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.

Exploring outcomes for women and neonates having skin-to-skin contact during caesarean birth: A quasi-experimental design and qualitative study.

PROBLEM: Women having an elective caesarean birth are often separated from their babies at birth with newborns transferred to a postnatal ward with the significant other. BACKGROUND: Two midwives were employed in 2019 to provide skin-to-skin contact for women who planned for elective caesarean births in a public hospital in metropolitan New South Wales with 4000 births per year and a 39% CB rate (57.8% of these births being elective). AIM: To compare the outcomes for women and their newborns on the effects of skin-to-skin contact at elective caesarean births within the first five minutes of birth to those who did not have skin-to-skin contact and to explore the lived experiences of women having skin-to-skin contact during their elective caesarean births. METHODS: A quasi-experimental design study with a qualitative component of in-depth interviews. Quantitative analyses included independent t-tests, chi square and logistic regression. Thematic analysis was used for the qualitative data. FINDINGS: In the quantitative results, there was a reduction in the time to the first feed (t(100) = -11.32, p < 0.001) (M = 38.9, SE = 20.7) (M = 124.9, SE = 50.1) and the first breastfeed (t(100) = -5.2, p < 0.001) (M = 53.2, SE = 82.5) (M = 277, SE = 295.8) with increased breastfeeding on discharge for women that had skin-to-skin contact at caesarean birth in comparison to those who did not receive skin-to-skin contact χ2(1) = 10.22, p < 0.05. In the qualitative results, women who had skin-to-skin contact during their caesarean birth had a positive experience with improved bonding and reported less anxiety and depression than their previous caesarean birth. CONCLUSION: This study provides evidence of the benefits of skin-to-skin contact during a caesarean birth.

Midwives providing woman-centred care during the COVID-19 pandemic in Australia: A national qualitative study.

BACKGROUND: The COVID-19 pandemic has caused isolation, fear, and impacted on maternal healthcare provision. AIM: To explore midwives' experiences about how COVID-19 impacted their ability to provide woman-centred care, and what lessons they have learnt as a result of the mandated government and hospital restrictions (such as social distancing) during the care of the woman and her family. METHODS: A qualitative interpretive descriptive study was conducted. Twenty-six midwives working in all models of care in all states and territories of Australia were recruited through social media, and selected using a maximum variation sampling approach. Data were collected through in-depth interviews between May to August, 2020. The interviews were recorded, transcribed verbatim, and thematically analysed. FINDINGS: Two overarching themes were identified: 'COVID-19 causing chaos' and 'keeping the woman at the centre of care'. The 'COVID-19 causing chaos' theme included three sub-themes: 'quickly evolving situation', 'challenging to provide care', and 'affecting women and families'. The 'Keeping the woman at the centre of care' theme included three sub-themes: 'trying to keep it normal', 'bending the rules and pushing the boundaries', and 'quality time for the woman, baby, and family unit'. CONCLUSION: Findings of this study offer important evidence regarding the impact of the pandemic on the provision of woman-centred care which is key to midwifery philosophy. Recommendations are made for ways to preserve and further enhance woman-centred care during periods of uncertainty such as during a pandemic or other health crises.