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Background/Aims The COVID-19 pandemic significantly affected teaching for nursing and midwifery academics, as it shifted from face-to-face to online teaching from home. However, their experiences and how this impacted their ability to fulfil their academic roles has not been reported. This study investigated midwifery and nursing academics' working from home experiences during the COVID-19 pandemic and how this has impacted their ability to fulfil their academic roles. Methods A qualitative approach was used for this study, analysing demographics and the answers to open-ended questions from 91 midwifery and nursing academics. Results Six themes were derived: isolation, loneliness, work rituals, productivity, blurred boundaries and health and wellbeing. Generally, participants reported that they were more organised, focused and efficient, which gave them more time to spend with their families and pets. Most thought that they were more productive at home. However, the working environments for some participants were not ideal, as they were working in their kitchen or dining area, or in ‘make-do’ offices. Conclusions The COVID-19 pandemic posed new working challenges for academics, many of whom had worked from home for a few days, but then needed to work from home for extended periods because of lockdowns. Academics reported an overall positive outlook for working from home, as it enabled more family time and more productivity.

The purpose of this research project was to investigate midwives' job satisfaction in Australian maternity care settings.A mixed methods pilot study using the convergent parallel design, and a mixed-methods approach was used for this study. The Nursing Workplace Satisfaction questionnaire was used to collect data online via social media platforms, and consisted of Likert Scale responses, and both closed and opened ended questions.The quantitative results noted an overall positive result to participants' job satisfaction, however there were areas that participants reported as problematic. These areas were delved into further via the results of the qualitative data which highlighted eight themes that explored the participants' perception of the worst things that impacted upon their job satisfaction, and also the best things which impacted in relation to their current jobs.This study revealed factors including staff shortages, being time-poor, missing basic human rights like meals and comfort breaks which were linked to midwives' dissatisfaction with their jobs in Australia. The study also identified that midwives valued being of service to women, and that this factor was a driving force in job satisfaction.

To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led).This retrospective quantitative study has employed a descriptive design using administrative health data.Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis.The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to screening was found in the midwifery led model of care (MMC, 68.76%, n = 7232) when compared with the non-midwifery led model of care (NMMC, 90.49%, n = 10,767). Over the 5 years, screening rates trended down in the MMC with stable numbers in the counterpart. Adherence in relation to intrapartum antibiotic prophylaxis revealed discrepant findings between the study groups.Adherence to screening and management guidelines of maternal GBS colonization in pregnancy is lower within the MMC when compared with the NMMC.This is the first cohort study to describe the adherence to the recommended Western Australian GBS screening guidelines in the two different models of care. Findings may assist in the guidance and improvement of clinical protocols as well as the planning of clinical care in relation to GBS screening to reduce the risk of neonatal GBS infection.

INTRODUCTION Currently, caesarean section is the primary mode of birth for a breech presenting fetus, leading to a deskilling of clinicians and limitation of birth choices for women. The aim of this review is to present a synthesized summary of existing literature related to women’s experiences of breech birth mode decision-making. METHODS A systematic search of the literature was conducted in April 2021, utilizing five databases to identify and obtain peer-reviewed articles meeting the predetermined selection criteria. RESULTS Four major categories were synthesized from the integrated review: 1) Women who desire a vaginal birth may experience a range of negative emotions such as feelings of disempowerment, loss, uncertainty and a sense of isolation; 2) Women who experience a breech presentation at term experience significant pressures to conform to expectations of medical professionals and their families due to perceptions of risk related to breech birth; 3) Breech birth decision-making in a limiting system; and 4) Overall satisfaction with the decision to plan a vaginal breech birth. CONCLUSION Women with a breech presenting fetus at term experience a complex range of emotions and internal and external pressures due to perceptions of risk around breech birth. Midwives were seen as helpful throughout the breech experience. The reduced caesarean section rate for breech, observed in studies exploring specialized care pathways or dedicated services, could reduce the incidence of Severe Acute Maternal Morbidity.

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.

Background: As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity. Aim: The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice. Method: The scoping review was conducted according to the Preferred Reporting Items for Scoping reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) recommendations. The search was applied to the databases CINAHL, MEDLINE, PschInfo and Pubmed which were searched in September 2019 and again in July 2021. The inclusion criteria were guided by the mnemonic for search terms: Participants, Concept, and Context (PCC) and included variations of health care professionals, care ethics and utilization. The search was limited to qualitative studies published in English between 2010 and 2021. A data extraction tool was used to extract and synthesize data into categories. The articles were screened for eligibility by title, abstract and full text review, by two independent reviewers. Ethical Considerations: The scoping review was guided by ethical conduct respecting authorship and referencing sources. Results: Twelve of the initially identified 129 studies were included in the scoping review. Data synthesis yielded four categories of care ethics use by health professionals: relationship, context, attention to power and caring practices. In combination, the evidence forms a framework for care ethics use in midwifery practice. Conclusion: Care ethics use by health professionals enhances ethical sensitivity. A framework and definition for care ethics for midwifery practice is proposed. This review will be of interest to midwives and other health practitioners seeking to enhance ethical sensitivity.

Contemporary ethical issues in the maternity system are nuanced, complex and layered. Medicalisation and the reported rise in incidence of mistreatment and birth trauma, has been described as unethical. Some authors suggest bioethical principles are limited in terms of guiding everyday care of pregnancy and birth. There is currently no known published research which explores what birthing people say is ethical.This study sought to explore women's experience of maternity care from an ethical perspective.A Feminist Participatory Action Research (FPAR) was conducted over three years, in two phases. A Community Action Research Group (CARG) was formed of nine participants, and data were captured from five focus groups. A further ten participants were recruited for individual in-depth interviews, the data corpus was combined, and thematic analysis was applied. All 19 participants had experienced a midwifery model of care in Western Australia.A unique ethical perspective was described by the participants. The central theme: 'Radical desires: Individuals values and context' placed the woman at the centre of the care, in determining what is ethical. Two categories captured the care experienced: Woman-centred ethics or Authoritarian ethics. A conceptual model Woman-centred ethics is offered to enhance everyday ethical midwifery care.The participants in this study perceived care as either ethical or unethical based on the quality of the relationship, the knowledge that was shared and the manner of the care given. The Woman-centred ethics model may be a starting point for moving the field forward in ethical discussion.

Social media has become incorporated into the practice of contemporary nursing. It must be acknowledged by the nurse and the nursing profession that social media has the power to enable the nurse to network with colleagues and share research findings through both private and open forums. However, it also has the potential to negatively influence patient care. This article discusses the use of social media and the dilemmas both ethical and legal. It highlights the need for the nurse and the nursing profession to remain vigilant regarding its use within both their personal and professional lives, to ensure that no boundaries are inadvertently crossed.

Aims and objectives To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care. Background Midwifery is a research-informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice. Design A five-step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search strategy, selection criteria and quality appraisal process, and the extraction and synthesis of data to inform an integrative review. Methods The databases CINAHL, MEDLINE, Web of Science, Implementation Science Journal and Scopus were searched for relevant articles. The screening and quality appraisal process complied with the PRISMA 2009 checklist. Narrative analysis was used to develop sub-categories and dimensions from the data, which were then synthesised to form two major categories that together answer the review question. Results The six articles reviewed report on midwives' use of best available evidence in Australia, the UK and Asia. Two major categories emerged that confirm that although midwifery values evidence-based practice (EBP), evidence-informed maternity care is not always employed in clinical settings. Additionally, closure of the evidence-to-practice gap in maternity care requires a multidimensional approach. Conclusion Collaborative partnerships between midwives and researchers are necessary to initiate strategies that support midwives' efforts to facilitate the timely movement of best available evidence into practice. Relevance to clinical practice Understanding midwives' use of best available evidence in practice will direct future efforts towards the development of mechanisms that facilitate the timely uptake of latest evidence by all maternity care providers working in clinical settings.

Objective The purpose of this study was to identify midwives’ attitudes towards women using substances during pregnancy, which informed the development of an integrated care pathway for the provision of optimal care. Methods A mixed methods research design was used, that included an online survey via the online survey tool Qualtrics™ which collected quantitative data, and interviews and focus groups were used to collect qualitative data. Findings Participants held a positive or neutral view towards women who used substances during pregnancy, and the participants had an empathetic perception of the issue of substance use within pregnancy, believing that women were using substances due to the environment and circumstances that they lived in, and that they had been raised and socialised in. Conclusion Caring for women during pregnancy with substance misuse issues is complex and requires coordination and multidisciplinary care. Midwives have the capacity to provide sensitive midwifery care but require the framework to ensure women needing additional resources during pregnancy receive the services available and specific to their needs. The midwives in this study were supportive of developing an integrated care pathway to allow for collaborative care, and to enable a specialised midwifery approach.

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.

AIM To test whether infrared non-touch forehead thermometry (FNTT) obtains comparable temperature readings in adults compared with common, non-invasive thermometry methods such as axillary (DAT), oral (DOT) and infrared tympanic (ITT). DESIGN A prospective, repeated-measures comparative diagnostic test study design was used for this study. METHODS Data were collected from a convenience sample of 169 nursing students over 3 months (March 2019 to May 2019). Participants had their temperature measured once with each of the four thermometers. Agreement between thermometers was assessed using repeated-measures analysis of variance with Bonferroni post hoc testing. RESULTS/FINDINGS One hundred and sixty-one participants were included in the final analysis. A repeated-measures ANOVA showed statistically significant differences between the four thermometer temperature readings. Post hoc pairwise comparisons with Bonferroni adjustment revealed infrared non-touch forehead thermometry demonstrated statistically significant higher mean temperatures compared with digital oral thermometry MD = 0.466℃ (95% CI, 0.357-0.576, p

Aims To explore women's experiences of breech pregnancy and birth to identify areas in practice for improvement. Design A descriptive exploratory study was conducted involving 20 women who had experienced a breech birth between 2013 and 2018. Methods Semi-structured interviews were audio recorded and transcribed. Transcripts were examined using a free-form 'circling and parking' style of analysis. Foucault's concepts of power/knowledge were utilized to describe existing power relations. Results Women experienced varying degrees of disciplinary power throughout their experiences. Knowledge was used as a means of enforcing disciplinary power by some clinicians and by women to 'arm' themselves and 'fight' to regain what they perceived as a loss of power and autonomy. Midwives were seen as navigators of a restrictive, medicalized healthcare system. Conclusion By better understanding the power dynamics which exist as well as the stages women go through when experiencing a breech presentation, there remains the potential to identify areas in practice which need improving, and aid clinicians in better supporting women through what can be a very difficult time.

BACKGROUNDSkilled attendance at birth by well-educated and regulated midwives has been identified to reduce maternal and neonatal deaths, however, it has been established that midwives experience barriers that can affect their ability to provide quality care to women and neonates.AIMThis systematic review and meta-synthesis of qualitative data was conducted to investigate the barriers to midwives' ability to provide quality care focusing on African and developed countries.METHODSThe Joanna Briggs Institute process for conducting systematic reviews was followed for this review. Qualitative studies that reported on barriers to midwives' ability to provide quality care were identified by searching the following databases: CINAHL, PubMed, Web of Science, and PsychINFO. Studies reported in English in the last 10 years, within which most participants were midwives and the data reported on barriers to quality care provision by midwives were included in this review.RESULTS813 published research studies were screened, and 11 research papers were included in this review. The meta-synthesis of the findings resulted in six categories: the lack of equipment; inadequate skills and training, lack of space and infrastructure, staff shortages and high workloads, emotional barriers, and workplace culture. Using the Donabedian model of quality care, the barriers were grouped into structure, process, and outcome factors.CONCLUSIONCurrently efforts to improve quality care in African countries focus on structural factors. Efforts to improve quality care in developed countries focus on process factors. In order to improve quality care for women and neonates, efforts need to be focused on all the factors that promotequality care.

Student midwives are increasingly taking the initiative to organise and host conferences with impressive results. This article celebrates the creativity and leadership of Veronica Merton, Ashlee Guerin, Kate Gee, Mia Pemble and Shannon Minnett, newly qualified midwives who, with the assistance of midwifery professor Sadie Geraghty, arranged and facilitated a midwifery conference when they were students at Charles Darwin University.

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.

BACKGROUND The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. OBJECTIVE This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech birth in Western Australia and professional recommendations regarding the care of women experiencing breech presentation close to or at term. This study was designed to inform the development of an integrated care pathway for women experiencing a breech presentation. This mixed methods approach situated within the pragmatic paradigm was determined to be the optimal way for incorporating multidisciplinary recommendations with current clinical practice guidelines and consumer feedback. METHODS A mixed methods study utilizing semistructured interviews, an electronic Delphi (e-Delphi) study, and clinical practice guideline appraisal was conducted to generate new data. The interviews were designed to provide insights and understanding of the experiences of women in Western Australia who are diagnosed with a breech presentation. The e-Delphi study explored childbirth professionals’ knowledge, opinions, and recommendations for the care of women experiencing breech presentation close to or at term. The clinical practice guideline appraisal will examine the current national and professional breech management and care guidelines. This study has the potential to highlight areas in practice that may need improvement and enable clinicians to better support women through what can be a difficult time. RESULTS Data collection for this study began in November 2018 and concluded in March 2020. Data analysis is currently taking place, and the results will be disseminated through publication when the analysis is complete. CONCLUSIONS The results of this study will guide the development of an integrated care pathway for women experiencing a breech presentation close to or at term, with the hope of moving toward standardized breech care for women in Western Australia. This study protocol has the potential to be used as a research framework for future studies of a similar nature. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23514

BackgroundDespite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report uncertainty in both knowledge and confidence to implement sustained evidence-based change in clinical areas. This study aimed toexplore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practices, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators of evidence-based change.MethodsThis qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained by a nominal group workshop and individual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes.ResultsOne overarching core finding emerged from four major categories to fulfil the aim of this study: Fear can stop change and midwives lack the confidence and time to implement new evidence-based practices, however having high level midwives in leadership roles is a huge advantage.ConclusionThis study confirms what is known about the hinderances and helpers of translating latest evidence into everyday practice, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop intervention strategies applicable to midwives initiating evidence-based practice change in clinical areas.

Despite global efforts to reduce maternal and neonatal mortality rates, the problem continues to persist, especially in Lower- and Middle-Income Countries like Ghana. For years it has been acknowledged that the deployment of well-trained and regulated midwives could provide a cost-efficient way of reducing maternal and neonatal mortality. However, multiple factors including; recently increasing demands made by birthing women, the growing complexity of midwifery work and a shortage of midwives as well as other barriers have affected the ability of midwives to provide quality maternal and neonatal care. This study aims to provide insight into some of the consequences of these barriers that midwives face in their workplaces.MethodsGlaserian Grounded Theory was applied in this study. Semi structured interviews were conducted with twenty-nine (29) midwives and four (4) other workers whose roles impacts on the work of midwives. In accordance with the requirements of grounded theory, data collection and analysis occurred concurrently while building on the data that has already been analyzed. Constant comparison was used throughout the data analysis.ResultsThe analysis of the data indicated that barriers to midwives’ ability to provide quality care have physiological, psychological and socioeconomic consequences on midwives thereby affecting the quality of the care that they offer to women and newborns. ConclusionThe effects of the barriers to midwives’ abilities to provide quality care are intertwined and have consequences on both the midwives as well as on the quality of the care that they provide to patients. By implementing measures to ameliorate or mitigate the effects of the barriers that midwives face in their work, the quality of the care that they provide to women and neonates will be enhanced, which in turn will positively affect the retention of midwives and maximize the benefits of implementing the midwifery model of care.

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.

Aims The aims of this study were to gain an understanding of the experiences of nurses and midwives enrolled in a PhD, explore any barriers that PhD students encounter whilst completing the degree, and develop recommendations for consideration in formulating support strategies to encourage completion for nurses and midwives enrolled on a PhD degree. Background It is important to understand what is happening at doctoral level education for nurses and midwives, and how those enrolled on PhD courses can successfully complete their studies, transition learning, and acquire the ability to undertake research into the clinical environments. Design The criteria for inclusion into the study was that participants were either a Registered Nurse or Registered Midwife enrolled in a PhD degree. Methods A mixed methodology, non-experimental design approach was used with purposive sampling in an anonymous survey, that included both qualitative and quantitative questions to collect data in 2017. Findings Supervisors and supervision were the focus of the participant's responses, and issues were identified in negotiating the right supervisors for nurse/midwife PhD students. PhD students would benefit from specific teaching and the opportunity to discuss issues that occur as part of the PhD process. Conclusion Academia needs to consider new approaches to more effectively integrate teaching time into supervision, thereby optimising PhD completion for nursing and midwifery PhD students.

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.

Background Undergraduate nursing students from culturally and linguistically diverse backgrounds experience unique challenges with their learning needs during clinical placements. There is limited research on clinical supervisors' perspectives of the factors impacting clinical learning experience of nursing students from culturally and linguistically diverse backgrounds during placement. Objectives This study sought to identify clinical supervisors' perspectives of the factors impacting on the clinical learning experience of nursing students from culturally and linguistically diverse backgrounds and strategies to overcome challenges. Design A qualitative research design using semi-structured interviews. Methods Nine nurses who had experience supervising culturally and linguistically diverse nursing students were interviewed as part of data collection. Thematic analysis was used for data interpretation. Results Identified factors include: Poor proficiency in English language, unfamiliarity with Australian slang and medical terminologies, cultural expectations interfering with professional responsibilities, incongruity with teaching delivery and learning style, short duration of placement, inconsistency with preceptor allocation and inadequate preceptor training. Conclusion Recommendations to facilitate the learning of nursing students from culturally and linguistically diverse (CALD) backgrounds on clinical placement include flexibility with assessments, modifying teaching styles according to learning needs, providing appropriate orientation, creating a welcoming environment, providing consistency with allocation of preceptors, and providing appropriate training for preceptors. Inconsistency in preceptor allocation was reported to have a negative influence on CALD student learning. A collaborative approach between Universities and the health care settings is essential in assisting clinical supervisors to address the unique learning needs of nursing students from culturally and linguistically diverse backgrounds while on clinical placement.

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.

Currently, within the nursing and midwifery curriculum of Australia, the concepts of caring and compassion are not routinely taught. While these are thought of as integral components for nursing and midwifery students to develop during their theoretical and practical training, it is questionable whether they can actually be taught, or whether they are innate to the individual's own disposition. This article suggests that compassion is under threat, and examines whether it is possible to teach these concepts within the nursing and midwifery curriculum to address this possible deficit within the professions.