstetrics and Gynecology, Temeke Regional Referral Hospital, Dar es Salaam, Tanzania

Elisabeth Darj

c Department of Obstetrics and Gynecology, St Olavs Hospital, Trondheim, Norway

d Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

Background : Maternal and infant mortality rates in Tanzania have decreased over the past decades, but remain high. One of the challenges the country faces, is the lack of skilled health care workers. High fertility rates make midwives and their patients particularly susceptible to stress as a result of understaffing.

Objective : This paper explores the challenges midwives face in their day-to-day practice at a regional referral hospital in Tanzania, and investigates which measures the midwives themselves find necessary to implement to improve their situation.

Methods : A qualitative study design with focus group discussions (FGDs) was employed to explore which challenges the midwives experienced. Each focus group consisted of five to six midwives. A FGD topic guide covering challenges, consequences, motivation, ideal situation and possible solutions was used. These data were analyzed using Systematic Text Condensation.

Results : A total of 28 Midwives, six men and 22 women, participated in five FGDs. Four categories emerged from the collected material: Feelings of demoralization, shortage of resources, societal challenges and personal struggles. A feeling of demoralization was especially prevalent and was caused by a lack of support from the leaders and little appreciation from the patients. Shortage of resources, and shortage of personnel in particular, was also highlighted as it led to an excessive workload resulting in difficulties with providing adequate care. These difficulties were intensified by lack of equipment, facilities and a non-optimal organization of the healthcare system.

Conclusion : The challenges revealed during the FGDs prevent the midwives from providing sufficient midwifery care. To improve the situation, measures such as supportive leadership, reduction of workload, increasing availability of equipment and increasing knowledge of reproductive health in society, should be taken.

Maternal and neonatal health have been one of WHO’s key priorities for decades. The Millennium Development Goals (MDGs), and the Sustainable Development Goals (SDGs), have especially targeted the maternal mortality ratio (MMR) and the infant mortality ratio (IMR) [ 1 ]. In Tanzania, working to reach the MDGs has been important [ 2 ]. Tanzania has a total population of 45 million people, where women of childbearing age make up 47.1% [ 3 ]. The Total Fertility Rate is 5.2 [ 4 ]. The infant mortality rate is 43 per 1000 live births, which is lower than the average infant mortality in sub-Saharan region of 79.1 per 1000 [ 4 , 5 ]. The maternal mortality ratio (MMR) was estimated to be 556 per 100.000 births in 2016. This is higher than the ratios reported in 2010, but a decrease from the 2005-levels of 578 per 100.000 [ 4 , 6 ].

Method of Systematic Text Condensation for data analysis using an example from the collected material.

Theme	Meaning unit	Category	Subcategory
General shortage	‘There are so many patients, but the staff is few’	Shortage of resources	Personnel

Overview of main categories and subcategories emerging from the focus group discussions with the midwives.

Categories	Sub-categories
Feelings of demoralization	Blamed by patients
	Lack of support from superiors
Shortage of resources	Personnel
	Equipment
	Facilities
Societal challenges	Low level of education in the population
	Lack of collaboration within the health system
Personal struggles	Health problems
	Lack of personal development
	Family life troubles

The fluctuations in MMR, and persistent high levels of mortality in both mothers and children, illustrates the required need for further research on how to improve the situation, which does not yet meet the goals postulated by WHO. One of the main challenges is that there are only four nurse-midwives per 10.000 inhabitants [ 7 ], which is considerably lower than the minimum of 23 per 10.000 recommended by the WHO [ 8 ]. This shortage of qualified personnel affects both healthcare professionals and their patients. The high fertility rate and large number of fertile women amplifies this problem and makes the shortage of midwives especially challenging.

Midwives and the barriers they face have been studied before and are regarded as key for improving child and maternal health. A worldwide systematic review on midwifery care in low and middle-income countries argues that barriers for providing good midwifery care are created by social, economic and professional factors [ 9 ]. The consequences of these barriers are feelings of exhaustion and moral distress, which in turn affects the quality of the care provided [ 9 ]. A study from Tanzania (2015) identified three main barriers to providing quality midwifery care in the country; poor-working conditions, lack of status and perceived lack of knowledge [ 10 ].

The aim of this study was to explore and highlight the challenges the midwives face in their day-to-day practice, and to investigate which measures the midwives find necessary to implement to improve their condition. This may enable actions to be taken informed by the midwives’ firsthand experience of the situation. Seeing their own suggestions being taken into account may lead to increased motivation, thereby improving the midwives’ working conditions, which in turn could better maternal and child health in the country.

Study design

A qualitative study design using focus group discussions (FGDs) was employed to explore the challenges midwifes at a regional referral hospital in Dar es Salaam face in their day-to-day practice. FGDs was considered a suitable method for data collection as it allows interactions between participants and provides the possibility of obtaining multiple views and perceptions of a subject [ 11 ]. The COREQ-guidelines for reporting qualitative research were followed [ 12 ].

Study setting

This study was conducted at the Obstetrics and Gynecology (OBGYN) department at a Regional Referral Hospital in Dar es Salaam, Tanzania. Tanzania has a pyramidal healthcare system organized in five levels, where regional referral hospitals serve as the fourth level of healthcare facilities. The hospital in question is responsible for providing healthcare to a population of around 1.6 million people in one district of Dar es Salaam [ 3 ]. The facility gets both self-referrals and referrals from the 55 government owned district health care facilities in the surrounding region [ 5 ]. The OBGYN department at the hospital has five wards; Antenatal ward with a capacity of 12 beds, labor ward with 20 beds, post-operational ward with 10 beds, post-natal ward with 30 beds and intensive care unit (ICU) with 6 beds. The hospital has approximately 17,000 annual deliveries, between 40 and 50 each day. The staff consists of doctors and nurse-midwives. Most deliveries and other routine work are performed by nurse-midwives. There are two to three midwives present per shift in the Labor ward, making the patient-nurse-ratio 10:1. In the other wards, except the ICU, there is fewer staff, with one midwife being responsible for up to 30 patients during afternoons and nights. When a complication arises a specialist doctor on call is summoned for intervention.

Study participants

Participants were recruited from the OBGYN department at the Regional Referral Hospital using a purposive sampling technique [ 13 ]. Midwives of both genders, all ages and of varying seniority were included in order to ensure a rich and diverse data material. The only inclusion criterion was to be employed as a midwife at the hospital and to be willing to participate in the study. Thirty nurse-midwives were asked to take part in the FDGs, of which two declined. In total, 28 participated, among them six men and 22 women. Their age ranged from 23 to 57, and their working experience from 2 months to 33 years.

Data collection

Five FGDs were conducted over a 2 week period with 5–6 midwives in each group. The group size was decided based on recommendation from Malterud [ 11 ], who regards 5–6 participants as suitable number to secure both participation and presentation of multiple views. After the 5 FGDs were conducted, the material was perceived to be saturated as no new topics emerged during the final interview [ 11 ]. To avoid compromising the patient care, the interviews took place during the least busy time of day, after ward rounds and before changing of shifts, and with midwives from different wards. The interviews were conducted in Kiswahili. An independent translator, who works as a midwife at another hospital in Dar es Salaam, moderated the FGDs assisted by the two first authors who observed and took notes. An FGD guide with topics covering specific areas was used, such as: challenges, consequences of the challenges, motivation, ideal situation and possible solutions. The FGDs were on average 60 minutes long and were audio-recorded with permission from the participants. The audio-recordings were translated verbally into English by the translator after the FGDs and simultaneously transcribed by the first authors into written English transcripts. The written translations were verified against the audio-recordings for accuracy by the local supervisor. No significant incongruences or mismatches were found.

Data analysis

The qualitative method of Systematic Text Condensation (STC), as described by Malterud [ 14 ], was applied to the material. This proved to be a suitable method for analyzing the manifest content of the material and provide a systematic presentation of the midwives’ experiences and situation. The main steps of the analysis involved interpretation of data through multiple readings of the transcripts and identification of themes and meaning units. The meaning units were then coded and grouped into categories and subcategories which were labeled at a manifest level and validated against the original transcripts ( Table 1 ).

All participants actively participated in the discussions. The atmosphere in the interview room was characterized by a shared frustration. The topics of challenges and solutions sparked passionate debates and the midwives eagerly shared their experiences. Four key categories emerged from the collected material: feelings of demoralization, shortage of resources, societal challenges and personal struggles ( Table 2 ).

Feelings of demoralization

One of the main concerns reported by the participants during the interviews was a feeling of demoralization induced by both their clients and their supervisors.

Blamed by patients

The midwives felt that when something went wrong, e.g. maternal death or stillbirths, the patients and their relatives would always blame them.

‘ I don’t think there is any nurse who would be happy for anybody to lose their baby, or that there is any nurse who would want a woman to die. These things are accidents, but the patient will always blame the nurse’. (Midwife 4 FGD3)

They reported to have been verbally abused by their patients, something that made them feel that their hard work was being undermined. It was their general impression that midwives had a bad reputation in the society, and they wished that the population would learn more about the work midwives do. Their hope was that this would make patients and their close ones appreciate their work to a greater extent.

Lack of support from superiors

The midwives also experienced a loss of motivation at work due to limited support from their superiors, something that contributed to their feeling of demoralization. They felt that they had no advocate in their leaders, and that the leaders always were on the patient’s side in conflicts. They wanted an arena for dialogue with their superiors and the possibility to defend themselves in situations where complications had occurred.

‘Well, our leaders are on the side of the patients, not us. That’s just politics. It’s painful, we always get the punch’. (Midwife 2 FGD1)

‘ Yes, that’s right. And you’ll just have to forget that something unfair happened to you yesterday’. (Midwife 5 FGD1)

The midwives also found it problematic that they were not compensated for working overtime, and this contributed to them feeling even more devalued in their work. Lack of other incentives for working, like tea or compensation for transport when staying late, enhanced this feeling.

Shortage of resources

The participants described a shortage of personnel, equipment and facilities that leads to problems with overwork and risk of infections for the midwives, and poor monitoring, delays in treatment and unnecessary complications for the patients.

All the participating midwives reported a substantially higher patient-nurse-ratio than the one recommended at the hospital. Two midwives could be responsible for up to 60 women in different stages of labor per shift when delivery frequency is at its highest. To make the situation bearable, each midwife has to work longer hours and more shifts than they are supposed to. ‘You come to work in the morning, and no matter how tired you are you can’t leave work when you are supposed to because there are too many women who needs your help.’ (Midwife 3 FGD1)

All participants reported being tired, something that affects patient care. Several of the midwives confessed that they sometimes acted rudely towards patients because they were tired and impatient. Increasing the amount of staff was seen as one of the most important factors for improving the working conditions and the care provided to patients.

‘Everybody is busy! Let’s talk about reality. So there are two midwives and there are 60 women in different stages of labor. And all these women expect to deliver under supervision of a midwife and afterwards have their babies assessed, is that possible? It’s impossible!’ (Midwife 5 FGD3)

The Tanzanian government state that delivery services should be free for all women, but the participants reported that the government does not provide the hospital with enough equipment to cover their most basic needs. They lacked everything from essential supplies like gloves, masks, syringes and catheters, to more advanced material like digital monitors of blood pressure and fetal heart rate. The lack of equipment endangers both the midwives and their patients.

‘We’ve got too low amounts of equipment compared to the number of women in the ward. Due to this we have to ask them to buy their own equipment, which makes the women angry because they’ve heard in the media that hospital treatment is free’. (Midwife 1 FGD1)

The midwives reported a constant fear of getting infected with for example hepatitis, HIV or TB because of the lack of protective gear, something that made them more reluctant to help women with known infections. They were convinced that if they had better and more available equipment, they would feel safer. More advanced equipment would also make it possible for them to monitor and follow-up patients more adequately and make it easier to determine which patients need their help the most.

‘The protective gloves are seasonal. It’s uncommon to help a woman deliver without getting blood on your forearms.’ (Midwife 5 FGD3)

When the hospital is out of equipment, the midwives have to ask their patients to go buy the equipment to be able to provide the required care. Since policy states that delivery services are free, the midwives reported that asking for equipment was often interpreted by the clients as asking for money for the midwives’ own personal use.

The participants reported a shortage of necessary facilities needed to provide good obstetric care. The lack of available theaters for conducting C-sections was the prime concern. The hospital only has one operating theater, which is shared by all departments. A frequently reported problem was the need to bring a patient in for an emergency C-section, but having to wait for several hours because the theater was busy, resulting in stillbirths that could otherwise have been avoided.

‘I had an incident where I took two women to the theatre and they had to wait in line. One got a low score baby and the other one was a stillbirth.’ (Midwife 2 FGD1)

Another issue was that there was only one ambulance available for the entire hospital. If the theater was busy and a woman needed a C-section, it would, in theory, be possible to refer her to the national hospital, but the lack of ambulances makes this difficult.

Societal challenges

During the FGDs it became clear that there were several societal factors that made the working situation at the hospital difficult. The midwives found the low education level in the population especially challenging. They thought that insufficient education caused delayed arrivals at the hospital. Lack of cooperation between health care facilities was another problem, especially the lack of a well-functioning referral system.

Low level of education in the population

The hospital is located in one of the most densely populated areas of Dar es Salaam. The participants reported that the population in the area has a low level of education, which affects their knowledge of family planning and reproductive health. The nurse-midwives postulated that the lack of knowledge resulted in more complications, because women arrived late at the hospital, often only if complications arose. A factor that contributed to an increase in complications was the use of local herbs to speed up labor, a common practice in the area, according to the participants. They wished that they had the resources to help educate women on reproductive health. This would lead to less complications and unnecessary deaths.

‘The clients that we take care of are challenging in themselves. These women come in when they have used local herbs to speed up the labor, or they delay coming to the hospital. Some come when it’s almost pushing time or when they have macerated babies’. (Midwife 3, FGD2)

Lack of cooperation within the health system

The healthcare system in Tanzania has a pyramidal organization where the women are supposed to attend antenatal check-ups in their local clinics during pregnancy. This was problematized by the midwives because some of the peripheral clinics did not collect or transfer vital information about the women, for example HIV-status, measuring of HB-levels and blood pressure (BP) control. This is problematic in emergencies and may cause delays in treatment.

‘BP is very crucial for a pregnant woman. If you don’t measure these women and they have no idea what eclampsia is, that’s when they end up coming here with eclampsia’. (Midwife 5 FGD4)

Another challenge the midwives pointed out was the fact that the women come without a referral letter, which increases the patient load. The hospital has many normal deliveries that could have been taken care of at a lower healthcare level. This would have eased the workload and given the midwives more time to care for the remaining patients.

Furthermore, the cooperation with the doctors was mentioned as a problem. The participants reported that they felt underrated by the doctors and that this sometimes led to delays in diagnosis and treatment because the doctors did not trust the midwives’ observations. Defined routines and teamwork between doctors and nurses was mentioned as a possible way of improving the healthcare provided.

Personal struggles

The participants reported that the heavy workload and stressful situation at work affected their personal and family lives in several ways. They experienced both physical and mental health problems, limited personal development and trouble with their families.

Health problems

The long shifts and heavy workload affect the midwives both psychologically and physically. They reported that the heavy lifting and the long hours causes back aches and disc prolapses. Some also had miscarriages. Because the work is so stressful, the midwives seldom have time to eat or sit down to rest, and they come home exhausted. Many find it difficult to leave work behind when they return home and continue thinking about their patients after their shift has ended.

‘We get health problems and severe back aches due to disc prolapse. A lot of the midwives have disc prolapse’. (Midwife 2, FGD2)

Lack of personal development

Opportunities for further education and promotions are limited, and the midwives felt that this makes it harder for them to gather motivation for their work. Low salaries and restricted compensation for overtime work contributed to this demotivation. The midwives reported that the few trainings and update courses that actually are arranged are unavailable to them, either because they are too busy working in the wards or because the people who work in administration are prioritized. More access to trainings and possibilities for career advancement would motivate them more and make them able to perform better at work.

Family life troubles

The participants highlighted that the long shifts at work are difficult to combine with family and social life. They complained that they do not see their spouses and children enough. They have no time for household chores or to follow up on their children’s school work. They were concerned that their maids were raising their children, and it bothered them not to be in control of their upbringing themselves.

‘Well your family perishes; you’re making other people’s family happy, but you’re making your own sad. You work on somebody else’s happiness when you’re killing your own back home’. (Midwife 2, FGD1)

The most prevalent findings in this study was the feeling of demoralization. Other factors of importance were personal struggles, shortage of staff, equipment availability, and unawareness and challenges in society. The feeling of demoralization and lack of motivation is in line with findings from other studies conducted in the region [ 15 – 17 ]. Positive support from supervisors have been demonstrated to be of importance for the quality of services that health workers are able to deliver [ 18 ]. In the World Health report on improving performance in healthcare, the WHO stress that supportive supervision can contribute to improved performance of health workers [ 18 , 19 ]. In situations where employees experience lack of motivation, consequences are lack of courtesy to patients, poor process quality and failure to treat patients at an appropriate time [ 20 ]. The health outcomes of patients are therefore critically dependent on the nurses’ motivation [ 21 ]. Changing the management strategy, or providing supportive management training for supervisors, are documented measures that can be taken to increase the level of motivation in the workplace [ 16 , 18 ]. Another important factor to improve performance is adequate salaries [ 21 ]. Hospitals where at least a minimum of allowances are paid, tend to have a more motivated work force, and consequently more content patients, according to Tibandebage et al. [ 16 ].

The experienced lack of opportunities for career advancement and personal development, which were presented in the category ‘personal struggles’, also contribute to the feeling of demotivation. Continued education is one of the most effective ways to heighten midwives’ motivation and cultivate midwives’ skills [ 22 ]. Skilled and motivated midwives with possibilities for career development has proven to be an efficient way to reduce mother and child mortality [ 5 ]. Another way to heighten motivation is through promotion. Providing midwives with the possibility of future education, and/or possibilities for promotion is therefore something that may lead to higher staff retention and a more motivated staff.

Shortage of staff, equipment and facilities were other reported barriers to providing adequate midwifery care, a finding supported by other studies from the region [ 16 , 17 ]. Delivery attended by skilled personnel with appropriate supplies and equipment has been found to be strongly associated with reduction of child and maternal mortality [ 23 , 24 ]. Taking measures to increase access to human resources is of great importance to improving patient care. One option is to bring in more qualified staff, but a severe shortage of healthcare providers in the region makes this challenging [ 23 ]. Another way of reducing the workload suggested by the midwives is to make changes to the organization of the healthcare service. If the referral system is more controlled and the patients are required to have a referral letter from their district hospital before they can come to the referral facility, the workload may be reduced. Shortage of equipment is ideally solved by getting more resources. However, governmental spending on health in percentage of GDP is decreasing, making less resources available [ 25 ]. At the same time, the government proclaim that maternal healthcare during pregnancy and delivery is free [ 26 ]. This is a challenge for the midwives, since it causes a gap between government policy and reality. The goal should be to provide free healthcare, as this has been shown to reduce mortality [ 26 ], but a prerequisite for this is an increase in governmental spending on health. Other factors important for the reduction of mortality are advanced monitoring equipment and available operating theaters for emergency C-sections [ 27 ]. Investments in monitoring devices that can detect problems early will help the midwives in prioritizing the patients that need closer attention or emergency care. Operating theaters for C-section will reduce unnecessary delays in treatment, and thus avoiding preventable deaths.

Being mistreated by their patients and having a bad reputation in society are also factors that were reported to be challenging for the midwives, contributing to the aforementioned feeling of demoralization. Women giving birth in healthcare facilities in Tanzania report limited support, neglect and physical and verbal abuse during labor [ 17 ]. A possible way to alter the midwives’ bad reputation is tackling some of the other challenges they face. If the midwives were more motivated, they might be more polite and attentive towards the patients, something that may lead to more frequent follow ups and better care, according to Franco et al. [ 20 ]. Increasing the amount of staff would be helpful since this will give the midwives more time to care for each patient. The same is true for obtaining the necessary equipment and facilities, as these are integral factors in providing quality healthcare [ 24 ].

The population’s knowledge of reproductive health was reported to be limited and increasing this can be another way to aid the midwives’ reputation and position in society. The knowledge will help patients understand the importance of getting qualified assistance during labor and the effect this has for birth outcome. Increased knowledge in itself has been documented to increase rates of facility-assisted deliveries, which in turn will have a positive effect on both mother and child mortality [ 28 ]. Higher levels of education have been shown to increase the use of delivery services [ 29 ]. Focusing on a general increase in education in the region, with emphasis on awareness of danger signs during pregnancy and delivery [ 30 ], might therefore have an effect on birth outcome, and help eliminate the problem of seeking professional help too late.

Strengths and limitations

In this study we have described what kind of challenges midwives meet practicing midwifery in a busy Tanzanian Referral Hospital, overcrowded with women in the wards and delivery rooms. One of the main strengths of the study is that it offers the midwives’ own perspectives on their working situation and their own thoughts about possible measures to improve it. This can create a foundation for further research on interventions that are adapted to the local context. A second strength is using a Tanzanian midwife as a moderator and translator. She understood the midwives’ situation, thereby making the participants feel more comfortable and willing to share their stories. Moreover, the preliminary results from the FGDs were presented both to the staff and administration at the hospital. This made it possible for the midwives to confirm the findings, which strengthens their credibility, and made sure that the midwives’ concerns were heard on an organizational level.

However, focusing solely on the perspective of the midwives is a limitation. Including patients, doctors or the hospital administration in the study would provide more diverse experiences and broader insight into the situation at the hospital. Other topics that affect the perceptions of workload and women’s utilization of the provided health care, such as education, culture, religion, economic status, women’s health seeking behavior and knowledge of danger signs, could also have been discussed further. A second limitation is that the study was conducted by two foreign researchers without the ability to speak Kiswahili and insight into the local context of midwifery. This might have affected the interpretation of the material. Using English was considered, but the authors concluded that this would lead to a more substantial loss of information than a translation process would. Measures taken to limit these disadvantages were spending time in the wards to familiarize with the midwives and their working environment before the interviews, having a co-author and local supervisor who works at the hospital and knows the midwives well, and using a moderator and translator who is familiar with the local context of midwifery, being a midwife herself. The local supervisor and co-author, who is fluent in Kiswahili, double-checked the recordings against the transcripts to make sure the quality of the translations was satisfactory, to limit the disadvantage of using only one translator.

Trustworthiness

The credibility of this study was ensured by describing the qualitative research method, the use of FGDs, analyzing the data with STC, frequently revisiting the data, and presenting the content with quotes from the research participants. Furthermore, the collaboration of students and international researchers was important for gaining an in-depth understanding of the data. This collaboration included two Norwegian fifth year medical students, a Tanzanian supervisor who works as an obstetrician in a busy District Hospital, and a Scandinavian professor and obstetrician, familiar with the Tanzanian context and with vast experience of research in reproductive health in several other low-income settings. In addition, the FGDs were conducted, within a short period of time, by a Tanzanian midwife fluent in Kiswahili and with understanding of the context, allowing for consistency throughout the data collection process, and thereby increasing its dependability. All material was immediately translated to English after each FGD. A clear and detailed description of the study context and setting, as well as descriptions of the participants, the data collection and analysis processes has been provided for the readers to improve transferability.

This study aims to show that midwives working at a regional referral hospital in Dar es Salaam face considerable challenges, both pertaining to the management of the healthcare service (locally and nationally), possibilities for advancement (education and promotion), availability of resources (materials and personnel) and reputation and knowledge in the population. The challenges they face, constitute barriers to providing good midwifery care for their patients, causes problems for them on a personal level, and demotivates them in their work. They therefore need to be addressed, both by government funders, health policy makers and regulators. A feeling of demoralization is particularly apparent. The main cause of this feeling is an absence of support and understanding from their leaders. Creating an arena for dialogue and implementing a more supportive leadership style would be efficient measures that can, and should, be taken to improve the midwives’ working conditions. Other important measures are reduction of workload, either with increased amount of staff or reorganization of the referral system, providing sufficient equipment, either through a larger supply or modification of polices, and increasing the knowledge level, both through providing training for the midwives and through educating the population. Taking these measures will improve the quality of care the midwives provide, which in turn can lead to improved health for both mothers and children in Tanzania.

Funding Statement

This work was supported by the Norwegian University of Science and Technology under Grant number 652010.

Responsible Editor Maria Emmelin, Umeå University, Sweden

Acknowledgments

The authors are grateful to all the midwives who participated in the study and willingly shared their thoughts, and to our eminent translator Yvone Kamala.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

Ethical approvals to conduct the study are confirmed by Regional Committee for Medical and Health Research Ethics Mid-Norway (project reference number 2017/577), Norwegian Centre for Research Data (project reference number 54406) and obtained by the Ethics Review Committee at the Muhimbili National Hospital (project reference number (MNH/IRB/2017/011). The participants were briefed on the aim and purpose of the study before the FGDs took place. They were also informed that participation was voluntary, that they could withdraw at any time and that their names were not registered. They were aware that the FGDs would be audio-recorded, but that the information they provided would be anonymized and only used for research purposes. All participants gave a verbal consent of participation.

Paper context

Tanzania has a high fertility rate and lacks skilled health workers to provide care for delivering women. Combined, these factors cause excessive work-pressure for midwives in the country. Our research gives insight into midwives’ perception of their working situation and which measures they find necessary to implement to ease the burden. Findings from this study may provide a starting point for interventions to improve midwives’ working conditions and strengthen maternal and child health in Tanzania.

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Literature review.

Midwifery students' experiences of learning to be ‘with woman’: a scoping review

This scoping review was conducted according to the Preferred Reporting Items for Scoping Reviews, as outlined by the Joanna Briggs Institute (Aromataris and Munn, 2020). A priori protocol was...

Breastfeeding knowledge assessment tools among nursing and midwifery students: a systematic review

This systematic review was conducted to identify tools that have been developed to evaluate breastfeeding knowledge and practice among nursing and midwifery students. The review followed the Preferred...

Impact of the midwife-led care model on mode of birth: a systematic review and meta-analysis

A systematic review is the best approach to determine the most effective intervention/treatment in clinical decision-making (Harvey and Land, 2017). This method follows explicit, rigorous and...

The role of egg consumption in the first 1001 days of life: a narrative review

For this narrative review, PubMed was searched to identify key articles published between 2019 and 2024 investigating egg consumption during pregnancy, breastfeeding and/or infancy. The following...

Autistic women's experiences of the antenatal, intrapartum and early postnatal periods

The PICO mnemonic (Stern et al, 2014) was used to identify key words and develop the research question: what can midwives in England learn from studies exploring the experiences of autistic women in...

Perinatal outcomes in persistent occiput posterior fetal position: a systematic review and meta-analysis

Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess the results of previous research to derive conclusions about that body of research (Haidich, 2010)....

Carbetocin vs oxytocin in third stage labour: a quantitative review of low- and middle-income countries

This review was carried out to determine if the use of carbetocin in low- and middle-income countries would reduce the risk of postpartum haemorrhage, and associated morbidity and mortality, in...

mHealth interventions to improve self efficacy and exclusive breastfeeding: a scoping review

The electronic search was carried out in September 2022, using the population/problem/patient, intervention, comparison, outcome and study design strategy. The primary source of literature was online...

Routine examinations such as palpation can help to recognise adverse events

The use of gender-neutral language in maternity settings: a narrative literature review

A preliminary search of the Cochrane Library, CINAHL, and MEDLINE databases was undertaken to identify articles relating to the topic. Search terms or text words contained in titles, abstracts and...

Midwives’ practice of maternal positions throughout active second stage labour: an integrative review

An integrative review was considered suitable for this study, as this methodology allows inclusion of data from all types of literature to fully answer review questions (Whittemore and Knafl, 2005;...

Health-seeking behaviours of pregnant adolescents: a scoping review

This study was developed based on Arskey and O'Malley's (2005) scoping review methodology. According to this framework, there are six stages: (1) identifying the research question, (2) identifying...

Maternal intrapartum fluids and neonatal weight loss in the breastfed infant

Searches of key databases (CINAHL, MEDLINE, EMBASE, EMCARE) were conducted using a search strategy developed in collaboration with the local NHS library service (Table 1). Known researchers in this...

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Welcome to the Midwifery Subject Guide

Selected midwifery texts available through the library, key resources, meet your academic librarian, any questions - ask the library staff, accessibility and copyright statement.

Introduction to Academic Resources
How to run your search
Finding Books
Finding Journal Articles
Finding policy papers and other evidence sources
Evaluating Health Sources
Keeping track of your sources
Writing and Referencing
Research resources

This is your guide to how the library can support you when studying and researching Midwifery at UWS.

You will find links to the publicly available and specialist information resources (books, journals, subject-specific bibliographic databases) you’ll be expected to use to find the best research evidence. In addition, there is advice on using information sources effectively as a health professional.

Key resources are listed below, with more tips and links on other pages in this guide.

Myles Textbook for Midwifves

Global Midwifery: Principles, Policy and Practice

Mayes' Midwifery

A Beginner's Guide to Evidence Based Practice in Health and Social Care. Third edition

Sustainability, Midwifery and Birth

Nursing and Healthcare Research at a Glance

Getting started (books and journal articles).

You can find print books, eBooks and electronic journal articles on a range of topics on our One Search catalogue and discovery tool.

OneSearch This link opens in a new window OneSearch is UWS's in-house database. It functions as both a traditional library catalogue and platform to search a wide range of databases to find full-text journal articles. It covers all subject areas.

Getting started (Textbooks with images)

Search the Clinical Key collection for core texts and images you can, legally and easily, incorporate into your own presentations

Clinical Key Nursing and Midwifery e-book collection This link opens in a new window Clinical Key provides full-text access to a bespoke collection of nursing and midwifery e-books and includes access to 1000's of subject-related images. more... less... Use your student email address and usual password to access.

Digging deeper

We also have access to several bibliographic databases indexing journal articles published in different specialties, or for scholarly purposes. These are helpful when running more focused searches. See 'Finding journal articles' for a fuller selection but core databases are:

CINAHL Ultimate This link opens in a new window CINAHL provides full text access to articles in professional and academic journals on nursing, midwifery, and allied health care. Also, it is an index of English-language and selected other-language journal articles about nursing, allied health, biomedicine and healthcare. more... less... Searchable via One Search. Use your student/staff email address and password to access the resource.
MEDLINE This link opens in a new window MEDLINE (1950-present) is the U.S. National Library of Medicine (NLM) premier life science database. more... less... Not Searchable via One Search. Use your student/staff email address and password to access the resource.
Psychology and Behavioral Sciences Collection This link opens in a new window Psychology and Behavioral Sciences Collection provides full access to literature in emotional and behavioral characteristics, psychiatry and psychology, mental processes, anthropology and observational and/or experimental methods. more... less... Searchable via One Search. Use your student/staff email address and password to access the resource.
SocINDEX with Full Text This link opens in a new window SocINDEX is the authoritative bibliographic database for sociology research. It offers millions of indexed records from top sociology journals covering many subjects including gender studies, criminal justice, social psychology, racial studies, religion and social work. more... less... Searchable via One Search. Use your student/staff email address and password to access the resource.
Bioline International This link opens in a new window Bioline International provides open access to quality and peer-reviewd research journals published in developing countries (e.g. Bangladesh, Brazil, Chile, China, Colombia, Egypt, Ghana, India, Iran, Kenya, Malaysia, Nigeria, Tanzania, Turkey, Uganda and Venezuela). BI's goal supports a global understanding of health (tropical medicine, infectious diseases, epidemiology, emerging new diseases), biodiversity, the environment, conservation and international development.

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Nursing and Midwifery Personal Statement
The principles and practice of obstetric medicine, in a series of
A TEXTBOOK OF MIDWIFERY AND OBSTETRICAL NURSING By DR. S VIJAYALAKSHMI

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Midwifery Dissertation Topics
To find midwifery dissertation topics: Explore childbirth challenges or trends. Investigate maternal and infant health. Consider cultural or ethical aspects. Review recent research in midwifery. Focus on gaps in knowledge. Choose a topic that resonates with your passion and career goals.
Midwifery Dissertations
Midwifery is a health profession concerned with the care of mothers and all stages of pregnancy, childbirth, and early postnatal period. Those that practice midwifery are called midwives. ... Latest Midwifery Dissertations. Including full dissertations, proposals, individual dissertation chapters, and study guides for students working on their ...
The Impact of Midwifery on Infant and Maternal Outcomes Among Black Mothers
Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 The Impact of Midwifery on Infant and Maternal Outcomes ... that midwifery could be a mediating mechanism between elements of systemic and . 3 structural racism and individual risk factors in mothers (Allen et al., 2019; Alliman &
PDF The Role of Midwifery Care in Urban Settings: Mitigating Disparities
This thesis will discuss the role of. midwives generally, and how midwives are integrated into care in urban settings. I will. then discuss the geographic imbalance of midwifery care, how midwives can and do. assist to mitigate health disparities, and how midwives improve maternal and neonatal. health outcomes.
Nursing and Midwifery (Theses and Dissertations)
Henderson, Ciara(Trinity College Dublin. School of Nursing & Midwifery. Discipline of Nursing, 2023) This thesis showcases an interdisciplinary and comprehensive exploration of perinatal death in Ireland through the nineteenth and twentieth centuries. Employing a social constructionist approach, this study questions the ...
Theses and Dissertations
Navarro, Kimberly, "Black midwives for Black mothers: ameliorating racial disparities in the quality of maternal healthcare" (2023). Theses and Dissertations. 1346. https://digitalcommons.pepperdine.edu/etd/1346. In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance.
Midwifery students' perceptions and experiences of learning... : JBI
tion for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education. Inclusion criteria ...
Theses and Dissertations
This is only available to students and staff at the University. To access the repository, please enrol on the Undergraduate Dissertations Moodle site. All examples on the repository received a mark of 2:1 or above. Examples are available from a number of subject areas, including Business and Management, Dental Technology and Health and Social Care.
Midwifery Dissertation Topics List (30 Examples) For Your Research
Find 30 examples of midwifery dissertation topics for your research in various fields and areas. Get expert help with topic selection, literature review, methodology and more.
Midwife experiences of providing continuity of carer: A qualitative
Midwife to Mid Wif [dissertation] Thames Valley University (2001) Google Scholar [58] K. Stoll, J. Gallagher. A survey of burnout and intentions to leave the profession among Western Canadian midwives. Women Birth, 32 (4) (2019), pp. e441-9. View in Scopus Google Scholar [59]
201 best Midwifery Dissertation Topics and Titles 2024
Midwifery is a noble profession with a lot of growth potential. There could be more thought-provoking nursing dissertation topics for research in this field. Interested in further details, call us for more Midwifery Dissertation topics. 87 Dementia dissertation topics in nursing.
Doctoral Thesis Collection
This midwifery PhD thesis collection is an exciting new initiative for the RCM. The aim of the collection is to provide a platform for midwives to showcase their academic work, and to inspire and support midwives who are considering or who are currently undertaking further academic study. Additionally, the collection will provide a source of ...
LSBU Library: Midwifery: Theses and Dissertations
Midwifery: Theses and Dissertations. Getting Started; Academic Resources Toggle Dropdown. Find Journal Articles ; Books & E-books ; TV, Radio & Film ; Anatomy Resources ; Theses and Dissertations ; New and Trial Resources ; Web Resources Toggle Dropdown. Current Awareness ; Websites ;
Midwifery Dissertation
Module learning outcomes. This module will enable the student to: Critically review in depth the research literature related to their chosen topic of study. Critically evaluate a range of theoretical and philosophical dimensions in order to contextualise their study. Integrate relevant theoretical concepts with reflections on experience.
Dissertations / Theses on the topic 'Training in midwifery'
Consult the top 17 dissertations / theses for your research on the topic 'Training in midwifery.'. Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago ...
Midwives' experience of their education, knowledge and practice around
Phase one. Table 1 summarises the midwives' perception of their education, knowledge and practice around immersion in water for labour and birth. A total of 29 (85%) out of a potential 34 midwives returned a questionnaire. The mean time midwives were qualified was 162 months (13 years and 5 months), with the mean time midwives had been facilitating waterbirth being 83 months (eight years and ...
Challenges in day-to-day midwifery practice; a qualitative study from a
A worldwide systematic review on midwifery care in low and middle-income countries argues that barriers for providing good midwifery care are created by social, economic and professional factors . The consequences of these barriers are feelings of exhaustion and moral distress, which in turn affects the quality of the care provided [ 9 ].
British Journal Of Midwifery
Impact of the midwife-led care model on mode of birth: a systematic review and meta-analysis. A systematic review is the best approach to determine the most effective intervention/treatment in clinical decision-making (Harvey and Land, 2017). This method follows explicit, rigorous and...
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Welcome to the Midwifery Subject Guide. This is your guide to how the library can support you when studying and researching Midwifery at UWS. You will find links to the publicly available and specialist information resources (books, journals, subject-specific bibliographic databases) you'll be expected to use to find the best research evidence.
PDF Frontier communities of Donetsk and Luhansk oblasts: a neglected resource
UN Soci Coeion nd Reconciition Index or Etern Urine FRONTIER COMMUNITIES OF DONETSK AND LUHANSK OBLASTS: A NEGLECTED RESOURCE 2 Introduction The contact line (CL) stretches for 487 kilometers between the GCAs and non-government controlled
PDF FALLING THROUGH THE CRACKS
COVER Maria Horpynych, a Ukrainian civilian in Opytne, a village approximately two kilometers from the Donetsk airport, has been living through the conflict for more than five years. She holds a picture of her only son, a medic, who died in 2016 after being struck in the head by shell fragments. "I buried my son in a garden, in a crater from ...
Donetsk National Medical University
Words from rector. As a Rector of State Higher Medical Educational Establishment of Ukraine "Donetsk National Medical University (Kirovohrad Medical Institute)", I would like to congratulate every one of you for selecting medicine as your career.
Conflict in Ukraine's Donbas: A Visual Explainer
Learn about the eight-year war between Ukrainian government forces and Russian-backed separatists in the Donbas region of eastern Ukraine that started in 2014. See interactive maps, charts and data on casualties, explosions and diplomatic efforts.