Midwives' experiences using a peanut ball for women during labour: A qualitative study.

OBJECTIVE: To gain insight into the benefits, shortcomings, and practical considerations when using the peanut ball for women during labour. DESIGN & SETTING: We used a descriptive qualitative approach using semi-structured, in-depth interviews to explore the experiences of eight midwives working in a tertiary hospital birth unit in New South Wales, Australia when using the peanut ball for women during labour. PARTICIPANTS: Participants were recruited from the birthing unit of a tertiary hospital in New South Wales. The final sample included eight midwives working in the birth unit. FINDINGS: Three overarching themes were identified: 'Education and encouragement', 'benefits and disadvantages of peanut ball' and 'techniques'. The 'Education and encouragement' theme included three sub-themes: 'selling it to the woman', 'educating midwives' and 'becoming usual practice and improving confidence'. The 'Benefits and disadvantages of peanut ball' theme included two sub-themes: 'facilitates labour and birth' and 'discomfort'. The 'Techniques' theme included three subthemes: 'positioning', 'sizing' and 'using alternative techniques'. Midwives are confident in their practice with the peanut ball and acknowledge the importance of educating midwives and women to promote its use. Midwives also discussed favoured techniques when using the ball, especially relating to size and maternal positioning. CONCLUSION: Our study provides insight into midwives' experiences about using a peanut ball for women during labour. The midwives reported that the peanut ball encourages vaginal births and shortens labour times, whilst enabling women to participate actively in the birth. Education for midwives and women is vital for using peanut balls. IMPLICATIONS FOR PRACTICE: Peanut balls are not usual practice in birthing units in Australia and they are a novel intervention to improve labour and birthing outcomes for women, especially when using an epidural.

A pilot study: Transitioning into a new graduate midwife - perspectives about a unique student-led practice.

OBJECTIVE: To explore midwifery students' (and as new graduates') experiences and level of satisfaction about a student-led midwifery model of care. METHODS: This was a qualitative study to elicit rich descriptive data from the participants. Thematic analysis was used. The students were interviewed at the end of their final year of study and they were subsequently interviewed at the end of their graduate year. RESULTS: Two overarching themes were identified from the qualitative findings from the first and second interviews including the students building and sustaining important relationships and transitioning from a student to new graduate. CONCLUSIONS: The midwifery students valued the opportunity to spend one year in a student-led model of care so that they could build and sustain important relationships with women and their team including the mentor midwife as new graduates. The students developed confidence by being respected by midwives and enabled them to advocate for women.

Evaluation of a student-led midwifery group practice: A woman's perspective.

BACKGROUND: . OBJECTIVE: To evaluate women's experiences of a student-led midwifery group practice. DESIGN: A mixed methods design was used to examine women's experiences and level of satisfaction about a student-led midwifery model of care. An on-line survey elucidated women's levels of satisfaction and experiences with the student-led midwifery group practice. The online survey was sent to all women (n = 25) who were receiving care from third year Bachelor of Midwifery students in 2018 via email up to 6 weeks postnatally. The online survey was distributed in the first instance to obtain baseline information about the importance of this student-led midwifery group practice and so the survey information was linked to the in-depth interview in the analysis for the purpose of identifying if the women were primiparous or multiparous. Women (n = 9) were invited to participate in an in-depth interview by self-opting on the survey and this extra data provided a richer understanding about the level of satisfaction about woman-centred care led by midwifery students. Retrospective data were also collected from the Maternity database - E-Maternity about birth outcomes. SETTING: A tertiary teaching public hospital in New South Wales (NSW). PARTICIPANTS: Fifteen women participated in an online survey. Five primiparous and four multiparous women opted to be involved in the in-depth interviews on the online survey. MEASUREMENTS AND FINDINGS: Analysis in SPSS provided descriptive statistics including frequencies and percentages of data including birth outcomes. Simple correlations enabled associations to be established between levels of satisfaction, individualised care, quality of care, benefits and anxiety during pregnancy. The overarching themes from the qualitative findings identified the students' presence for the women as the most important component of the women's journey. The four main themes that emerged from the study included: familiarity of the caregiver, staying informed on the journey, feeling supported and reassured by their expertise, and control and decisions over birth events. KEY CONCLUSIONS: For a variety of reasons, women valued the presence of the students throughout their childbearing journey, including valuing the woman's private space during labour and her time with her partner. This combination of pedagogical approaches provides an alternative to the current placement approach, which includes working shifts in all areas of maternity. This approach will better support midwifery students to achieve the skills necessary to provide a continuity of care experience (CoCE) amongst a small team by a student-led midwifery group practice that is supported by a registered midwife in the antenatal clinic. The midwifery student is able to develop a relationship with the woman as a component of the CoCE under the guidance of a registered midwife and this is an important underpinning of the philosophy of woman-centred care. IMPLICATIONS FOR PRACTICE: This model of care provides evidence that women do value the students' support and presence throughout their experience and that the benefits of this model should be offered to all women as a normal component of their midwifery care.