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Aim The aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia. Background Cultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women’s individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs. Methods This study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n = 9), a Balinese private midwifery school (n = 4) and a Balinese public midwifery school (n = 4). Thematic analysis was used to analyse the data. Findings The findings were categorised into major themes under the headings of “Learning together despite differences”; “Cultural differences”, “Communication, Resources”, and “Recommendations for future placements”. Conclusion This study provides a valuable insight into how shared learning increases students’ midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students’ clinical midwifery practice.

Vitamin D deficiency is widely recognised as a major public health issue around the world; and is essential for optimal development and strengthening of the musculoskeletal system including the prevention of conditions such as osteoporosis, osteopenia and rickets. The association between vitamin D and childhood rickets has led to the fortification of food sources and consequently the eradication of the rickets disease. Vitamin D levels are of particular importance for pregnant women, especially for the development of the bone and muscle development of the fetus. In the last decade there has been a substantial increase in the incidence of vitamin D deficiency and the re-emergence of the childhood rickets disease. It is vital that vitamin D levels are at optimal levels during pregnancy as maternal calcium demands increase significantly to meet the demands of the developing fetus, especially in the third trimester.

Aim The aim of this study was to investigate whether an International two-week clinical maternity placement enhances, and is beneficial, to midwifery students’ future practice and employment decisions during the final year of an undergraduate degree. Background International placements are common in undergraduate pre-registration nursing midwifery university curricula, with the emphasis on preparing students to work with diverse women in multicultural environments whilst incorporating cultural competence. However, little is known as to whether an International placement influences future graduate’s work place choice. Methods Using a qualitative approach, focus groups were undertaken with 16 final year midwifery students from a University in Western Australia who had experienced a two-week International clinical midwifery placement in Tanzania (Africa) or Manilla (Philippines). Data was analysed using thematic analysis. Findings The results of the study revealed eight over-arching themes that revealed an increase in midwifery student’s confidence; an awareness of the need to consolidate knowledge and skills, reinforcement of their own career aspirations, midwifery beliefs and trust in women and physiological birth. Conclusion This study confirms the benefits of overseas clinical placements, which provide opportunities beyond developing cultural sensitivity. Midwifery students are challenged to develop not only practical competence, but confidence to trust in themselves and the process of physiological birth. These experiences validate theoretical learning and provide opportunity to reflect on the possibilities of future employment and decision making as a midwife.

The history and values of the chiropractic profession are part of the complementary and alternate medicine model. Chiropractic care in pregnancy is used for relief of back pain, turning breech presenting fetuses, and treatment of colic, breastfeeding and constipation issues in the neonate.

Background Midwives face direct and indirect barriers in their workplaces that have negative consequences on their ability to provide quality care to women and neonates, however, they still carry on with their duties. This study aimed at investigating the coping strategies that Ghanaian midwives adopt to be able to complete their work. Methods Glaserian Grounded theory was used in this study. Data were collected through non-participant observations and semi-structured interviews. The study participants included 29 midwives who worked in labour/birthing environments and a pharmacist, a social worker, a national Health Insurance Scheme manager and a health services manager. Findings The midwives’ motivation due to their strong desire to save the lives of women and neonates and their strong affection for the midwifery profession was identified to help them cope with the barriers that they faced in their workplaces. The midwives’ motivation was found to spur actions such as improvising, taking control of the birthing process and the birthing environment and the maintenance of social and professional networks to help them to complete their duties. Conclusion Ghanaian midwives face myriad barriers in their workplaces; however, they are able to adopt coping strategies that enable them to complete their duties. The provision of care resources for maternity services in the country will reduce the barriers that the midwives face and improve the quality of maternal and neonatal care. In the short term however, pre and post midwifery educational programmes should focus on developing resilience in the midwifery workforce to help midwives cope more effectively with the challenges that they face in their workplaces.

Colonization with Group B Streptococcus in pregnancy is a major risk factor for neonatal infection. Universal screening for maternal streptococcal colonization and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions of neonatal early-onset Group B Streptococcus disease. To achieve the best neonatal outcomes, it is imperative for maternity healthcare providers to adhere to screening and management guidelines. This literature review uses a systematic approach and aims to provide a synthesis of what is known about compliance with Group B Streptococcus screening protocols in a variety of global settings, including maternity homes, private obstetric practice, and hospital clinical environments. The review was carried out using electronic databases as well as hand-searching of reference lists. Included papers reported primarily on compliance with Group B Streptococcus screening guidelines, potential factors which influence compliance rates, and implementations and outcomes of interventions. Six international studies have been retained which all focused on adherence to Group B Streptococcus screening guidelines and demonstrated that different factors might have an influence on adherence to GBS screening protocols such as financial aspects and high caesarean section rates. Findings of relatively low compliance rates led to recognizing the need of developing improved strategies for optimising antenatal GBS screening adherence. Adhering to Group B Streptococcus screening guidelines to prevent neonatal infection is crucial. Various factors influence compliance rates such as financial aspects and high proportions of caesarean sections. The implementation of strategies and different forms of education can result in improved compliance rates.

Objectives To explore and describe the preferred model of practice and first job decisions of final stage midwifery students from three Western Australian universities. Design Qualitative descriptive. Setting Three Western Australian (WA) universities offering courses leading to registration as a midwife. Participants Twenty-seven midwifery students from undergraduate and postgraduate (pre-registration) courses. Methods Data were collected from recorded interviews and focus groups. Thematic analysis of interview transcripts was used to identify commonalities. Data saturation guided when recruitment ceased and final sample size was achieved. Findings Participants’ preferred model of maternity care was influenced by learning about and witnessing both autonomous midwifery practice and collaborative care during their studies. The greatest influence was clinical experience, with most preferring a continuity of midwifery model (CoM) but first consolidating their practice in a public hospital. Most students reported that they would not choose a private hospital as their first option. Work/life balance was also considered, with some accepting that family commitments and a need to work close to home may prevent them from choosing a CoM model. Conclusion and implications Although many Australian midwifery students start their midwifery course with preconceived ideology of their eventual workplace, the influences of their educators, clinical placement environment, preceptors and continuity of care experience relationships with women helped determine their final direction. To provide students with the experiences to become woman-centred autonomous practitioners it is important for universities and all maternity care providers to carefully consider their responsibility in how they influence midwifery students in education and practice.

Objective To examine literature surrounding suicidal ideation and suicidality in the perinatal period. Design Systematic Literature Review of published 15 research studies. Findings There is a scarcity of prospective studies conducted in suicidal ideation during the perinatal period. More research is needed to ensure childbearing women at risk of suicidal ideation during pregnancy receive the appropriate care and maternity services required to support them throughout this period. Key conclusions Midwives play an important role in screening women for possible emotional distress and mood disorders during pregnancy. Therefore, midwives need to have knowledge of risk factors so vulnerable women are monitored and supportive maternity services can be implemented if indicated. Implications for practice Suicidal ideation can have serious consequences for the women and the product if left untreated. Screening for suicidal ideation, antenatal and postnatal depression is imperative. Women with a pre-existing mental health disorders are a particularly vulnerable population group and should be monitored closely for suicidal ideation. Women who experience intimate partner violence or are from low socioeconomic backgrounds also present a risk of suicidal ideation, all of which require complex mental-health care.

Background Not all midwives embrace the word feminism however, it could be argued that providing midwifery care is an expression of feminism's core values. Aims To describe and explain the views and knowledge of midwifery students on feminism and midwifery. Methods A qualitative descriptive approach, employing an anonymous online questionnaire was implemented and analysed using thematic and content analysis. Findings Eight themes were identified in this study that revealed midwifery student's views and knowledge on feminism and the impact it may have on midwifery clinical practice. Conclusions This study suggests midwifery students should receive adequate education regarding feminism. The advantages of midwifery students understanding feminism within the midwifery professional are undeniable and it is important that feminism is integrated into midwifery programmes.

Worldwide, a large proportion of childbearing women are overweight or obese, and it is becoming increasingly common for pregnant women to have undergone bariatric surgery before conceiving. Women with a history of sleeve gastrectomy may not be able to undertake the oral glucose tolerance test, due to the risk of dumping syndrome. There is limited research on the effects of weight loss surgery on the pregnancy oral glucose tolerance test and conducting this test on a woman who has had bariatric surgery may be an inadequate form of diagnosing gestational diabetes mellitus. A cost-effective alternative to an oral glucose tolerance test is to monitor pre-and post-meal blood glucose levels.

In many countries, including the UK, Australia, China, and the USA, more than 80% of breech-presenting fetuses are born by caesarean section. However, it is important for midwives to note the options that are available to women desiring a vaginal birth. This article will investigate cephalic version methods available to women with a breech-presenting baby, including external cephalic version, moxibustion and acupuncture. The literature emphasises the need for further research into alternative methods of cephalic version, for clinicians to up-skill on vaginal breech birth techniques and, if not recommend, then advise women of alternative methods available if mainstream interventions are unacceptable or contraindicated.

While the value of the clinical skills and expertise required to enable safe vaginal breech birth remains high, midwives who possess these skills are becoming scarce. Additionally, for many midwifery students, vaginal breech birth is becoming somewhat of an elusive event, rarely experienced in clinical practice when completing their training. Not so long ago, this was a standard competency taught to and held by obstetricians and midwives alike, but for those in developed nations working within robust healthcare systems, the frequency of planned vaginal breech birth is on a downward trend, and this is reflected in midwifery educational curriculums.

Pre-eclampsia occurs in approximately 2-8% of pregnancies worldwide, and is characterised by hypertension and multi-organ system involvement. Globally, approximately ten million women develop pre-eclampsia each year, and an estimated 76 000 women die as a result of pre-eclampsia or other hypertensive disorders. Despite ongoing research, the pathogenesis of pre-eclampsia remains unclear. This article will focus on the diagnosis, risk factors and aetiology of pre-eclampsia, while attempting to outline the collaborative management, including treatment and prevention.

The increasing use of smartphone technology in health care provides midwifery students with unprecedented access to online resources that facilitates the optimal care of women and supports ongoing learning.A small pilot study was conducted in Western Australia, with 29 undergraduate and postgraduate midwifery students to explore the use of smartphone technology whilst in clinical practice.This study aimed to define the impact of smartphones in clinical decision-making and learning whilst in clinical areas, by midwifery students at the point of care.An online survey was used to collect data.Five consistent themes were identified from the results. Smartphone technology encourages self-directed learning, consolidation of theory, engagement through blended learning, complements online education in clinical practice and is a trend in the future of midwifery curriculum.Smartphones enhance the learning and mobility of supportive resources that consolidate midwifery students' clinical experience in workplace environments.

Gastroschisis is an abdominal wall defect in the fetus, affecting as many as 1 in 2000 pregnancies. This is a complex medical condition that is growing in prevalence worldwide, and one to which midwives will inevitably be exposed. There is a lack of consensus in the literature as to the cause of gastroschisis and for clear evidence-based treatment regarding indication and timing of birth. While it is agreed that specialist multidisciplinary collaboration is needed from pre-conception, through antenatal surveillance, and into labour, birth and postnatal care, the research is medically led, with no description of a midwifery role. In acknowledging that gastroschisis is a complex medical issue, specific medical and surgical interventions are not examined, but instead a midwifery plan of care within the multidisciplinary approach is derived from the available literature.

In order to examine hypnotherapy, the psycho-physiological science underpinning the practice is an important issue and is significant for the use of hypnotherapy by women in labour and birth. Contemporary literature regarding hypnotherapy and its’ side effects and limitations focuses on the culture inherent in hypnotherapy ideology, whilst the pertinent ethical issues that arise and question its alignment with the contemporary midwifery perspective are an important factor within midwifery care. While it is possible for women to undertake hypnotherapy through self-taught measures, this paper will focus on women purchasing the CAM therapy, including the services of a supportive hypnotherapist who trains and partners with women antenatally and through their labour and birth.

As the rates of amphetamine use continue to rise, so do the significant social and health implications associated with substance abuse in communities. This presents unique challenges for women, newborns and providers of perinatal care. This article aims to explore amphetamine use among women of childbearing age, and the subsequent effects on the woman and fetus/newborn. The complexity of these cases require a collaborative, woman-centred and multidisciplinary approach, in addition to specialised interventions and adjustments regarding routine antenatal, intrapartum and postnatal plans of care

The herpes simplex virus (HSV) is associated with possible risks for both the mother and fetus, and potential complications may arise throughout pregnancy, including transmission in utero, intrapartum and postpartum. This article discusses the prevalence and risk factors for acquiring the virus, and the pharmacological, surgical, complementary and alternative treatment options. HSV-2 and its significance in pregnancy is also explored, including the management during and after pregnancy.

A common concern expressed by women to health professionals providing care during pregnancy and in the postnatal period is whether they will be able to produce enough breast milk to meet the nutritional requirements of their baby. This article will review the use of domperidone as a galactagogue to increase laction. Galactagogues are defined as substances, including drugs and foods, which promote lactation. This term encompasses therapies that have been clinically proven, alongside remedies which have limited current evidence to support the claims associated with them. Domperidone is an antiemetic drug that is gaining in popularity and use as a galactagogue.

It has become increasingly acknowledged that a woman's experience of childbirth can adversely affect her transition to parenthood. Routine discussion of the childbirth experience is not always offered to women in the postnatal period. A postpartum talk, encourages a woman to express her emotional experience, and is an informal discussion of the birth experience with a midwife. This study explores the experiences of hospital-based midwifery students' knowledge and experience of routine discussions of the childbirth experience with women in the postnatal period. Midwifery students stated that they felt they had not received adequate training and education in leading a routine birth discussion with a woman, and they felt they required further knowledge and education to increase levels of confidence in this area.

Studies have described the value of international clinical placements from the student perspective. However, little has been reported on the experiences of clinical facilitators during international clinical placements. This study is part of a larger study that explored shared learning experiences of Australian and Balinese midwifery students and clinical facilitators during a two-week international clinical placement in Bali, Indonesia. This paper reports on the experiences of clinical facilitators from both visiting and host countries in facilitating Australian and Balinese midwifery students whilst on clinical placement in Bali. A qualitative research design using focus group discussion was used to gain insight into the experience of the clinical facilitators. Data was analysed using thematic analysis and three broad themes emerged, those being “new experiences”, “differences in midwifery practice” and “revised learning approach”. New experiences included learning together and English language challenges. Working together allowed the exploration of midwifery practice differences between countries and an appreciation of the different approaches to teaching and learning practices. These findings suggest that international midwifery placements benefit clinical facilitators from host and visiting countries through learning together, creating new experiences and exploring different midwifery and facilitation practices.

Problem The evidence-to-practice gap continues to persist in healthcare and midwives report limited knowledge and use of effective intervention strategies to support the implementation of new evidence-based practices in clinical settings. Background Despite ongoing development and dissemination of high quality research findings, the translation of latest research evidence by midwives into new evidence-based practices remains sub-optimal. This inefficiency places consumers at risk of obsolete or potentially dangerous healthcare interventions. Aim To explore midwifery leaders’ views on what information and support midwives require to lead practice change initiatives in clinical areas. Methods The study formed part of a broader Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical settings. The study employed a qualitative design and was guided by the methodological underpinnings of Action Research (AR). Findings One core finding emerged to fulfil the aim and objectives of the study. To lead implementation of evidence-based practices, midwives need practical solutions and a map of the process, packaged into a centralised web-based resource. Discussion The findings reported in this study provide valuable insight into the specific needs of midwives wanting to improve the uptake and longevity of new evidence based practices in clinical areas. This includes information specific to evidence implementation, support networks and knowledge of Implementation Science. Conclusion To lead practice change initiatives, midwives require a web-based resource that standardises the process of evidence implementation, while providing midwives with clear direction and the support needed to confidently champion for evidence base change in clinical areas.

Aim The aim of this study was to explore graduate midwives’ experiences of completing a Bachelor of Midwifery online theory course and how that experience led to preparation for practice and future employment as a midwife. Methods This study used a questionnaire, with the core research design having a quantitative component using open-ended questions, via the use of an electronic platform. Results The main themes emerging from the data that the graduates considered important issues were flexibility, isolation and lack of support. Conclusion Course completion, experience of online learning/preparation for practice, and recommendations for improvement were identified as areas of importance for graduates of the online midwifery theory course.

Sepsis is a complex, multi-organ disorder that may have catastrophic effects on the woman and fetus, resulting in the rapid deterioration of the woman's health and subsequent serious morbidity and mortality. Guidelines specifically for pregnant women are derived from research on the non-pregnant population, and a lack of hospital guidelines for the management of sepsis in pregnancy has been identified. Considerations of physiological changes that occur in pregnant women make diagnostic thresholds difficult, thus identifying the need for a standard definition of sepsis in the obstetric population. This article will discuss the diagnosis and the midwife's role in the management of sepsis in pregnancy.

After headache, epilepsy is the second most common neurological disorder encountered in pregnancy. Epilepsy is one of the most common chronic neurological conditions in the world, with an estimated 50 million people affected worldwide. The majority of pregnant women with epilepsy have an uneventful pregnancy, labour and birth. Many pregnant women with epilepsy have well-controlled seizure activity owing to antiepileptic drugs. The use of antiepileptic drugs during pregnancy is challenging because of the need to maintain the balance between the benefits for the woman in seizure control and the risks to the fetus from the teratogenic effects of antiepileptic drugs. Sodium valproate and lamotrigine are currently prescribed for seizure control in pregnancy; midwives should be aware of the effects of these antiepileptic medications on the pregnant woman and her fetus.

Globally, thalassaemia is one of the most common genetic blood disorders affecting women's ability to conceive and progress through a normal pregnancy and birth. Thalassaemia is associated with late-onset puberty, infertility due to endocrine dysfunction, growth retardation, jaundice, deformities in skeletal development and enlargement of the abdomen secondary to spleen and liver anomalies. Despite medical innovations, the management of thalassaemia remains associated with significant risk factors for women during pregnancy, birth and the postnatal period. The management of women with thalassaemia is complex, requiring a multidisciplinary approach to care as the potential for maternal and fetal complications presents risks during pregnancy and birth. Women can remain silent carriers of the disease until pregnancy induces symptomatic haematological and coagulation changes, leading to diagnosis of thalassaemia.

Aim To identify undergraduate and postgraduate student midwives' attitudes towards women using licit and illicit substances during pregnancy. Background Literature shows that globally, substance misuse during pregnancy is growing rapidly. Women who use substances during their pregnancy have specific healthcare needs and require midwives to demonstrate positive attitudes to improve appointment compliance and treatment completion. Methods A cross-sectional quantitative survey design was used. A total of 42 surveys were retained for full data analysis. Findings Of the 42 participants, 22 were undergraduate midwifery students and 20 were postgraduate midwifery students. The results revealed that both undergraduate and postgraduate students had positive attitudes towards women who used substances during pregnancy. Specifically, postgraduate students, with 1–2 years' experience looking after pregnant women, had the most positive attitudes towards substance use in pregnancy. Conclusion This study revealed that undergraduate and postgraduate midwifery students have positive attitudes towards women who misuse illicit and licit substances, which is important for providing quality care upon qualification as a registered midwife. It is essential that midwifery students, who will go on to qualify as registered midwives, are non-judgmental and positive to ensure adequate antenatal care and regular antenatal attendance so maternal and fetal wellbeing can be better managed.

This paper describes an evaluation of postgraduate midwifery students' experiences of a model of blended learning, following completion of a newly accredited Master of Midwifery Practice (MMP) course in a Western Australian university. Successful completion of the course leads to registration as a midwife with a Master's degree. This is the first midwifery degree at Master's level offered in Western Australia, which offers another route into the midwifery profession alongside existing options for postgraduate and undergraduate students. Midwifery students enrolled on the 2-year MMP course are registered nurses, who are offered flexible learning options involving on-campus and online learning, as opposed to traditional on-campus lectures and tutorials. The evaluation consisted of a 10-part questionnaire given to 25 midwifery students, of which 17 were completed and returned. Responses were analysed by the authors and a consensus on the final interpretation was reached. Four main themes were identified from the evaluation: variety of teaching methods, feeling overwhelmed, contextualising midwifery, and support.

Sunlight is fundamental in synthesising vitamin D in humans. However, the sun is also responsible for negative short- and long-term health effects on the population. Babies and young children who are subjected to unprotected sun exposure are at an increased risk of skin cancer later in life, and therefore they should be considered as a particular target population. Prevention is an important aspect of parental education in the protection of babies' and children's skin, in order to avoid and reduce the consequences of exposure to the sun. Increased awareness of skin cancer has led to individuals using chemical protection and physical barriers to protect their skin from the harmful rays of the sun. However, this protection can lead to a reduced level of absorption and uptake by the body of the natural vitamin D. Health visitors are in a position to advise and support parents in protecting their babies from sun damage, and should actively encourage uptake of vitamin D.

Depression is a condition that affects millions of people worldwide and is the highest cause of disease burden for women. Postnatal depression affects up to 25% of all childbearing women; however, its prevalence is often under-detected and under-diagnosed. Early screening and early intervention are integral in the prevention of postnatal depression. Preventive interventions focus on the efficacy of omega-3 supplements, physical activity and placentophagy practices. However, there is promising evidence regarding the efficacy of antidepressant therapy, increased social support, and technological-based psychological interventions in the prevention of postnatal depression.

Throughout pregnancy, women are offered various screenings and diagnostic procedures. Group B Streptococcus (GBS) screening is currently a routine screening process in Australia, but not in the United Kingdom, which is offered to women at 35–37 weeks gestation. The results of GBS screening alter a woman’s course of care for labor and the postnatal period. This article is a review of evidence, policy, and clinical practice and aims to determine whether GBS screening is necessary and whether the screening has a positive or negative impact on women and their babies.

Objective To generate new knowledge that describes and explains the views and understanding, regarding midwifery and normal birth, that newly enrolled midwifery students hold at the commencement of their midwifery education. Design A qualitative descriptive approach was used in conjunction with an anonymous questionnaire. Setting A tertiary University in Western Australia Findings Eighteen postgraduate midwifery students (PG), and twenty undergraduate midwifery students (UG), completed the questionnaire.Postgraduate midwifery students with a nursing background had a pronounced medical terminology and philosophy, as opposed to undergraduate midwifery students. Implications for practice Midwifery educators will need to ensure the teaching of midwifery philosophy and normal birth at the commencement of midwifery courses, before historical perspectives and anatomy and physiology. Students need to be aware that birth is not reliant on risk management or student's personal values, otherwise it will be difficult for new midwifery students to understand birth as a normal, physiological process.

Pregnant women who misuse alcohol or substances often develop obstetric conditions that further complicate their pregnancy. This case study reflects on the maternity care provided for a woman who continued to use amphetamines during her pregnancy; and who was diagnosed with placenta praevia and subsequently suffered a placental abruption. Alcohol and substance misuse in pregnancy is currently escalating, increasing the risk in maternal and neonatal morbidity and mortality. Midwives must be confident in the advice and care they provide in order to reduce the risks caused by substance misuse, and be able to support this with evidence-based care. Purpose The purpose of this case study is to discuss the obstetric condition involved with placenta praevia with the occurrence of a placental abruption in a woman who uses amphetamines during pregnancy; and the midwifery and obstetric care involved. Interest/relevance/congruency It will highlight the importance of evidence-based care in high risk obstetrics. Content (1) Case summary; (2) discussion; (3) risk factors; screening, diagnosis and management; foetal and neonatal monitoring; postnatal management, and trauma informed care. Conclusion It was shown with planning, understanding, communication, and vigilance, the care of an amphetamine using pregnant woman with a diagnosis of placenta praevia and abruption can be successfully accomplished. The management of the woman discussed in this case study was within the recommendations currently available in the literature.

There is an absence of sufficient evidence regarding naltrexone use in pregnancy due to the limited range of human studies. Naltrexone implants are being used in Western Australia as a treatment for opioid dependency, and although contraindicated for insertion during pregnancy, there are a number of women who conceive while undergoing treatment. A review of the available data revealed that naltrexone is associated with improved maternal and fetal outcomes. Extensive research into this area in the form of large, multicentre trials is required to confirm the results of the current research.

Background There has been a significant cultural shift in attitudes towards male partners' involvement in maternity care, resulting in a cultural acceptance that male partners should be involved throughout pregnancy and birth. Anecdotal evidence, however, shows that male partners may still experience negative attitudes from obstetric and midwifery professionals. Aim To explore midwifery students' experiences of negative attitudes or behaviour directed toward male partners by women, midwives, and/or doctors during antenatal and intrapartum care. Methods An open online anonymous survey was used to collect data from 21 midwifery students. Findings Two main themes were revealed: observed negative behaviours, and behaviour reasoning. Each theme contained sveral sub-themes, namely aggression, exclusion, and condescension (observed negative behaviours), and excusable by pain, preoccupied, misplaced support and respectful inclusion (behaviour reasoning). Conclusions The accommodation of male partners into maternity settings does not always meet their needs, and is at time disempowering through negative attitudes and behaviours.

The aim of this investigation was to develop insight into what a sample of migrant African parents now residing in Western Australia knew about, and were able to provide in relation to the dietary needs of their recently-diagnosed diabetic teenager through an exploration of family food habits.In recent years, Western Australia has seen a sharp increase in the size of its African population due to both economic and refugee migration. A rise in the numbers of teenagers of African origin diagnosed with both type 1 and type 2 diabetes and associated complications has been noticeable. A different ethnic background is a known risk factor for poor metabolic control, and this trend is reflected in recent studies wherein people of African origin have been found to have a high risk of developing diabetes. What is also clear from the health promotion literature is that parents of teenagers with a chronic health condition, when they are well informed about that condition, play a key part its management. Little is known, though, about what African migrant parents’ understand about diabetes and its dietary controlTwelve parents from five different countries of origin participated in this survey. Despite all participants having received education on the topic from a dedicated paediatric diabetes nurse, it was evident from their families’ food habits that either an understanding of or the capacity to accommodate the dietary requirements of their diabetic teenager was minimal.The results of this small survey indicate a need to revise the information provided to African migrant parents of diabetic teenagers to more closely accommodate cultural preferences. Further work is necessary to determine the most effective approach to health education with this group of health care consumers.

Background: Papanicoloau (Pap) smear screening has helped to reduce cervical cancer rates significantly through the detection of premalignant cells ( Bray et al, 2005 ). Uptake among women who use alcohol and other drugs (AOD) is known to be low ( Chau et al, 2002 ) so they are at increased risk of being under-represented in the adequately screened population. AOD-using women experience disproportionately increased morbidity and mortality from cervical dysplasia and cancer ( Nogara et al, 2013 ). Pregnancy may provide the midwife an opportunity to offer this vital screening test. Objective: The audit investigated Pap smear uptake and results among AOD-using pregnant women. Setting: Pregnant women cared for by an obstetric AOD service based in a tertiary hospital in Perth, Western Australia, were eligible for inclusion in the study. Results: Across a period of 12 months, 333 childbearing-aged AOD-addicted women were audited: 142 had a Pap smear in the previous 3 years; 80 had not had a Pap smear in the previous 3 years; 80 declined a Pap smear; and 31 were either illegible or no record was available. Conclusion: This audit emphasises the importance of Pap smears being offered and followed up among the population of AOD-using pregnant mothers. Encouraging early booking and access to early antenatal care with midwives who are proficient in Pap smear collection is essential in order to provide optimal care.