A satisfação da grávida com os cuidados das enfermeiras obstétricas durante a pandemia COVID-19 / Pregnant women's satisfaction with the care provided by nurse midwives during the COVID-19 pandemic / Satisfacción de las embarazadas con la atención de las enfermeras obstétricas durante la pandemia de COVID-19

Resumo Enquadramento: Em tempo de pandemia, as consultas de enfermagem de vigilância da gravidez sofreram alterações, nomeadamente na restrição de acompanhantes. Por esse motivo, é importante a avaliação da satisfação das grávidas com a assistência de enfermagem durante este contexto pandémico. Objetivo: Avaliar a satisfação da grávida com a assistência das enfermeiras obstétricas nas consultas de vigilância da gravidez durante o contexto de pandemia COVID-19. Metodologia: Estudo transversal descritivo de natureza quantitativa, com uma amostra de 196 grávidas. Aplicado a Escala de Satisfação dos Pacientes com a Assistência de Enfermagem (General Practice Nurse Satisfaction Scale - GPNS), constituída pelas dimensões: relacionamento interpessoal e comunicação, confiança, credibilidade e dedicação. Resultados: As grávidas apresentam-se em média mais satisfeitas na dimensão relacionamento interpessoal e comunicação e menos satisfeitas na dimensão dedicação. Conclusão: As grávidas apresentam-se satisfeitas com a assistência de enfermagem percecionando a sua importância. Tal reforça a pertinência das consultas serem realizadas por um Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica.

Abstract Background: Prenatal nursing appointments underwent changes during the COVID-19 pandemic, namely in the restriction of companions. For this reason, it is important to assess pregnant women's satisfaction with nursing care during this period. Objective: To assess pregnant women's satisfaction with nurse midwife-led prenatal appointments during the COVID-19 pandemic. Methodology: A qualitative descriptive cross-sectional study was conducted with a sample of 196 pregnant women. The Portuguese version of the General Practice Nurse Satisfaction Scale (Escala de Satisfação dos Pacientes com a Assistência de Enfermagem) was administered to the sample. The tool consists of the following dimensions: interpersonal relationship and communication, confidence, credibility, and dedication. Results: Pregnant women are, on average, more satisfied in the interpersonal relationship and communication dimension and less satisfied in the dedication dimension. Conclusion: Pregnant women are satisfied with nursing care and acknowledge its importance. This finding reinforces the importance of nurse midwife-led consultations.

Resumen Marco contextual: En tiempos de pandemia, las citas de enfermería para el seguimiento del embarazo cambiaron, sobre todo la restricción de acompañantes. Por esta razón, es importante evaluar la satisfacción de las mujeres embarazadas con los cuidados de enfermería durante este contexto pandémico. Objetivo: Evaluar la satisfacción de las mujeres embarazadas con la atención prestada por las enfermeras obstétricas en las consultas de seguimiento del embarazo durante la pandemia de COVID-19. Metodología: Estudio descriptivo transversal de carácter cuantitativo, con una muestra de 196 mujeres embarazadas. Se aplicó la Escala de Satisfacción de los Pacientes con Asistencia de Enfermería (General Practice Nurse Satisfaction Scale - GPNS), compuesta por las siguientes dimensiones: relaciones interpersonales y comunicación, confianza, credibilidad y dedicación. Resultados: Las mujeres embarazadas están, de media, más satisfechas en la dimensión relaciones interpersonales y comunicación, y menos satisfechas en la dimensión dedicación. Conclusión: Las embarazadas se mostraron satisfechas con los cuidados de enfermería y se dieron cuenta de su importancia. Esto refuerza la pertinencia de que las consultas sean realizadas por una enfermera especializada en Enfermería de Salud Materna y Obstétrica.

Nutrition knowledge and practice of midwives in Botswana.

Background: The roles and responsibilities of midwives include providing adequate nutrition assessment, nutrition and health education, counselling, and support to pregnant women. Aim: This study aims to assess midwives' nutrition knowledge and to what extent they integrate maternal nutrition in services provided at health facilities. Setting: This study included hospitals and clinics within the three selected districts in Botswana. Methods: A cross-sectional study design with an analytical component was employed. Direct observation through a checklist and a structured interviewer-administered questionnaire were used. Data were analysed using SPSS IBM version 26. Results: A sample of 102 midwives participated, resulting in a response rate of 82%. Most of the participants were females (89.2%). Maternal nutrition knowledge was found to be variable but decreased with midwives' age. A statistically significant correlation coefficient of p < 0.005 at r = -0.278 was observed between maternal nutrition knowledge and age. Similarly, there was a statistically significant negative correlation between maternal nutrition knowledge, practices and maternal nutrition course attended using Pearson correlation (r = -0.217 p < 0.028). Conclusion: Midwives had adequate to variable but declining maternal nutrition knowledge and practices with age. There is a need to provide midwives with refresher courses, as their nutrition knowledge and practices were related with courses attended. Contribution: The study contributes to provide the literature concerning nutrition knowledge and practices of midwives. The results will assist in addressing the gaps encountered and lead to the improvement of maternal nutrition and pregnancy outcomes.

Responding to Domestic Violence and Abuse during COVID-19 through Remote Interventions: An Evaluation of the Identification and Referral to Improve Safety (IRIS) Service.

Aim: To explore the perspectives of patients/service users receiving specialist domestic violence and abuse (DVA) support from the Identification and Referral to Improve Safety (IRIS) service during the coronavirus disease 2019 (COVID-19) pandemic. Design: A qualitative approach was used to conduct this study. Methods: Thematic analysis of data collected via in-depth individual interviews with 11 patients/service users who received DVA support following their disclosure of abuse to a health-care professional in general practice (GP) and subsequent referral to the IRIS service. Findings: Six themes were identified-experience of DVA during COVID-19; awareness of the IRIS service; pathway to care; accessibility, safety, and remote consultations; adequacy of telephone support; and impact of IRIS support. Participants reported feeling supported by the GP team and the DVA specialists from the IRIS service. Conclusion: The pandemic had a significant impact on health care and specialist DVA service providers. The swift shift to remote consultations proved to be an effective way to identify DVA, determine the support needs of those experiencing DVA from their own perspective, and make appropriate referrals for specialist support. Further research is needed to understand the views of health-care professionals and those working in the IRIS service to explore factors affecting their ability to provide remote services. The study highlighted the need for health-care professionals other than doctors (including nurses, midwives, and others) to build knowledge, confidence, and competence in asking about DVA.

Newly qualified nurses' and midwives' experience with continuing professional development during transition: A cross-sectional study.

AIM: To explore newly qualified nurses and midwives' experience of continuing professional development (CPD) and factors associated with CPD participation during newly qualified nurses and midwives' transition, such as job satisfaction and intention to leave. BACKGROUND: Newly qualified nurses and midwives find it difficult to make the transition to their first registered post. During the transition, professional support through CPD is essential to build competence and confidence and increase job satisfaction and retention. DESIGN: A cross-sectional study. METHODS: This study was conducted from September 2021 to October 2022. The online survey, consisting of 83 items, included: the Questionnaire of Professional Development of Nurses (Q-PDN), the McCloskey/Mueller Satisfaction Scale, three questions about Intention to Leave and two open-ended questions. The analysis was conducted by combining the results from the three European countries. Descriptive and logistic regression analyses were performed. The participants were Newly qualified nurses and midwives from Ireland, Italy and Croatia RESULTS: A total of 476 Newly qualified nurses and midwives completed the survey. Of these, 32 % (n=152) were satisfied with opportunities to participate in CPD activities and 54.8 % (n=261) had participated in a formal CPD programme. Most newly qualified nurses and midwives (89.1 %, n=424) agreed that they would like to participate in a formal CPD programme. Almost half of the participants (46.4 %, n=219) had thought of leaving the profession in the previous 12 months. We found that 'having participated in a programme to support newly qualified nurses (OR=0.29; p<.001), 'participating in mandatory CPD activities' (OR=0.76; p=0.016) and 'working in the clinical area of community' (OR=0.31; p<.001) or in maternity (OR=0.46; p=0.040) were positively associated with better job satisfaction. CONCLUSIONS: Participation in support programs during the transition period contributes to increasing job satisfaction for newly qualified nurses and midwives. During their transition, newly qualified nurses and midwives need more support from their institution managers, in terms of ensuring a better learning environment, as well as formal and informal supports.

Historical Study of the Graduates of the Tuskegee School of Nurse-Midwifery, a Program for Black Nurses.

OBJECTIVE: To increase awareness of the contributions of Black nurses to midwifery and to provide an understanding of how initiatives in the past address racial disparities in maternal health that are still relevant today. DESIGN: Historical research. SETTING: The Tuskegee School of Nurse-Midwifery. DATA SOURCES: Thirty-one Black nurse-midwives who graduated from the Tuskegee School of Nurse-Midwifery and oral histories of two of these graduates. METHODS: Historical research that involved locating and analyzing primary and secondary sources about the graduates of the Tuskegee School of Nurse-Midwifery from 1941 to 1946; the oral histories conducted with two graduates are examples of primary sources. RESULTS: The Tuskegee School of Nurse-Midwifery opened September 15, 1941, in Tuskegee, Alabama. The purpose of the school was to educate Black nurses in midwifery to address maternal health in the Black communities where the maternal and infant mortality rates were greatest. By the end of the second year of the program, the maternal mortality rate declined from 8.5 per 1,000 live births to 0, and the infant mortality rate decreased from 45.9 per 1,000 to 14 among the women served in Macon County. However, the school closed in 1946 after graduating 31 Black nurse-midwives. CONCLUSION: The history of early Black nurse-midwives is relevant to the disciplines of nursing, midwifery, and public health. The Tuskegee graduates obtained an education in a relatively new and evolving profession during a time when racism and discrimination in education, financial opportunity, and housing profoundly affected the health and well-being of Black communities. These factors continue to contribute to racial disparities in maternal health and create barriers for those in the Black community who want to become nurses or midwives. The challenges and successes Black nurse-midwives experienced are significant to the present day, but their stories are often not told.

" I carry their stories home ": experiences of nurses and midwives caring for perinatal adolescent mothers in primary health care settings in Rwanda.

INTRODUCTION: Adolescent mothers require trauma- and violence-informed care during the perinatal period due to trauma histories and ongoing violence as a result of pregnancy. Nurses and midwives play a critical role in caring for adolescent mothers in primary healthcare settings in Rwanda in the perinatal period. PURPOSE: To explore the experiences of nurses and midwives working with adolescent mothers in selected primary healthcare settings in Rwanda to inform the delivery of trauma- and violence- informed care. METHODS: This study utilized an interpretive description qualitative approach and was conducted in eight primary healthcare settings in Rwanda. Twelve nurses and midwives working in perinatal services and four heads of health centers participated in in-depth individual interviews. Data were analyzed thematically. RESULTS: The analysis revealed four main themes and 11 (sub-themes): (a) relational practice (being creative and flexible, "lending them our ears"); (b) individual challenges of providing care to adolescent mothers (lack of knowledge to provide care related to gender-based violence, and gendered experience); (c) factors contributing to workarounds (inflexible guidelines, lack of protocol and procedures, lack of nurses' and midwives' in service training, and the physical structure of the perinatal environment); and (d) vicarious trauma (living the feelings, "I carry their stories home," and hypervigilance in parenting). CONCLUSION: Nurses and midwives find caring for adolescent mothers challenging due to their unique needs. These needs require them to be creative, adaptable, and attentive listeners to better understand their challenges. These practitioners face difficulties such as insufficient specific knowledge related to, for example, gender-based violence, inflexible guidelines, and a lack of protocols and training. Additionally, in the perinatal environment attention to the needs of practitioners in those settings is often lacking, and many nurses and midwives report experiencing vicarious trauma. Consequently, there is a pressing need for guidelines and protocols specifically tailored for the care of adolescent mothers. Ongoing trauma- and violence- informed care training and professional education should be provided to enhance the ability of nurses and midwives to care for adolescent mothers and prevent re-traumatization and mitigate vicarious trauma effectively.

Embodiment and the technologies of induction of labour.

OBJECTIVE: To critically engage with the body project of induction of labour. DESIGN: A nested, qualitative study that formed part of a feasibility Random Controlled Trial investigating different methods of outpatient induction of labour. The data reported in this article were gathered via interview with women and midwives involved in the trial. All the participants who took part in the trial presented as cisgender women. FINDINGS: Analysis of 27 interview transcripts suggested that the expansion in choice of when, how and where to start labour can change the way decisions about labour onset is understood. The space needed for a new body project is emerging where distinctions between medicalised labour and spontaneous labour are less clear. CONCLUSION: The embodiment of the new technologies of induction for those involved in this study was both a facet of increased freedom and autonomy and a gendered discourse where the normative function of routine intervention appeared more complete.

Nurses' and Midwives' Stress of Conscience and Its Correlation With Selected Sociodemographic and Work-Related Variables.

AIM: To assess the level of stress of conscience experienced by Polish nurses and midwives and its determinants. DESIGN: Descriptive cross-sectional study. METHODS: The study was conducted from March 2019 to December 2020 and included convenience sampling of nurses and midwives working in hospitals in south-eastern Poland. An adapted version of the stress of the conscience questionnaire was used. RESULTS: A total of 476 nurses and midwives completed the survey. The stress of conscience mean value was 67.57. There were no differences in stress of conscience between nurses and midwives. There were five predictors of stress of conscience for nurses: additional job, place of residence, care for patients over 65 years of age, satisfaction with one's salary and having specialised courses, for midwives: social status, work mode and postgraduate studies. CONCLUSION: With the knowledge of predictors of stress of conscience, educational institutions, policymakers and hospital managers should focus their interventions on the factors that lead to a higher level of stress of conscience. It is essential to provide psychological support, building positive relationships between colleagues and focusing on organisational conditions. IMPLICT: Further research in this area is therefore encouraged, along with pre- and postgraduate training in coping with challenging situations such as the death of a patient and caring for elderly patients with dementia or multiple diseases. The study identifies predictors of stress of conscience and problems that can influence their appearance. Factors that increase the stress of conscience, such as organisational conditions and caring after patients are over age 65, should receive special attention in clinical education and result in the provision of an increased level of support from supervisors. Policymakers should also direct their future actions towards the ageing population, staff shortages, the resignation from the profession by improving working conditions and reducing the stress of conscience. REPORTING METHOD: STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Traumatic experiences, quality of life, and organizational commitment among midwives: A cross-sectional study.

BACKGROUND: The work of midwives is emotionally challenging. Midwives share moments of joy, when a baby is born, and attend complex events of loss and trauma. Exposure to childbirth complications, emergencies, and loss can affect their professional quality of life and functioning. This aspect of midwives' practice has not been sufficiently researched. AIM: To examine the associations between exposures to traumatic events, post-traumatic symptoms, and personal resilience with professional quality of life and organizational commitment among hospital midwives. METHODS: Participants in this cross-sectional study conducted in 2020 included 131 midwives from three large hospitals in central Israel. Data were collected using a structured self-administered questionnaire that examined socio-demographic characteristics, exposure to traumatic events during childbirth, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. RESULTS: The three most traumatic events for midwives were: neonatal death or feared death, maternal death or feared death, and stillbirth. The more frequent the exposure to traumatic events, the more numerous and intense the post-traumatic symptoms. The more numerous and intense the post-traumatic symptoms, the higher the level of professional burnout and compassion fatigue and the lower the compassion satisfaction. Higher compassion satisfaction and lower professional burnout were associated with higher organizational commitment. Personal resilience, country of birth, post-traumatic symptoms, and organizational commitment predicted compassion satisfaction. CONCLUSIONS: Midwives' exposure to traumatic events is associated with the onset of post-traumatic symptoms, impaired professional quality of life, and reduced organizational commitment, and is accompanied by burnout and compassion fatigue. There is a need to address this issue in training programs and to develop organizational support and policies to improve midwives' well-being and quality of care.

Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives' experiences - A qualitative study in the Netherlands.

BACKGROUND: Midwife-led continuity of carer (MLCC) improves health outcomes and increases pregnant women's satisfaction. Working in smaller teams in community midwifery practices is one of the ways to promote continuity of carer. AIM: To gain insight into the experiences of Dutch community midwives regarding working in smaller teams, by identifying motivators and barriers. METHODS: A qualitative study was conducted using individual, semi-structured interviews (n=9). The sample was purposively selected. The interviews were analysed using the Abbreviated Grounded Theory. FINDINGS: Four themes were identified: 1) Ideal implementation of working in smaller teams, 2) Best care for pregnant women, 3) Conflicts with the current maternity care system, 4) Personal interests of the midwife. The core concept connecting all themes was midwives' experiences of an 'inner conflict' regarding working in smaller teams. CONCLUSION: A strong motivation for working in smaller teams is the wish to provide the best care for pregnant women through offering more continuity of carer. The structure of maternity care, financially and organisationally, acts as a barrier in the transition to working in smaller teams. How community midwives manage these motivators and barriers depends on their personal interests, vision, and personal life. The balance between the motivators and barriers can create an inner conflict among the midwives. This inner conflict encompasses an ethical issue: what is the best care and what is it worth? A discussion within the professional group concerning the practical and ethical aspects of working in smaller teams is needed to find ways to reduce the inner conflict of community midwives who wish to work in smaller teams, thereby promoting the implementation of MLCC.

Implementation of aspirin use during pregnancy in community midwifery-led care in the Netherlands: A pilot survey.

INTRODUCTION: Aspirin nowadays is widely used in pregnancy, but implementation among gynecologists took nearly four decades. For a complete insight in the implementation of aspirin, community midwives are to be involved. Community midwives do not have authority to prescribe aspirin and have to refer to a general practitioner or consultant obstetrician for a prescription. METHODS: The study was an online, national pilot survey about the implementation of aspirin use during pregnancy among independently practicing community midwives consisting of 29 items with five categories: background, advising, prescribing, possible indications, and clinical practice. RESULTS: Forty-seven community midwives completed the survey between April and May 2021. All respondents had experience on advising aspirin use in pregnancy. History of preterm pre-eclampsia or HELLP syndrome was identified as a risk factor for developing utero-placental complications by 97.9% of the community midwives. Moderate risk factors in women with otherwise low-risk pregnancy were identified by >75% of the participants. Practical issues in prescribing aspirin were experienced by one-third of the respondents. Suggestions were made to obtain authority for community midwives to prescribe aspirin and improve collaboration with consultant obstetricians and general practitioners. CONCLUSIONS: Community midwives seem to be adequate in identifying risk factors for developing utero-placental complications in women with otherwise low-risk pregnancy. Practical issues for prescribing aspirin occur often. Obtaining authority for community midwives to prescribe aspirin after education should be considered and consulting a consultant obstetrician should become more accessible to overcome the practical issues. Further educating community midwives and general practitioners might improve implementation rates and perinatal outcomes.

The primary health care environment and the performance of advanced antenatal care trained nurse-midwives in South Africa.

Transfer of learning in the workplace depends on various factors, one of which is the work environment. The aim of this study was to describe the interplay between the primary healthcare work environment, the performance of advanced antenatal care trained nurse-midwives, and birth outcomes. A cross-sectional, quantitative study was conducted in two purposely selected districts in South Africa. Document analyses were also completed. Statistical Analysis Software version 9.4 was used for descriptive statistical data analysis. The participating clinics, in the TM and LJ districts, both achieved ideal clinic status. The scores for the management of low- and high-risk pregnancies ranged between 86-89% and 87%, respectively. Babies born had Apgar scores of between 7-9 and 8-10 in 1 minute and 5 minutes after birth, respectively. Nurse-midwives scored low on interpreting assessment findings. Contrary to the Transfer of Learning Theory, nurse-midwives performed better in poorer work environments. The study suggests that the performance of advanced antenatal care trained nurse-midwives may not solely depend on a well-equipped work environment. Further studies should highlight the broader determinants of advanced antenatal care nurse-midwives services output.

Le transfert des apprentissages en milieu de travail dépend de divers facteurs, dont l'environnement de travail. Le but de cette étude était de décrire l'interaction entre l'environnement de travail des soins de santé primaires, la performance des infirmières sages-femmes formées en soins prénatals avancés et les résultats de l'accouchement. Une étude transversale et quantitative a été menée dans deux districts délibérément sélectionnés en Afrique du Sud. Des analyses de documents ont également été réalisées. Le logiciel d'analyse statistique version 9.4 a été utilisé pour l'analyse de données statistiques descriptives. Les cliniques participantes, dans les districts de TM et LJ, ont toutes deux atteint le statut de clinique idéale. Les scores pour la gestion des grossesses à faible et à haut risque variaient respectivement entre 86 et 89 % et 87 %. Les bébés nés avaient des scores d'Apgar compris entre 7-9 et 8-10 respectivement 1 minute et 5 minutes après la naissance. Les infirmières sages-femmes ont obtenu de faibles résultats dans l'interprétation des résultats de l'évaluation. Contrairement à la théorie du transfert de l'apprentissage, les infirmières sages-femmes ont de meilleurs résultats dans des environnements de travail plus pauvres. L'étude suggère que la performance des infirmières sages-femmes formées en soins prénatals avancés ne dépend peut-être pas uniquement d'un environnement de travail bien équipé. D'autres études devraient mettre en évidence les déterminants plus larges de la production des services avancés d'infirmières et de sages-femmes en soins prénatals.

Assessment of professional empowerment among midwives in selected LAC: A multisite descriptive study.

OBJECTIVE: to identify the perception of professional empowerment among midwives in selected Latin American countries (LA). Specifically, this study aimed to compare i) the global level of empowerment among midwives in different LA countries, ii) the scores according to the different dimensions of the scale, and iii) scores according to area the of expertise. DESIGN: A quantitative, observational, analytical, cross-sectional and multisite study using an adaptation of the Perceptions Midwifery Empowerment Scale (PEMS). SETTINGS: Clinical, educational and managerial midwifery positions in 5 LA countries belonging to a Latin American Research Network in Midwifery. All the participating countries reported a similar profile regarding type of education, association and regulation procedures. PARTICIPANTS: A total of 1127 responses from midwives with different professional backgrounds were included in the study. FINDINGS: A total mean score of 73.28 (74.23-72.03) points was reported. Chile reported the lowest score of empowerment compared to the other countries, while Argentina reported the highest. Midwives' perceptions of empowerment within their area of expertise, primary health care (PHC) was the area of reference, and gynaecology reported a significantly lower score. Midwives working in management were significantly more empowered compared with those in other areas. Midwives who had continuous education and postgraduate studies were the most empowered. Regarding the provision of woman-centred Care, Chile and El Salvador differed significantly from Argentina (reference), while Uruguay reported a significantly higher score in this dimension. Midwives working in hospital wards reported significantly lower scores compared to those working in PHC. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study suggests that midwifery programmes in the LA countries would benefit from prioritising professional empowerment, especially in the areas of hospital practice, where midwives' perceptions of empowerment were most limited.

Meta-synthesis of the experiences of midwives providing care during the COVID-19 pandemic.

PROBLEM: During the COVID-19 pandemic, midwives faced emotional and physical risks while on the frontlines providing care. BACKGROUND: To maintain a healthy midwifery workforce, it is necessary to understand midwives' pandemic challenges and successes, including how they personally and professionally faced changes to care provision. AIM: The aim of this meta-synthesis was to understand the experiences of midwives working during the COVID-19 pandemic. METHODS: Noblit and Hare's (1988) approach to synthesising qualitative research studies was followed. Fifteen qualitative research reports were identified using PRISMA guidelines, producing a sample of 588 midwives from 12 countries. FINDINGS: The synthesis revealed three overarching themes: (1) Turmoil and confusion: a spectrum of emotions due to ever-changing protocols, (2) COVID-19 stripped the "being with" out of midwifery care, and (3) Finding our way: midwifery resilience and growth. Analysed together, these three themes contribute to understanding the experiences of midwives working during the COVID-19 pandemic. DISCUSSION: Midwives experienced fear, stress, and anxiety. They felt they couldn't physically be with women during the pandemic. They were frustrated by being left out of institutional decision-making regarding COVID-19 protocols that impacted the women they served. Professional growth as a midwife, and personal resilience were ultimately realised. CONCLUSIONS: The COVID-19 pandemic disrupted the routine ways in which midwives provide care in all settings. Understanding the complete experience of midwives during the pandemic allows for midwifery organizations to be aware of their members' needs, as well as for institutions to ensure supports are in place for midwives in the event of future pandemics.

Experiences of workplace conflicts by midwives and implications for their wellbeing in selected hospitals in the Northern Region of Ghana.

AIM: Conflicts are ubiquitous in human societies and manifest in varied forms and scales within societies, communities and organisations. While many studies have investigated workplace conflicts, least attention has been paid to how midwives differently experience these conflicts and the impacts of these conflicts on their wellbeing. This study fills this gap by investigating the multifaceted impact of workplace conflicts on the wellbeing of midwives. METHOD: The study employed a purely qualitative approach within the analytical framework of the Stress Theory of organisational conflicts. Thirty-five participants were selected for the study through an expert purposive sampling technique. Interviews and Focus Group Discussions were used to collect primary data for the study. Collected data were analysed using an inductive thematic analytical technique. RESULTS: The findings highlight the multifaceted impact of conflict on both the professional and personal well-being of midwives. Conflicts induce severe physical and psychological strains on midwives, generate fears, angst, and anxieties, and disrupt social harmony prompting exclusion and discrimination among midwives in the hospital. CONCLUSION: We argue that apart from task-demand generated stress, workplace conflicts prompt both physical and psychological stress on midwives which culminate into a myriad of physical, emotional, and mental health issues. IMPLICATION FOR PRACTICE: Initiation of conflict resolution and mediation training programs for midwives so as to equip them with essential skills for effectively managing and resolving workplace conflicts. Setting up internal grievance mechanisms for midwives in their work places and training of midwives on social skills, and stress management skills.

Male midwifery practice and acceptability: attitudes, beliefs, and associated factors among expectant mothers in Savelugu Municipal Hospital, Northern Region of Ghana.

Introduction: male midwifery is a relatively new phenomenon in Ghana and most expectant mothers still do not recognize their contribution to reproductive healthcare. This study aims to assess the acceptability of male midwifery practice among expectant mothers in Savelugu Municipal Hospital. Methods: this was a descriptive cross-sectional study. A total of 391 mothers were recruited using a simple random sampling technique. Data was collected using a structured questionnaire and analyzed using SAS JMP Pro V16.0. Results: approximately 75.7% of mothers would go to a hospital where male midwives examine and attend to them, and 71.9% accepted to be delivered by a younger male midwife. Also, 70.1% agreed to share their obstetric information with a male midwife, and 43.5% agreed that their religious beliefs allowed them to be delivered by a male midwife. Mothers who had no formal education (aOR=2.23, 95% CI: 1.040-4.788, p=0.039) were more likely to go to a hospital where male midwives examine and attend to them than the others, and mothers who were employed (aOR=3.91, 95% CI: 1.770-8.631, p=0.001) were more likely to accept to be delivered by a male midwife who is younger than them than the others. Conclusion: a significant portion of expectant mothers are open to receiving care and examinations from male midwives, even opting to go to hospitals where male midwives are available for maternal care. This suggests that male midwives can contribute to the health of expectant mothers significantly and should be encouraged to practice their profession.

Assessment of Diet Quality Based on Selected Dietary Quality Indices and Consumption of Specific Food Items of Midwives Working on a Shift Schedule in Wroclaw, Poland.

The aim of this study was to assess the quality of diets among midwives working in a shift system and to analyze variations in their dietary habits according to their working hours. In a group of fifty midwives employed in four public hospitals in Wroclaw, the HDI-2015, HEI-2015, AHEI-2010, and Mellen's DASH diet index were calculated. The significance of differences in terms of the prevalence of selected dietary habits, meal frequency, average content of selected food items, and the percentage of energy obtained from them was assessed. Over half of the diets of the participants exhibited low adherence to the selected dietary indices. Only the scores on Mellen's DASH diet index were significantly associated with other components of the diet. Diets scoring ≥ 4.5 points were characterized by significantly lower processed meat content, meal frequency, and energy value, as well as lower sugar content and lower dietary energy value, compared to diets scoring < 4.5 points. Regardless of their working hours, the diets of midwives are characterized by low quality. Therefore, it appears essential to introduce targeted educational programs and provide guidance on appropriate dietary models, such as the DASH diet.

Academic education of midwives in Germany (part 2): Opportunities and challenges for the further development of the profession of midwifery. Position paper of the Midwifery Science Committee (AHW) in the DACH Association for Medical Education (GMA).

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of "health around childbirth". The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany.

Academic education of midwives in Germany (part 1): Requirements for bachelor of science programmes in midwifery education. Position paper of the Midwifery Science Committee (AHW) in the DACH Association for Medical Education (GMA).

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise.

How to promote midwives' recognition and professional autonomy? A document analysis study.

OBJECTIVE: To identify challenges associated with midwives' professional autonomy in Belgium and develop recommendations to promote midwives' recognition and professional autonomy. DESIGN: Through a document analysis study we identified challenges, categorized them into themes and linked them with Greenwood's sociological criteria for a profession. This involved an in-depth synthesis of findings from our published studies to comprehensively examine the challenges to optimizing midwifery autonomy and to develop corresponding recommendations. FINDINGS: We identified challenges related to midwife-led continuity care models, regulation of the midwifery profession, collaboration with stakeholders, professional esteem and professional culture. Based on them, our recommendations include prioritizing midwife-led continuity of care, fostering collaboration, tailoring continuous professional development, increasing public awareness and advocating for policy changes. The attribute of a profession which is lacking the most in midwifery in Belgium is recognized authority, which may result in midwives being undervalued, underutilized and underpaid. KEY CONCLUSIONS: In this paper we identified challenges in Belgian midwives' recognition and professional autonomy and provided recommendations to address them, emphasizing the importance of recognized authority in midwifery. Implementing these recommendations can positively impact midwives' recognition and autonomy in Belgium and potentially in other countries. IMPLICATIONS FOR PRACTICE: It is essential for policy makers to address the issue of the lack of recognized authority in midwifery, as it plays a critical role in facilitating decision-making, policy development, and the professionalization of the field. Implementing the outlined recommendations can drive positive changes in midwifery recognition and autonomy in Belgium and beyond.