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Homebirth to hospital transfer: The client perspective
S10
ACM2015 Oral Presentations / Women and Birth 28S (2015) S7–S32
[O9] Midwifery students embedded in continuity: Students’ and mentors’ experiences Amanda Carter 1,*, Karen McDonald-Smith 3, Elizabeth Wilkes 3, Padraig O’Luanaigh 4, Jenny Gamble 1, Debra Creedy 2 1
Griffith University, School of Nursing and Midwifery, Brisbane, Australia 2 Griffith Health Institute, Brisbane, Australia 3 My Midwives, Toowoomba, Australia 4 Office of the Chief Nursing and Midwifery Officer, Brisbane, Australia *Corresponding author. Introduction: The Rural and Private Midwifery Education Project (RPMEP) is a strategic Queensland government funded initiative to: (1) grow the midwifery workforce within private midwifery practice and rural midwifery; by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. Aim: To report on Phase two of the evaluation strategy and discuss students’ and mentors’ perceptions of an innovative clinical placement model which embeds student’s practice within midwifery continuity of care. Method: A descriptive cohort design was used. All RPMEP students (n = 17) enrolled through Griffith University and their clinical mentors (n = 28) were invited to complete an online survey in June 2015. There are two versions of the survey (student and mentors) and consists of 4 scales related to perceptions of caseload care; student–mentor relationship; the clinical learning environment; and assessment of preparation to practice. Responses will be analysed using descriptive and inferential statistics. Open-ended responses will be analysed using content analysis. Internal reliability of the scales will be assessed using Cronbach’s alpha. Results: Students’ and mentors’ perceptions of the RPMEP clinical program will be presented by group and compared. Changes in students’ perceptions since the first survey (presented at the ACM Qld conference in 2014) will also be discussed. Conclusions: This is the first study of its kind presented nationally and internationally. We anticipate that embedding midwifery students within midwifery continuity of care models will be perceived by students and mentors as highly beneficial to learning, fostering partnerships with women, and providing appropriate clinical skills development required for registration, while promoting students’ confidence and competence. http://dx.doi.org/10.1016/j.wombi.2015.07.042 [O10] Homebirth to hospital transfer: The client perspective Susan Constable McPhee Monash University, Melbourne, Australia Introduction: Homebirth is a safe alternative for low-risk pregnant women in the care of qualified midwives, working within the national assessment and referral guidelines. Women who give birth at home are more likely than those who give birth in hospital to have a normal birth with fewer interventions. Aim: To describe the concerns of women living in rural and regional areas who planned to give birth at home about the possibility of transfer to hospital and their preparation for this possibility.
Methods: A qualitative interview and focus group study was conducted of women recruited through the homebirth network of a rural New South Wales town. Nine women were recruited with six women eligible to participate. Three women gave birth at home, one transferred to hospital during pregnancy and two transferred intra-partum. Half the women were nulliparous; half were multiparous. Results: Women who plan homebirth develop a close and trusting relationship with their midwife which provides emotional and psychological safety in their preparation for birth. The experience of those women in this study who transferred to hospital shows the extent of the adaption required by this change of location and the grief that accompanies the loss of their birth plan. The message of these women to mainstream maternity services included the need to respect the choice of women to give birth at home, and to be willing to develop a non-judgemental relationship with them should they require transfer to hospital. Conclusion: This study reveals several ways that women, private practising midwives and hospitals can respond to these concerns of women to create a better journey for women whose homebirth plan results in transfer to hospital. http://dx.doi.org/10.1016/j.wombi.2015.07.043 [O11] Helpful or harmful: A critical look at popular childbirth observational documentaries Felicity Copeland 1,2 1 2
Royal Hospital for Women, Sydney, Australia University of Technology Sydney, Australia
Introduction: The media is becoming an increasing influence in informing women about childbirth. The recent popularity of childbirth observational documentaries, where multiple remote cameras are placed in maternity facilities to capture the duration and experience of women’s labours, is shaping how women and their partners view childbirth. The UK series, One Born Every Minute claims that ‘the experience of labour and birth is so emotionally charged that the ability to capture every detail of an experience in this way makes for compelling television’. This raises the question about the integrity and moral framework of these productions. Aim: To examine television footage from two UK and US maternity hospitals to examine the ways they portray the processes of birth asking the question: Do these somewhat dramatized portrayals of childbirth discourage and disempower women as what they see overwhelms them? Or conversely, do women and their partners feel more prepared and realistic about the experience of labour and birth? Methods: A thematic analysis was undertaken of multiple episodes of One Born Every Minute. Thematic analysis is a qualitative research analysis tool widely used in the field of psychology but it is also appropriate for other related fields such as sociology, nursing and midwifery. Results: Three major themes were identified within the data that warrant discussion about the effects this program has on women’s perceptions of labour and birth. These include: The Characterisation of Birth, Characterisation of Midwifery Practice and the Characterisation of Women in Labour. Each theme has a series of sub themes that shapes the way the producers format the program. Conclusion: The changing status of childbirth in a 21st century western culture can transport the process of labour and birth, graphically, into the lounge room. There is little research
ACM2015 Oral Presentations / Women and Birth 28S (2015) S7–S32
[O9] Midwifery students embedded in continuity: Students’ and mentors’ experiences Amanda Carter 1,*, Karen McDonald-Smith 3, Elizabeth Wilkes 3, Padraig O’Luanaigh 4, Jenny Gamble 1, Debra Creedy 2 1
Griffith University, School of Nursing and Midwifery, Brisbane, Australia 2 Griffith Health Institute, Brisbane, Australia 3 My Midwives, Toowoomba, Australia 4 Office of the Chief Nursing and Midwifery Officer, Brisbane, Australia *Corresponding author. Introduction: The Rural and Private Midwifery Education Project (RPMEP) is a strategic Queensland government funded initiative to: (1) grow the midwifery workforce within private midwifery practice and rural midwifery; by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. Aim: To report on Phase two of the evaluation strategy and discuss students’ and mentors’ perceptions of an innovative clinical placement model which embeds student’s practice within midwifery continuity of care. Method: A descriptive cohort design was used. All RPMEP students (n = 17) enrolled through Griffith University and their clinical mentors (n = 28) were invited to complete an online survey in June 2015. There are two versions of the survey (student and mentors) and consists of 4 scales related to perceptions of caseload care; student–mentor relationship; the clinical learning environment; and assessment of preparation to practice. Responses will be analysed using descriptive and inferential statistics. Open-ended responses will be analysed using content analysis. Internal reliability of the scales will be assessed using Cronbach’s alpha. Results: Students’ and mentors’ perceptions of the RPMEP clinical program will be presented by group and compared. Changes in students’ perceptions since the first survey (presented at the ACM Qld conference in 2014) will also be discussed. Conclusions: This is the first study of its kind presented nationally and internationally. We anticipate that embedding midwifery students within midwifery continuity of care models will be perceived by students and mentors as highly beneficial to learning, fostering partnerships with women, and providing appropriate clinical skills development required for registration, while promoting students’ confidence and competence. http://dx.doi.org/10.1016/j.wombi.2015.07.042 [O10] Homebirth to hospital transfer: The client perspective Susan Constable McPhee Monash University, Melbourne, Australia Introduction: Homebirth is a safe alternative for low-risk pregnant women in the care of qualified midwives, working within the national assessment and referral guidelines. Women who give birth at home are more likely than those who give birth in hospital to have a normal birth with fewer interventions. Aim: To describe the concerns of women living in rural and regional areas who planned to give birth at home about the possibility of transfer to hospital and their preparation for this possibility.
Methods: A qualitative interview and focus group study was conducted of women recruited through the homebirth network of a rural New South Wales town. Nine women were recruited with six women eligible to participate. Three women gave birth at home, one transferred to hospital during pregnancy and two transferred intra-partum. Half the women were nulliparous; half were multiparous. Results: Women who plan homebirth develop a close and trusting relationship with their midwife which provides emotional and psychological safety in their preparation for birth. The experience of those women in this study who transferred to hospital shows the extent of the adaption required by this change of location and the grief that accompanies the loss of their birth plan. The message of these women to mainstream maternity services included the need to respect the choice of women to give birth at home, and to be willing to develop a non-judgemental relationship with them should they require transfer to hospital. Conclusion: This study reveals several ways that women, private practising midwives and hospitals can respond to these concerns of women to create a better journey for women whose homebirth plan results in transfer to hospital. http://dx.doi.org/10.1016/j.wombi.2015.07.043 [O11] Helpful or harmful: A critical look at popular childbirth observational documentaries Felicity Copeland 1,2 1 2
Royal Hospital for Women, Sydney, Australia University of Technology Sydney, Australia
Introduction: The media is becoming an increasing influence in informing women about childbirth. The recent popularity of childbirth observational documentaries, where multiple remote cameras are placed in maternity facilities to capture the duration and experience of women’s labours, is shaping how women and their partners view childbirth. The UK series, One Born Every Minute claims that ‘the experience of labour and birth is so emotionally charged that the ability to capture every detail of an experience in this way makes for compelling television’. This raises the question about the integrity and moral framework of these productions. Aim: To examine television footage from two UK and US maternity hospitals to examine the ways they portray the processes of birth asking the question: Do these somewhat dramatized portrayals of childbirth discourage and disempower women as what they see overwhelms them? Or conversely, do women and their partners feel more prepared and realistic about the experience of labour and birth? Methods: A thematic analysis was undertaken of multiple episodes of One Born Every Minute. Thematic analysis is a qualitative research analysis tool widely used in the field of psychology but it is also appropriate for other related fields such as sociology, nursing and midwifery. Results: Three major themes were identified within the data that warrant discussion about the effects this program has on women’s perceptions of labour and birth. These include: The Characterisation of Birth, Characterisation of Midwifery Practice and the Characterisation of Women in Labour. Each theme has a series of sub themes that shapes the way the producers format the program. Conclusion: The changing status of childbirth in a 21st century western culture can transport the process of labour and birth, graphically, into the lounge room. There is little research