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Qualitative research on how midwives experience caseload midwifery
S48
ACM2015 Poster Presentations / Women and Birth 28S (2015) S39–S56
research relevant to midwifery, and what midwives, women and researchers can learn from it. The author will use photography and journal readings from her recent autoethnographic research into out-of-hospital birth in Indonesia to demonstrate the value of the process. Autoethnography involves investigating a cultural experience through describing and carefully analysing one’s personal involvement. This experience can be ‘layered’ within research on the topic to give a deep, meaningful and broad discussion. Autoethnography recognises the value of both subjective and objective truths which makes it particularly powerful in health research. It enables others to understand events through the eyes of individuals receiving care as well as to analyse the external and/ or medical processes which are simultaneously occurring. Research has found that autoethnography provides an opportunity to facilitate empathy, consideration of needs and improvements in quality of care. It also allows health professionals the opportunity to learn from each other and gain new understanding of health systems through the personal lens. Most health autoethnography focuses on experiences of ill-health, though the author’s recent study demonstrates its potential value in midwifery research. By highlighting the essential, human process of birth from the author’s personal experience, she was able to demonstrate the importance of considering the humanising aspects to birth care, even in contexts of high maternal mortality such as Indonesia. http://dx.doi.org/10.1016/j.wombi.2015.07.152 [P37] Qualitative research on how midwives experience caseload midwifery Ingrid Jepsen 1,*, Maralyn Foureur 2, Ellen Noehr 3, Erik Ellgaard Soerensen 4, Edith Mark 4 1
University College Northern Jutland, Denmark University of Technology Sydney, Sydney, Australia 3 Odense University, Odense, Denmark 4 Aalborg University Hospital, Aalborg, Denmark *Corresponding author. 2
Introduction: Continuity of care during pregnancy and labour by primary midwives (caseload midwifery) is an organisation of care for pregnancy and labor which in the last years has dramatically increased in Denmark. Caseload midwifery in Denmark is public and implemented parallel to the traditional system. There is a belief that caseload midwifery contributes to higher job satisfaction for midwives but the evidence is unclear. To get in-depth knowledge of how caseload midwifery affects midwives and their experiences of caseload midwifery qualitative research is needed. I have studied midwives who work in pairs and are on call for a week. Aim: To explore and investigate how caseload midwifery is experienced by midwives and how midwives perceive or valuate the relationship. Methods: A qualitative study with an etnographic methodology using field study including interviews as methods was undertaken. Results: Caseload midwifery really influences the midwives lives. Some of the major themes for the midwives are: ‘Doing good midwifery’, ‘Floating boarders’, ‘Recognition and visibility’, ‘Creation of space’ and ‘Independence and autonomy’ but ‘points of attention’ also appeared: eg ‘long calls’ and ‘the pressure of being known’. A supplementary investigation of burnout showed less burnout among caseload midwives compared to traditional midwives.
Conclusion: Caseload midwifery results in less burnout, but there is a fine balance between ‘the points of attention’ and the positive experiences of the midwives. It is important to recognize that for these midwives it is essential to fulfil expectations otherwise frustration will appear. I am aware of that caseload midwifery is known, but I think that the perspective of the midwives have been overlooked in our eager to do women centred care. This study generates in depth knowledge about how to work in caseloads parallel to the traditional care system in a public hospital. http://dx.doi.org/10.1016/j.wombi.2015.07.153 [P36] Transfer of knowledge Ingrid Jepsen University College Northern Jutland, Denmark Introduction: The topic of the poster is teaching midwifery students. The focus is on how to transfer theoretical knowledge to clinical practice. I want to share my experiences with other teachers or midwives by demonstrating how it has been possible for me to reduce the gap between theory and practice by using a new method in introducing epistemology. Aim: To demonstrate how I try to make epistemology transferable from theory in the midwifery education to practice. The level of planned interaction with participants: This will be an illustration of how I introduce epistemology early in the midwifery study in Aalborg. Results: The participants are very briefly informed about science, humanities and social sciences. I divide the participant into three groups: science, humanities or social sciences. In common we watch a short birth movie and the groups are asked to watch the movie with focus on their epistemological perspective. Afterwards the groups receive some questions to start to discuss the movie from their epistemological perspective. Then I form new groups so that the new groups have representatives from thethree epistemologys chosen here, and the participants will present their answers to each other. After this demonstration I have feedback and a discussion of the method. http://dx.doi.org/10.1016/j.wombi.2015.07.154 [P2] Obstetric referrals and their appropriateness in a PNG health setting Wanis Koral 1,*, Gerard Saleu 2 1
Goroka General Hospital, Goroka, Papua New Guinea Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea *Corresponding author. 2
Introduction: From October 2012 to May 2013, ninety-six obstetric referrals were made to the Goroka General Hospital from twenty-two primary health care facilities in the Eastern Highlands of PNG. Aim: To determine the ‘genuineness’ of the referrals and whether the utilisation of government services to assist mothers to reach provincial referral hospital was justified. Results: Final outcomes for mothers and babies showed that three quarters of the referrals resulted in a vaginal birth, either normal vaginal birth or vacuum extraction. One quarter were born by caesarean section.
ACM2015 Poster Presentations / Women and Birth 28S (2015) S39–S56
research relevant to midwifery, and what midwives, women and researchers can learn from it. The author will use photography and journal readings from her recent autoethnographic research into out-of-hospital birth in Indonesia to demonstrate the value of the process. Autoethnography involves investigating a cultural experience through describing and carefully analysing one’s personal involvement. This experience can be ‘layered’ within research on the topic to give a deep, meaningful and broad discussion. Autoethnography recognises the value of both subjective and objective truths which makes it particularly powerful in health research. It enables others to understand events through the eyes of individuals receiving care as well as to analyse the external and/ or medical processes which are simultaneously occurring. Research has found that autoethnography provides an opportunity to facilitate empathy, consideration of needs and improvements in quality of care. It also allows health professionals the opportunity to learn from each other and gain new understanding of health systems through the personal lens. Most health autoethnography focuses on experiences of ill-health, though the author’s recent study demonstrates its potential value in midwifery research. By highlighting the essential, human process of birth from the author’s personal experience, she was able to demonstrate the importance of considering the humanising aspects to birth care, even in contexts of high maternal mortality such as Indonesia. http://dx.doi.org/10.1016/j.wombi.2015.07.152 [P37] Qualitative research on how midwives experience caseload midwifery Ingrid Jepsen 1,*, Maralyn Foureur 2, Ellen Noehr 3, Erik Ellgaard Soerensen 4, Edith Mark 4 1
University College Northern Jutland, Denmark University of Technology Sydney, Sydney, Australia 3 Odense University, Odense, Denmark 4 Aalborg University Hospital, Aalborg, Denmark *Corresponding author. 2
Introduction: Continuity of care during pregnancy and labour by primary midwives (caseload midwifery) is an organisation of care for pregnancy and labor which in the last years has dramatically increased in Denmark. Caseload midwifery in Denmark is public and implemented parallel to the traditional system. There is a belief that caseload midwifery contributes to higher job satisfaction for midwives but the evidence is unclear. To get in-depth knowledge of how caseload midwifery affects midwives and their experiences of caseload midwifery qualitative research is needed. I have studied midwives who work in pairs and are on call for a week. Aim: To explore and investigate how caseload midwifery is experienced by midwives and how midwives perceive or valuate the relationship. Methods: A qualitative study with an etnographic methodology using field study including interviews as methods was undertaken. Results: Caseload midwifery really influences the midwives lives. Some of the major themes for the midwives are: ‘Doing good midwifery’, ‘Floating boarders’, ‘Recognition and visibility’, ‘Creation of space’ and ‘Independence and autonomy’ but ‘points of attention’ also appeared: eg ‘long calls’ and ‘the pressure of being known’. A supplementary investigation of burnout showed less burnout among caseload midwives compared to traditional midwives.
Conclusion: Caseload midwifery results in less burnout, but there is a fine balance between ‘the points of attention’ and the positive experiences of the midwives. It is important to recognize that for these midwives it is essential to fulfil expectations otherwise frustration will appear. I am aware of that caseload midwifery is known, but I think that the perspective of the midwives have been overlooked in our eager to do women centred care. This study generates in depth knowledge about how to work in caseloads parallel to the traditional care system in a public hospital. http://dx.doi.org/10.1016/j.wombi.2015.07.153 [P36] Transfer of knowledge Ingrid Jepsen University College Northern Jutland, Denmark Introduction: The topic of the poster is teaching midwifery students. The focus is on how to transfer theoretical knowledge to clinical practice. I want to share my experiences with other teachers or midwives by demonstrating how it has been possible for me to reduce the gap between theory and practice by using a new method in introducing epistemology. Aim: To demonstrate how I try to make epistemology transferable from theory in the midwifery education to practice. The level of planned interaction with participants: This will be an illustration of how I introduce epistemology early in the midwifery study in Aalborg. Results: The participants are very briefly informed about science, humanities and social sciences. I divide the participant into three groups: science, humanities or social sciences. In common we watch a short birth movie and the groups are asked to watch the movie with focus on their epistemological perspective. Afterwards the groups receive some questions to start to discuss the movie from their epistemological perspective. Then I form new groups so that the new groups have representatives from thethree epistemologys chosen here, and the participants will present their answers to each other. After this demonstration I have feedback and a discussion of the method. http://dx.doi.org/10.1016/j.wombi.2015.07.154 [P2] Obstetric referrals and their appropriateness in a PNG health setting Wanis Koral 1,*, Gerard Saleu 2 1
Goroka General Hospital, Goroka, Papua New Guinea Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea *Corresponding author. 2
Introduction: From October 2012 to May 2013, ninety-six obstetric referrals were made to the Goroka General Hospital from twenty-two primary health care facilities in the Eastern Highlands of PNG. Aim: To determine the ‘genuineness’ of the referrals and whether the utilisation of government services to assist mothers to reach provincial referral hospital was justified. Results: Final outcomes for mothers and babies showed that three quarters of the referrals resulted in a vaginal birth, either normal vaginal birth or vacuum extraction. One quarter were born by caesarean section.