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Midwifery Dissertation Topics

Published by Owen Ingram at January 3rd, 2023 , Revised On August 16, 2023

There have been midwives around for decades now. The role of midwives has not changed much with the advent of modern medicine, but their core function remains the same – to provide care and comfort to pregnant women during childbirth.

It is possible to be a midwife in the healthcare industry, but it is not always a rewarding or challenging career. Here are five things you didn’t know about midwifery nursing to help you decide if it could be the right career choice for you.

The profession of midwifery involves caring for women and newborns during pregnancy, childbirth, and the first few days following birth. Registered nurses are trained with four additional years of education along with major research on methods involve in midwifery and writing on midwifery dissertation topics, while midwives provide natural health care for mothers and children.

As a midwife, your role is to promote healthy pregnancies and births while respecting women’s rights and dignity. Midwives provide care to patients at every stage of life, from preconception to postpartum, family planning to home delivery to breastfeeding support.

Important Links: Child Health Nursing Dissertation Topics , Adult Nursing Topics , Critical Care Nursing Dissertation Topics . These links will help you to get a broad experience or knowledge about the latest trends and practices in academics.

Midwifery Is A Good Fit for the Following:

● Those who want to work with women, especially those at risk of giving birth in a hospital setting. ● Those who enjoy helping people and solving problems. ● Those who like to be creative and solve complex problems. ● Those who want to help others and make a difference in their lives.

Midwifery is a career with many benefits for both the midwife and the baby. They are well-trained and experienced in caring for pregnant women and newborns and often have access to the exceptional care that other nurses may not have.

Midwifery Dissertation Topics With Research Aim

Topic:1 adolescence care.

Research Aim: Focus on comprehensive medical, psychological, physical, and mental health assessments to provide a better quality of care to patients.

Topic:2 Alcohol Abuse

Reseasrch Aim: Closely studying different addictions and their treatments to break the habit of drug consumption among individuals.

Topic:3 Birth Planning

Research Aim: Comprehensive birth planning between parents discussing the possible consequences of before, between, and after labour.

Topic:4 Community midwifery

Research Aim: Studying different characters in community midwifery and the midwife’s role in providing care for the infant during the early days of the child’s birth.

Topic:5 Contraception

Research Aim: Understand the simplicity of contraception to prevent pregnancy by stopping egg production that results in the fertilization of egg and sperm in the later stages.

Topic:6 Electronic fetal monitoring

Research Aim: In-depth study of electronic fetal monitoring to track the health of your baby during the womb, record construction per minute, and make a count of your baby’s heart rate.

Topic:7 Family planning

Research Aim: Importance to follow the basic rhythm methods for the couple to prevent pregnancy and use protection during the vaginal sex to plan a family without fertility treatments.

Topic:8 Foetal and newborn care

Research Aim: Expansion of the maternal-fetal and newborn care services to improve the nutritional quality of infants after delivery during their postnatal care time.

Topic:9 Foetal well being

Carefully tracking indications for the rise in heart rate of the fetal by weekly checkups to assess the overall well-being of the fetal.

Topic:10 Gender-based violence

Research Aim: Studying the consequences of male desire for a child that results in gender-based violence, harming the child’s physical and mental health.

Topic:11 Health promotion

Research Aim: Working on practices that help in controlling the amount of pollution of people, taking care of their overall health, and improving quality of life through adapting best health practices.

Topic:12 High-risk pregnancy

Research Aim: Calculating the ordinary risks of a high-risk pregnancy and how it affects a pregnant body resulting in a baby with poor health or any by-birth diseases, increasing the chance for complications.

Topic:13 HIV infection

Research Aim: Common causes of HIV infection and their long-term consequences on the body’s immune system. An in-depth study into the acquired immunodeficiency and the results leading to this.

Topic:14 Human Rights

Creating reports on human rights and their link with the freedom of thought, conscience, religion, belief, and other factors.

Topic:15 Infection prevention and control

Research Aim: Practices for infection prevention and control using efficient approaches for patients and health workers to avoid harmful substances in the environment.

Topic:16 Infertility and pregnancy

Research Aim: Evaluating the percentage of infertility and pregnancy, especially those facing no prior births, and who have high chances of infertility and pregnancy complications.

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Midwives are nurses who provide continuous support to the mother before, during, and after labour. Midwives also help with newborn care and educate parents on how to care for their children.

How Much Do Midwives Make?

The salary of a midwife varies depending on the type of work, location, and experience of the midwife. Midwives generally earn $132,950 per year. The average annual salary for entry-level midwives is $102,390.

The minimum requirement for becoming a midwifery nurse is a bachelor’s degree in nursing, with the option of pursuing a master’s degree.

An accredited educational exam can also lead to certification as a nurse-midwife (CNM). The American College of Nurse-Midwives (ACNM) enables you to practice independently as a midwife.

There are many pros and cons to working as a midwife. As a midwife, you have the following pros and cons:

Midwives have the opportunity to help women during one of the most memorable moments in their lives.
Midwives can positively impact the health of mothers and their children.
Midwives can work in many hospitals, clinics, and homes.
In midwifery, there are many opportunities for continuing education and professional development.
You will often have to work nights and weekends, which can be mentally draining.
You will have to travel a lot since most births occur in hospitals or centres in different areas.
You will have to deal with stressors such as complex patients and uncooperative families.
You will be dealing with a lot of pain, so you need to be able to handle it without medication or other treatment methods.

A career in midwifery is a great fit for those with a passion for health and wellness, an interest in helping people, and a desire to work in a supportive environment.

It is important to become involved in your local midwifery community if you are contemplating a career in midwifery – the best source of learning is your major research work, along with writing a lengthy thesis document on midwifery dissertation topics that will submit to your university to progress your midwifery career.

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How to find midwifery dissertation topics.

To find midwifery dissertation topics:

Explore childbirth challenges or trends.
Investigate maternal and infant health.
Consider cultural or ethical aspects.
Review recent research in midwifery.
Focus on gaps in knowledge.
Choose a topic that resonates with your passion and career goals.

Best Midwifery Dissertation Topics Ideas & Examples

Table of Contents

List of Midwifery dissertations Topics and Some Tips for Selecting Better Dissertation Topics in Midwifery

Many students feel difficulty in pursuing their studies in midwifery, let alone making a selection of topics for the dissertation. If you are searching for examples of midwifery literature review topics, midwifery research topics, midwifery dissertation titles , midwifery dissertation topics, or midwifery research questions this post is for you.

Do you belong to the above group of students who are not only shy but are also confused about how to make a selection of dissertation topics in midwifery for the midwifery dissertation?

Let’s first define what midwifery means and what its importance is in our social and medical structure.

What is Midwifery?

Midwifery is a healthcare profession that provides care to childbearing women during pregnancy, labor, and birth and during the postpartum period. They take care of the newborn and the mother. They also provide primary care to women which includes primary care to women, gynecological examination of women, family planning, and menopausal care.

In the nursing profession, students may be asked to write a dissertation on any topic of midwifery.

Tips for Selecting Midwifery Dissertation Topics

Like any dissertation in which it is difficult to choose a topic and write it, midwifery dissertations also students face the same problem. So, it is not an exception. However, one must know the important areas for the selection of the topic for the dissertation. Therefore, prior to the final selection of the topic, there are some important tips that would help students in selecting midwifery dissertation topics. These tips are as follows.

The students must be sure that they are going to discuss one of the most important topics in the subject.
The dissertation on midwifery must touch on some of the serious problems which are faced by mothers and newborns.
The students must take care that their topic is specific, and it is not broad in its nature.
If someone has chosen a narrow topic, he/she must expand it through research and writing.
Clear attention should be given to traditional midwifery dissertation topics in order to know their content and scope.
The topic chosen must be aimed at explaining the profession in greater detail. The students choose the research topic which can help to improve the healthcare of mothers and their children.
The students must enhance their basic knowledge for a better understanding of the subject.

Prenatal Care:

The role of midwives in promoting healthy prenatal behaviors
Assessing the effectiveness of prenatal education programs
Addressing cultural barriers in accessing prenatal care

Postpartum Care:

Strategies for improving postpartum support for new mothers.
The impact of postpartum depression on maternal health outcomes
Exploring alternative postpartum care models, such as home visits

Labor and Delivery:

Examining the use of pain management techniques during labor
Investigating the influence of birth environment on labor outcomes
Evaluating the role of midwives in reducing cesarean section rates

Maternal Health:

Addressing disparities in maternal healthcare access
Exploring the impact of maternal nutrition on birth outcomes
Investigating interventions to reduce maternal mortality rates globally.

Neonatal Care:

Assessing the effectiveness of breastfeeding support in neonatal care units
Exploring the role of midwives in neonatal resuscitation
Investigating best practices for kangaroo care in low-resource settings

Women’s Health:

Examining midwifery-led models of women’s health care
Investigating the role of midwives in promoting sexual and reproductive health
Addressing cultural taboos surrounding women’s health issues

Family Planning:

Evaluating the impact of contraceptive counseling provided by midwives
Exploring the role of midwives in providing abortion care
Assessing barriers to accessing family planning services in rural areas

Midwifery Education and Training:

Assessing the effectiveness of simulation training in midwifery education
Exploring innovative teaching methods in midwifery programs
Investigating strategies for mentorship and professional development in midwifery

Midwifery Ethics and Legal Issues:

Examining ethical dilemmas faced by midwives in clinical practice.
Exploring legal frameworks for midwifery practice across different countries
Assessing the impact of litigation on midwifery practice

Mental Health in Pregnancy and Childbirth:

Investigating the prevalence of anxiety disorders in pregnant women
Exploring interventions for addressing trauma in childbirth
Assessing the role of midwives in identifying and supporting women with perinatal mental health issues

Integrative Medicine in Midwifery Practice:

Exploring the integration of complementary therapies in midwifery care
Assessing the safety and efficacy of herbal remedies during pregnancy and childbirth
Investigating cultural practices and rituals surrounding pregnancy and birth

Technology in Midwifery:

Examining the use of telemedicine in midwifery practice
Exploring the impact of mobile health applications on maternal and neonatal health outcomes
Assessing the role of artificial intelligence in improving prenatal diagnosis and monitoring

LGBTQ+ Inclusive Care:

Investigating the experiences of LGBTQ+ individuals in maternity care settings
Assessing cultural competency training in midwifery education programs
Exploring strategies for creating inclusive and affirming birth environments

Global Health and Midwifery:

Examining the role of midwives in addressing maternal and neonatal health disparities in low-income countries
Investigating the impact of international partnerships on improving midwifery services
Assessing the cultural appropriateness of western midwifery models in diverse global contexts

Midwifery and Public Health:

Exploring the role of midwives in promoting breastfeeding initiation and duration
Assessing the impact of midwifery-led prenatal care on birth outcomes
Investigating strategies for reducing maternal and neonatal morbidity and mortality through public health interventions

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Browsing Nursing and Midwifery (Theses and Dissertations) by Title

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A never-ending love story : a narrative exploration into the experiences of men who provide care in the context of dementia

Alcohol use and alcohol-related harms: Exploring risk and protective factors among young people living in urban disadvantage

An action research study evaluating the effect of an action learning programme on healthcare professionals' knowledge, attitudes and practice

An exploration of mothers' experiences in caring for children with complex needs

An exploration of stigma towards depression in rural Ireland : a mixed methods study

An exploration of the respite needs and experiences of parents caring for a child with a life-limiting condition requiring palliative care

An exploration of women's expectations of and preferences for childbirth experiences : a mixed methods study

Anxiety during pregnancy and at three months postpartum: prevalence, variations and associated factors in a cohort of nulliparous women

Attenuating anxieties : mental health nurses' responses to suicidal behaviour: a grounded theory study

Attitudes and perceptions of medical and nursing staff to an emergency nurse practitioner service

Breaking bad news: a phenomenological study into the giving and receiving of a cancer diagnosis

Breastfeeding support groups in Ireland: a mixed methods investigation from a cultural historical activity theory perspective

Bullying and work related post traumatic stress in nurses

Caesarean section in nulliparous women: a mixed methods study of factors influencing decision-making and outcomes for women - the MAMMI Study Caesarean Section Strand

Change and entrenchment in Irish maternity care policies and antenatal practices: An Institutional Ethnography

Characteristics of Social Frailty among Older Adults with Intellectual Disability

Childbirth in exile : refugee and asylum seeking women's experience of childbirth in Ireland

Children who live in disadvantaged areas: a case study of the health and well-being perceptions and experiences of school-aged children and their families

Children's and Parents' Experiences and Expectations of their Roles in Hospital-A Constructivist Grounded Theory study

Cognitive Dissonance and Depression: An Exploration Using Mixed Methods

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Interesting 40+ Midwifery Dissertation Topics for Students

Latest Midwifery Dissertation Topics 2023

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What Do You Understand by Midwifery Dissertation?

How to choose midwifery dissertation topics, latest midwifery dissertation topics 2024, trending midwifery dissertation topics 2024, midwifery dissertation literature review help, how our professionals can help.

Students are pursuing their studies in midwifery with the primary motive of gaining knowledge. Getting subject expertise requires hard work and concentration. Apart from that, students need to conduct a self-evaluation to examine their performance and progress. But talking specifically about midwifery dissertation topics, it offers a different range of research opportunities to explore maternal and newborn care. The term midwifery means it is a health profession that comes with the care of mothers and the various stages of pregnancy, childbirth, and the early postnatal period. To know more, read the information given in this blog, as it will tell you everything you need and will remove your query. Can anyone help me write my dissertation?

Midwifery refers to the healthcare of childbearing women and infants from pregnancy to post-birth. Where child protection during the pregnancy period is vital, maternal healthcare is also necessary. You can even use references from midwifery dissertation ideas to get clarity.

When it comes to writing a lengthy document on midwifery, it allows researchers and doctors to find ways to avoid maternal and infant mortality. Therefore, medical students must choose good midwifery dissertation topics in their academics and dissertation modules. Now that you have understood the meaning, let’s move on to the next section on how you choose such topics.

Many students face difficulty pursuing their studies in midwifery. Like any dissertation, it is tough to choose a topic and write about it. Midwifery dissertation topics give you the same feeling at times. It is not an exception. However, you must know the essential areas for selecting the topic for the dissertation. Therefore, first to last topic selection, read some of the tips that can help you on how to write a midwifery dissertation. The tips are as follows:

You need to be sure of the focal point you will discuss and elaborate on the topic throughout the whole document. It will help you with topic selection in a better way.
You can even look at the midwifery dissertation examples to take reference and get the basic idea. The examples will give you an idea of how you can choose a topic to minimize the hurdles.
The midwifery dissertation must convey and focus on the serious problems faced by mothers and newborns. So you must choose a topic around that only.
You need to ensure that dissertation topics in midwifery are specific and not too broad. In the topic selection process, you need to determine how much you can elaborate on and provide information.
If you have chosen a narrow topic, you must broaden the field of research and writing. In this type of dissertation, research is a core element. So regarding it, you need to do proper research so that while writing, you don’t face any problems.
Must give proper attention to traditional midwifery dissertation ideas about the topics to know the content flow and scope.
The midwifery dissertation topics should aim to explain the profession in depth. It should define the focal point rather than going off track.
Try to enhance your basic knowledge to understand the subject better. Knowledge is a core element because, without it, you cannot write and develop your thought process. You can even refer to midwifery dissertation titles.
You can choose a topic on maternal health care and their infants. These types of topics are generic and descriptive. You can choose your topics around these terms to make the process easier.

Now that you have understood how to choose midwifery nursing dissertation topics. Let's explore the best topics that you can get the idea from. Therefore, these can be the topics of nursing also. You can also get assistance from nursing dissertation help for your convenience.

We have listed some of the latest dissertation topics in midwifery to help you find good topics relatable to your research. Read the topics carefully and understand how they can benefit you in the topic selection process.

The Adverse cause of recurrent miscarriage
The cultural perspective on male midwives
How practical are the WHO perinatal recommendations?
Role of DNA testing in diagnosing a child's hereditary condition
Trends involving males who work as midwives
Elaborate on Surgical success in treating an umbilical hernia
What are the hereditary factors that contribute to miscarriage?
The significant importance of eating well and being nourished when pregnant
Treatment for a ruptured hernia
Midwives' treatment of postpartum depression
Perinatal treatment for disabled women
Miscarriages' underlying mechanisms
What is the difference between pregnant women's expectations and birthing experiences?
What dangers lurk in-home abortions?
Techniques for promoting a normal birth during the second stage of labor
Why do umbilical cord hernias occur?
What part do infections play in miscarriages?
The right to pick one's birthplace
Management of perinatal depression
Obese women are still able to give birth typically, right?
Describe the variables that prevent natural birthing.
Taking care of hepatitis B while pregnant

Selecting midwifery dissertation topics from the mentioned examples helps and makes your efforts countable. When you finish the deep analysis, our professionals have drafted these ideas for you to save time. You need to pick the topic that interests you and begin working on it. Therefore you can also get dissertation help from experts for your convenience. If you still feel 23 topic ideas are not enough, below are some more topics to take help from.

Also Read: Mental Health Dissertation Topics

It is understandable how difficult is to research a specific topic for dissertation writing. We have a qualified team of expert writers with good experience to give you some of the trending midwifery dissertation topics. It will give a basic idea of the current issues happening in the midwifery field.

Uses, expectations, perspectives, and experiences with birth plans
What causes pregnancy fear, and how can midwives help women?
Nurses and midwives manage hypoglycemia in healthy-term newborns
Midwife experiences with asylum seekers' maternity care
Pregnancy, childbirth, and IPV relationships
Increasing normalcy with midwifery care: aquatic births
During the postnatal period, it reduces pain and infection and promotes healing of the sutured perineum
Fathers' postnatal depression
Antidepressants and postnatal depression
Enhanced maternal safety in the Philippines
Pediatric, obstetric, and clinician-indirect home interventions for the Medicare population
A comprehensive assessment of the qualitative literature on the experiences of health workers in acute hospital settings with teamwork education
How have "care pathway technologies" affected integrating services in stroke care?
How strong is the evidence for their success in this area?
Our nation has a midwifery culture
Midwives have experience with difficult deliveries
Knowledge of gender in midwifery
Early midwives among the Native Americans: The art of midwifery
Midwifery trends happening in the nursing practice
What role does midwifery play in society?
A comprehensive assessment of the experiences of midwives and nurses working together to offer childbirth care
Relationship between women and midwives and childbirth education in your nation.

These interesting midwifery dissertation topics can impress your professors and will give you quick approval as professionals choose them personally. So if you face issues while writing a dissertation you can linger upon it by taking professional assistance and giving all your worries to the professional's.

Also Read: Quantity Surveying Dissertation Topics

Writing a midwifery dissertation is similar to a doctoral-level dissertation. Moreover, the area of study is highly competitive, and often it is a little time-consuming. Talking about midwifery dissertation topics it consists of dissertation literature segments also.

Midwifery Dissertation Literature Review Help

Choosing the Right Research Materials

When you are ready to start writing your dissertation, you require assistance from different areas to ensure to write the content properly. You need help to find the correct research materials can be online references or online libraries.

The Professional Editor Assistance

Finally, your next area of help will be with the assistance of an expert editor; however, taking help from them will be the best. They will be checking your grammar and spelling, as well as analyzing your argumentative choices.

If you do not understand how to research Midwifery dissertation topics, you can also take the help of experts.

Women's Physicians Group

The advisors will be more interested than willing to assist in your writing tasks. Another source of advice in your midwifery dissertation literature review help is the women's physician's group. It is a group of female physicians before they entered medical school and is specifically for women in the medical field.

Do you want to expertise in midwifery or need assistance with medicine nursing dissertation topics? We have a skillful team of experts to help you and can write your dissertation with 100% quality and accuracy.

As a nursing and midwifery student, you may need a dissertation written by an expert writer. Furthermore, it might require giving a dissertation structure and writing a dissertation proposal. We can give you all the essential steps to give what you need. It requires a lot of concentration. That is why you can get help from a professional writer who can complete your dissertation on time.We can give you all the essential steps to give what you need. Talking about choosing midwifery dissertation topics is not an easy job.

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Doctoral Thesis Collection

This midwifery PhD thesis collection is an exciting new initiative for the RCM.

The aim of the collection is to provide a platform for midwives to showcase their academic work, and to inspire and support midwives who are considering or who are currently undertaking further academic study. Additionally, the collection will provide a source of open access midwifery generated evidence for everyone to use.

The opportunity for midwives to include details of the resultant publications and their social media details and institutional link, if appropriate will hopefully also support the creation of professional networks related to their academic interests. Authors may have also published articles from their thesis, so please use an author’s contact details to ask about this.

If you are a midwife and have a completed a PhD and would like to include your thesis in this collection, please complete the online form below.

If you would like to search the Thesis Collection, "Control+F" (or "Command+F" on a Mac) is the keyboard shortcut for the Find command. Pressing the Ctrl/Command key + the F key will bring up a search box in the top right corner of your screen. You can then use this to search the Collection for keywords.

Submit details of your doctoral thesis to be included in the RCM collection

The Incarcerated Pregnancy: An Ethnographic Study of Perinatal Women in English Prisons

Prison Pregnancy, Incarceration Birth

The UK has the highest incarceration rate in Western Europe, with pregnant women making up around 6% of the female prison population. There are limited qualitative studies published that document the experiences of pregnancy whilst serving a prison sentence. This doctoral thesis presents a qualitative, ethnographic interpretation of the pregnancy experience in three English
prisons. The study took place during 2015-2016 and involved semi-structured interviews with 28
female prisoners in England who were pregnant, or had recently given birth whilst imprisoned,
ten members of staff, and ten months of non-participant observation. Follow-up interviews with five women were undertaken as their pregnancies progressed to birth and the post-natal phase.
Using a sociological framework of Sykes’ (1958) ‘pains of imprisonment’, this study builds upon existing knowledge and highlights the institutional responses to the pregnant prisoner. My original contribution to knowledge focuses on the fact that pregnancy is an anomaly within the patriarchal prison system. The main findings of the study can be divided into four broad concepts, namely: (a) ‘institutional thoughtlessness’, whereby prison life continues with little thought for those with unique physical needs, such as pregnant women; and (b) ‘institutional
ignominy’ where the women experience ‘shaming’ as a result of institutional practices which
entail their being displayed in public and characterised with institutional symbols of
imprisonment. The study also reveals new information about the (c) coping strategies adopted
by pregnant prisoners; and (d) elucidates how the women navigate the system to negotiate
entitlements and seek information about their rights. Additionally, a new typology of prison officer has emerged from this study: the ‘maternal’ is a member of prison staff who accompanies pregnant, labouring women to hospital where the role of ‘bed watch officer’ can become that of
a birth supporter. This research has tried to give voice to pregnant imprisoned women and to highlight gaps in existing policy guidelines and occasional blatant disregard for them. In this sense, the study has the potential to springboard future inquiry and to be a vehicle for positive
reform for pregnant women across the prison estate.

Threatened preterm labour: a prospective cohort study for the development of a clinical risk assessment tool and a qualitative exploration of women's experiences of risk assessment and management.

Preterm birth, risk, prediction

Background: Preterm birth (PTB) is a major cause of infant morbidity and mortality, and accurate assessment of women in threatened preterm labour (TPTL) is vital for identifying need for appropriate intervention. Risk assessment in TPTL is challenging, however, due to its complex and multifactoral nature. In many women, TPTL symptoms do not progress to spontaneous PTB (sPTB) so assessment that reassures quickly, often through use of tests, e.g. fetal fibronectin (fFN) and cervical length(CL), may reduce unnecessary intervention and decrease anxiety. Aims: This PhD project had two main objectives: first to improve TPTL risk assessment by further developing the clinical decision support tool, the “QUIPP” mobile phone application, which simplifies risk assessment by calculating individual % risk of sPTB based on risk status, fFN and CL results. The second objective was to understand TPTL from the women’s perspective in order to inform future improvements in care.

Method: The study comprised three components: 1) a prospective cohort study, collecting data on risk factors, test results and interventions. Predictive utility of fFN and CL were investigated, as well as generation and validation of risk prediction algorithms for the second version of QUIPP; 2) a qualitative study of women’s experience of TPTL through one-to-one semi-structured interviews; 3) a qualitative study of clinicians using the first version of QUIPP.

Results: Cohort study: 1186women were recruited at 11 UK hospitals between March 2015 and October 2017, with data available for analysis on 1037. Prevalence of sPTB was 3.9% (40/1037)and 12.1% (125/1037) at <34 and <37 weeks’ gestation, respectively. Validation of QUIPP algorithms, using risk factors and fFN results alone, demonstrated good prediction of sPTB <30 weeks’ gestation (AUC 0.96, 95% CI 0.94-0.99) and at <1 week of testing (AUC 0.91, 95% CI 0.87-0.96). Qualitative study: Four themes emerged following interviews with 19 women: i) coping with uncertainty; ii) dealing with conflicts; iii) aspects of care and iv) interactions with professionals. QUIPP users’ study: 10 clinicians expressed predominantly positive views and suggested improvements.

Conclusion: All components of this project informed development of QUIPP v.2 (algorithms and design), which appears superior in predicting sPTB compared to previously reported predictive utility of fFN, CL and QUIPP v.1 algorithms. The qualitative study was the first exploring women’s experience of TPTL in a UK hospital with a specialist preterm service, and findings further support the need for women of all risk groups to have timely access to advice and information, and continuity of care.

Grading student midwives’ practice: a case study exploring relationships, identity, and authority.

Grading practice, students, Assessment, Midwifery knowledge

Grading students’ practice in the UK is a mandatory requirement of midwifery programmes regulated by the Nursing and Midwifery Council. This thesis explores how grading affects midwifery students, mentors and lecturers’ relationships, identity and authority. Individual and group interviews with fifty-one students, fifteen mentors and five lecturers, recruited from three local NHS Hospital Trusts and a university provided a diversity of views and experiences. This was complemented with documentary data from student practice grades, practice assessment documents and action plans from underperforming students. The analytical framework for this case study draws on Basil Bernstein's pedagogic codes using the concepts of classification and framing. This enabled an exploration of what counted as valid practice knowledge, teaching and learning in clinical practice and the evaluation of learning.Differences between students, with respect to their orientation to midwifery knowledge, types of practice knowledge and relationships between the hospital and community mentors were identified. Despite these, students were consistently awarded high practice grades. The environment seemed to affect the structural and interactional practices between students and mentors and, according to Bernstein’s theory, should have affected the practice grade. However, there was limited stratification of grades. Therefore, the grades have been interpreted as competence rather than performance of midwifery and symbolise acceptance into the profession. Reasons for this were offered. This study provides a unique insight into grading students’ practice, resulting in recommendations such as the separation of the role of mentor from assessor as well asa call for greater assessment of communication skills and evidence to inform midwifery practice. New models of teaching and assessment in clinical practice may enable a change of pedagogic code. Understanding the complexity of the practice area and the types of discourses it produces is necessary to enable all students equal access to midwifery specific knowledge.

Home birth and the English NHS: Exploring the dynamics of institutional change in the context of health care.

Home birth; deinstitutionalisation; midwifery

This study aimed to understand and explain the work involved in creating, maintaining and disrupting divergent models of health service organisation and delivery, with a specific focus on maternity care provided to healthy women who chose to give birth at home. It investigated questions about the priorities that frame the allocation and management of health service resources and sought to understand how opportunities to advance new institutional practices were recognised, created or resisted by different stakeholders. This study drew upon concepts of deinstitutionalisation to examine why the disappearance of older institutional practices [in this instance, home birth] were not always inevitable when a newer practice [such as an obstetric unit birth] became prevalent or dominant. Work examining mature institutional fields exposed to modernising influences has suggested that non-dominant professional groups appear to engage in countervailing activities that maintain the persistence of older institutional practices while making efforts towards reinstitutionalisation. To date, studies have tended to focus attention at the top of organisations or on embedded or dominant occupational groups. This study has expanded and developed understandings of the agentic activity undertaken by a non-dominant professional group that sit largely outside strategic management and funding structures who sought to re-legitimise institutional practices which had been eroded or threatened with extinction. Methodology and methods: This was a multiple case site study that employed a variety of qualitative research methods. This was compatible with institutional theory which has sought to examine how enduring social patterns and arrangements are constructed, become taken for granted and treated as inevitable. This study engaged with three separate organisations providing maternity services and a range of organisations and individuals associated with, or affected by this activity. The case sites were selected to represent a range of settings, conditions and relationships that are recognisable across the English National Health Service (NHS). Intended contribution: The theoretical contribution of this study is to organisational and medical sociology questions about occupational relationships and the priorities that frame the allocation and management of health service resources. This was achieved by identifying institutional work both seeking to reinforce or resist existing medicalised and acute-focused maternity services. Practically, this study engaged with the socio-cultural and political complexities of maternity services’ organisation and delivery. It provides information for policy-makers, service leaders and innovators who are contemplating implementing changes in contexts where home birth services are under-developed or under-performing.

Meeting the health and social needs of pregnant asylum seekers; midwifery students' perspectives.

Critical discourse analysis, midwifery students, problem-based learning as a research method,
pregnant asylum seekers.

Current literature has indicated a concern about standards of maternity care experienced by
pregnant asylum seeking women. As the next generation of midwives, it would appear essential that students are educated in a way that prepares them to effectively care for pregnant asylum seekers. Consequently, this study examined the way in which midwifery students constructed a pregnant asylum seeker’s health and social needs, the discourses that influenced their
constructions and the implications of these findings for midwifery education. For the duration of year two of a pre-registration midwifery programme, eleven midwifery students participated in
the study. Two focus group interviews using a problem based learning (PBL) scenario were conducted. In addition, three students were individually interviewed and two students’ written reflections on practice were used to construct data. 2 Following a critical discourse analysis, dominant discourses were identified which appeared to influence the way that pregnant asylum seekers were perceived. The findings suggested an underpinning discourse around the asylum
seeker as different and of a criminal persuasion. In addition, managerial and medico-scientific discourses were identified, which appeared to influence how midwifery students approach their
care of women in general, at the expense of a woman centred, midwifery perspective. The findings from this study were used to develop “the pregnant woman within the global context” model for midwifery education and it is recommended that this be used in midwifery education, to facilitate the holistic assessment of pregnant asylum seekers’ and other newly arrived migrants’ health and social needs.

Birth Place Decisions: A prospective qualitative study of how women and their partners make sense of risk and safety when choosing where to give birth

Place of birth, risk, narrative, longitudinal

For the past two decades, English health policy has proposed that women should have a choice of place of birth, but despite this, almost all births still take place in hospital. The policy context is one of contested evidence about birth outcomes in relation to place of birth, and of international debate about the safety of birth in non-hospital settings; partly as a consequence of this, ‘birth place decisions’ have become morally and politically charged. Given the perceived lack of consensus about birth place safety, this study sought to explore the experience of making birth place decisions from the perspectives of women and their partners, in the context of contemporary NHS maternity care.

Longitudinal narrative interviews were conducted with 41 women and 15 birth partners recruited from three English NHS trusts, each of which provided different birth place options. Initial interviews were conducted during pregnancy, and follow up interviews took place at the end of pregnancy and again up to three months after the birth. Altogether, 141 interviews were conducted and analysed using a thematic narrative approach.

This research contributes new knowledge about how birth place decisions are undertaken and negotiated, and about the extent to which some are excluded from these choices. Participants’ beliefs about birth place risk originated in upbringing and drew upon normative discourses which positioned hospital as an appropriate setting for birth. Individual worldviews informed conceptualisations of birth place risk, and these were premised upon prioritisation of medical risks of birth, perceived quality of the maternity service or the likelihood that medical intervention would interfere with birth. These beliefs were often enduring and the overall tendency was for women to be increasingly conservative about their birth place options over time, but during their first pregnancies, participants views were most fluid and open to change.

An Interpretive Exploration of the Experiences of Mothers with Obesity and Midwives Who Care for the Mother During Childbirth

Obesity; Childbearing.

Obesity, as defined as a BMI ≥ 30 (kg/m2) had been established as a risk factor for increased morbidity and mortality during childbearing. There was a need for empirical research to explore the experiences of obese women and midwives during childbearing to stimulate debate and inform the delivery of care to this client group. This thesis provides a justification for a qualitative interpretivist study using semi-structured interviews with obese women and midwives. This study found that once an obese mother has been placed on the high-risk medicalised pathway, her choices are reduced and the ability to bring a sense of agency and choice to promote and support her own health is limited. The relationship with the midwife, which could have been focused on promoting the health and wellbeing of mother and baby, instead becomes a relationship of managing risk in a reductionist way. This makes it harder for both mothers and midwives to raise the issue of obesity, resulting in a tendency not to deal with the issue. Subsequently, the opportunities for health promotion offered by the midwife-mother relationship sustained over 7
to 8 months are lost, so that encouraging self-understanding and self-help in managing and reducing obesity cannot be achieved. The findings of this study suggest the need to enhance the health promotion role of the midwife. This thesis suggests reviewing the use of BMI, developing discussions about gestational weight gain and healthy lifestyle choices with women during antenatal care, and listening to mother’s lay theories, perceptions and concerns around weight. Midwifery care, which uses positive discourses and forward-facing care approaches and supported by continuity of carer schemes and access to midwifery-led care, could enhance the midwife’s health promotion role. This could lessen the risk of post-partum weight retention post-birth and enhance a new mother’s physical and emotional wellbeing.

Can an educational web intervention, co-created by service users, affect nulliparous women's experiences of early labour? (A randomised control trial)

Latent, Early, Digital, Experience

Women without complications have less obstetric intervention if they remain at home in early labour, yet report dissatisfaction in doing this, describing a disparity between expectations and the reality of this phase. A dichotomy exists between what is clinically beneficial (remaining at home) and what women require emotionally(support and reassurance). Previous research has been driven by maternity services’ needs, focusing on the transition between labour phases, commonly testing interventions that aim to improve clinical outcomes. Using self-efficacy theory, a web-based intervention was co-created providing early labour advice, alongside videoed, real-experiences of women who have previously had babies. The primary aim of this study was to evaluate the intervention’s impact on women’s self-reported early labour experiences. The intervention was trialled in a pragmatic RCT at an NHS Trust between 2018 and 2020. A total of 140 low-risk, nulliparous, pregnant women were randomised to the intervention group (n=69) or the control group (n=71). Data was collected at 7-28 days postnatally using the pre-validated Early Labour Experience Questionnaire (ELEQ). Secondary, clinical outcomes were also collected, as well as information about the acceptability and usability of the intervention. There were no statistically significant differences in the ELEQ scores between trial arms. The intervention group scored more positively in two of the three ELEQ subscale domains (emotional wellbeing and emotional distress) and less positively in the perceptions of midwifery subscale. Participants in the intervention group were less likely to require labour augmentation. The L-TEL Trial demonstrates that women evaluate aspects of their early labour experience continuum independently: an improved emotional experience does not necessarily equate to an overall improved experience of this phase. Equipping women to have better emotional experiences at home may negatively impact on their perceptions of midwifery care when sought. Further research is recommended on a larger scale to explore this.

A qualitative exploration of the role frontline health workers play in defining the quality of services provided to women experiencing an early miscarriage

Quality of Care, Early Miscarriage, Micro Organisational Theory, Frontline Staff

It is proposed that frontline health care workers in the English National Health Service (NHS) should have an important role in managing the quality of the services they deliver. Formal NHS quality management processes are structured in a highly rationalised way and the extent to which frontline workers have agency to apply their own knowledge to address suboptimal care practices is not well understood. This study explores how frontline NHS workers manage the quality of services offered to women experiencing an early miscarriage using qualitative semi-structured interview data collected from 34 frontline health care workers and managers from three hospitals in the North East of England. Secondary thematic data analysis, informed by micro-organisational theories, was used to explore the role of frontline health care workers in managing the quality of their services. This secondary analysis identified three key themes in the data; (1) the link between the quality gap and the difficulties associated with delivering humane and individualised care, (2) the role of collective understandings in defining the parameters of acceptable versus ideal quality of care, and (3) the use of discretionary practices to manipulate quality of care. These findings suggest that management of health care quality is complex and characterised by bureaucratic constraints that support
narratives of powerlessness and compromise amongst NHS workers. Structures that privilege rational models of organisational management pose a significant challenge to the delivery of relational
aspects of care. This study contributes to the evidence base by providing insight into the unseen discretionary practices frontline workers engage in to improve quality of care whilst also maintaining organisational functionality. These practices, based on collective beliefs about the parameters of “acceptable” quality of care, are paradoxical; they can improve quality for individual
patients but they also support the structures that create quality shortfalls in the first place. The findings of this study offer a model of optimal care for early pregnancy loss that could be used as a
framework on which to base quality improvement activities in this area. They also offer a unique insight into the issues that may result in suboptimal care practices perpetuating in the NHS, especially in relation to the delivery of humane and relational aspects of health care; this finding has implications for frontline clinicians, managers, educationalists and policymakers alike.

‘Practising outside of the box, whilst within the system’: A feminist narrative inquiry of NHS midwives supporting and facilitating women’s alternative physiological birthing choices.

Birth, guidelines, autonomy, midwives

This thesis presents the findings of an original study that explored NHS midwives practice of facilitating women’s alternative physiological birthing choices - defined in this study as ‘birth choices that go outside of local/national maternity guidelines or when women decline recommended treatment of care, in the pursuit of a physiological birth’. The premise for this research relates to dominant sociocultural-political discourses of medicalisation, technocratic, risk-averse and institutionalisation that has shaped childbirth practices in the UK. For midwives working in the NHS, sociocultural-political and institutional constraints can negatively impact their ability to provide care to women making alternative birth choices. A meta-ethnography was carried out, highlighting a paucity of literature in this area. Therefore, the aim of this study was to generate practice-based knowledge to answer the broad research question: ‘what are the processes, experiences, and sociocultural-political influences upon NHS midwives’ who self-define as facilitative of women’s alternative birthing choices’.Underpinned by a feminist pragmatist theoretical framework, a narrative methodology was used to conduct this study. Professional stories of practice were collected via self-written narratives and interviews to understand the processes of facilitation (the what, how, why), their experiences of carrying out facilitative actions (subjective sense-making), and what sociocultural-political factors influenced their practice. Through purposive and snowball sampling, a diverse sample of 45 NHS midwives from across the UK was recruited. A sequential, pluralistic narrative approach to data analysis was carried out, and a theoretical model was developed using the whole dataset. The findings were subjected to three levels of analysis.First, ‘Narratives of Doing’ highlight how and what midwives did to facilitate women’s alternative choices. The sub-themes reflect the temporal nature of a wide range of actions/activities involved when caring for women making alternative birthing decisions. The second analysis; ‘Narratives of Experience’ - highlighted the midwives polarised experiences captured as ‘stories of distress’, ‘stories of transition,’ and ‘stories of fulfilment’. For the third level of analysis, a theoretical model of ‘stigmatised to normalised practice’ was developed using notions of stigma/normal, deviance/positive deviance. A six-domain model was developed that accounted for the midwives sociocultural-political working contexts; micro, me so, and macro. The implications of this research related to a number of identified constraints, protective factors, and enabling factors for midwifery practice. Key barriers included negative organisational cultures that restricted both midwives’ and women’s autonomy. Disparities between the midwives’ philosophy and their workplace culture were highlighted as a key stressor and barrier to delivering woman-centred care. Protective factors related to the benefits of working in supportive, like-minded teams that mitigated against their wider stressful working environments. Facilitating factors included positive organisational cultures characterised by strong leadership where midwives were trusted and women’s autonomy was supported.Therefore, this study has captured what has been achieved, and what can be achieved within NHS institutional settings. Through the identification of both challenges and facilitators, the findings can be used to provide maternity professionals and services with insights of how they too can facilitate women’s alternative birthing choices.

Exploring decision making to create an active offer of planned home birth

Active offer, Planned home birth, Decision making, Social networks

Historically, the focus of the UK and international research exploring planned home birth decision making has been largely focused on understanding the experiences of women who decide to birth at home. As a result of high-profile research that suggests that non-OU birth locations are safe for low risk women, there has been a recent shift in focus resulting in research studies that aim to increase the rates of planned home birth, or more often the rates of all non-obstetric unit birth within the UK. However, despite this increased level of attention, the rate of home birth remains stubbornly low. Whilst there is some research to indicate why this might be the case, research that sheds a new light on the issue, and that develops an evidence base for new interventions is required. This thesis illuminates the factors that need to be considered in order to increase women’s abilities to make an informed decision about planned birth. A pragmatic approach, using mixed methods, was used to explore the current way that we offer planned home birth to maternity service users, and to ultimately make suggestions about how this could be improved. The application of active offer theory to the offer of planned home birth has been undertaken for the first time, and this has generated a new and useful perspective on this area of midwifery practice.

The resultant two-stage AOPHB process has the potential for developing midwifery practice in terms of supporting midwives to understand and facilitate women’s decision making around home birth, providing a flexible tool that can be used in clinical practice. This is the first approach that has been developed with the aim of increasing the ability of women to make an informed decision about whether they wish to birth at home.

Returning to the Path. A hermeneutic phenomenological study of parental expectations and the meaning of transition to early parenting in couples with a pregnancy conceived using in-vitro fertilisation

In Vitro Fertilisation, Hermeneutic Phenomenology, Pregnancy, Parenthood

Aim: To gain insight into the lived experience of the transition to parenthood for couples with a singleton IVF pregnancy.

Design: Heideggerian hermeneuticphenomenological study.

Methods: Data was collected in 2015, three couples were interviewed on three occasions each, using unstructured interviews; at 34weeks of pregnancy, six weeks and three months postpartum. Interviews lasted 32 -80 minutes (mean: 53) audio data later transcribed. Crafted stories (Crowther et al 2016) were used for analysis and an adaptation of Diekelman et al (1989) on both cross-sectional and longitudinal data.

Findings: The experience of pregnancy and parenting is influenced by the journey to conception and through pregnancy. ‘Returning to the Path’ was identified as the point couples had anticipated being at several years earlier. It drew on three over-arching themes: Seeking the Way, Returning to the Path and Journeying On.

Conclusion: Infertility is a deviation from the life path that a couple anticipated, returning to that path occurs at different times for different couples and is influenced by differing factors. The pregnancy may be experienced as a ‘tentative’ progression, however following birth, parenthood was embraced with an instinctive, baby-led style. Transition to parenthood was aided by social support and reliance on the couple relationship.

Impact: Findings have implications for those who support couples with IVF pregnancies in recognising their, often unspoken, concerns throughout pregnancy, shown as a reluctance to look too far ahead. They also need to appreciate the differing points at which these anxieties can recede.

Twitter: @suzannehardacr1

The experience of pregnant women being offered influenza vaccination by their midwife, a
qualitative descriptive approach

Pregnancy, Vaccination, Influenza, Risk

Aim To explore, interpret and develop an understanding of pregnant women’s experience of
being offered the seasonal influenza vaccination by their midwife and whether this affects the woman’s decision to either accept or decline the vaccine. Research Question ‘Does the
relationship between the woman and the midwife impact on the woman’s decision to accept or
decline the seasonal influenza vaccination in pregnancy?’ Objectives 1 To investigate factors
which when drawn from women’s experience of being offered the seasonal influenza vaccination, influence their decision to accept or decline the vaccine. 2 To explore whether women’s experience of the antenatal environment in which the midwife/ woman discussion takes place has any influence on the decision to accept or decline the vaccine. 3 To identify whether women’s experience differs according to their geographical location.

Methods The study was carried out within five geographical Boroughs within a large University Health Board in South East Wales. Semi-structured interviews were held with twelve pregnant women. A qualitative descriptive approach was used and data were analysed thematically. The theoretical framework of ‘reproductive citizenship’ developed by Wiley et al (2015) was used for interpretation of the study findings

Findings Women’s beliefs conflicted with their actions. Participants believed they were not at risk of influenza yet had the vaccination regardless. Characteristics of wanting to be a good mother and doing the right thing were evident, despite many competing priorities of pregnancy. The environment in which the women had their vaccination was not of concern and they displayed a quiescent approach to the influenza vaccination within the context of their antenatal care. Women placed trust in the midwife, relying on their advice without question. Discussion Fatalism, passive acceptance and influence of the healthcare professional was apparent, and participants spoke warmly of the ‘good midwife’. Magical beliefs and superstition explained the women’s perception of risk, derived from family experience. Fate, luck and perceived lack of control over life events framed women’s views. Women placed trust in the midwife taking comfort in that the knowledgeable professional was making the iii right decision ‘for them’ displaying traits of quiescent reproductive citizenship as characterised by Wiley et al (2015). Conclusion Influenza vaccination and the consequence of disease were perceived to be low down amongst many competing priorities of pregnancy. Participants did not believe that they were at risk of influenza disease and sometimes shifted responsibility for decision making to the midwife, placing trust in the mother / midwife relationship.

Rethinking postnatal care: A Heideggerian hermeneutic phenomenological study of postnatal care in Ireland

Postnatal care; Women's lived experiences; Future postnatal care possibilities; Heideggerian hermeneutical phenomenology

The postnatal period is an important and extremely vulnerable time for new mothers and their infants. Research has outlined the considerable extent of maternal physiological and psychological morbidity following childbirth. The underreporting and undiagnosed aspect of this morbidity has also been highlighted. Newborn infants are totally dependent on their needs being met and are also at risk of newborn conditions particularly if they are undiagnosed, for example neonatal jaundice. There is however, mounting evidence regarding the lack of postnatal support from health professionals, with women continuing to report their dissatisfaction with postnatal care. Research into postnatal care is pre-dominantly quantitative and clinically focused. Few empirical studies have examined the meaning women give to their postnatal care experiences. This research aims to generate a deeper understanding of the meanings, and lived experiences of postnatal care. In addition, it aims to reveal future possibilities to enhance women’s postnatal care experiences. Initially, an in-depth examination of relevant literature is undertaken followed by a presentation of the process and findings from a qualitative meta-synthesis. An in-depth exploration of Martin Heidegger’s biography and explication of his philosophy is then outlined. This research is a Heideggerian hermeneutical phenomenological study of Irish women’s aspirations for, and experiences of, postnatal care. Purposive sampling is utilised in this research, which was undertaken in two phases. Phase one involved group interviews over three different time periods
(between 28-38 weeks gestation, 2-8 weeks and 3-4 months postnatally), with a cohort of primigravid women and a cohort of multigravid women. The second phase involved recruiting two further cohorts of primigravid and multigravid women who participated in individual in-depth interviews over the same longitudinal period. In total nineteen women completed the study. Thirty-three interviews were held in total. The data analysis is guided by Crist and Tanner’s (2003) interpretative hermeneutic framework. The women’s aspirations/expectations for their postnatal care are represented through three interpretive themes: ‘Presencing’, ‘Breastfeeding help and support’ and ‘Dispirited perception of postnatal care’. In addition, five main themes emerged from the data and capture the meanings the women gave to their lived experiences of postnatal care: ‘Becoming Family’, ‘Seen or not seen’, ‘Saying what matters’, ‘Checked in but not always checked out’ and ‘The struggle of postnatal fatigue’. The original insights from this research clearly illuminate the vulnerability women face in the days following birth. A further in-depth interpretation and synthesis of the findings was undertaken. This philosophical-based discussion drew from the work of Heidegger (1962) and Arendt (1998). Engaging with these theoretical perspectives contributed to a new understanding about why some women within a similar context, have positive experiences of postnatal care while others do not. As such, the very nature that midwives and other postnatal carers are human beings has an influence on a woman’s experience of her care. These carers, in their exposition of ‘being’ have the ability to demonstrate ‘inauthentic’ or ‘authentic’ caring practices. It is those who choose to be ‘the sparkling gems’ that
are the postnatal carers who make a difference and stand out from the others. For the women in this study, their postnatal care experiences mattered. While some new mothers reported positive and meaningful experiences others revealed experiences which impacted unnecessarily. The relevance of these findings, recommendations and suggestions for future research are offered.

Conscientization for practice: The design and delivery of an immersive educational programme to
sensitise maternity professionals to the potential for traumatic birth experiences amongst
disadvantaged and vulnerable women.

Critical pedagogy, Birth trauma, immersive education, maternity

Birth is an important time in a woman’s life. While the journey into motherhood can be a
transformational and liminal experience, unfortunately, this is not the case for every woman. It is estimated that approximately 30 % of women experience childbirth as a traumatic event, with up
to 4% of women in community samples developing Post Traumatic Stress Disorder (PTSD) following childbirth. It is also highlighted that women who are vulnerable and disadvantaged, due to complex life situations such as poor mental health, poverty and social isolation, are more
likely to experience birth trauma and PTSD onset. Recent research highlights that women’s subjective experience of birth is one of the most important factors in determining birth trauma, and that negative interactions with health care professionals are a key contributor to its development. The aim of this study was to develop and evaluate a training programme for maternity care providers to raise awareness of birth trauma amongst disadvantaged and
vulnerable women. A critical pedagogical approach was adopted so that the design of the programme would aid reflection, critical thinking and conscientization. This study includes a meta-ethnographic review, empirical interviews and the design and delivery of a tailored educational programme within an NHS Trust. Firstly, a meta- ethnography was undertaken to explore disadvantaged and vulnerable women’s negative experiences of maternity care in high
income countries. Noblit & Hare’s (1988) meta ethnographic approach was used and four themes were identified through the synthesis of eighteen studies; ‘Depersonalisation’
‘Dehumanisation’, ‘Them & us’ and ‘No care in the care’. Secondly, ten local disadvantaged and vulnerable women in North West of England were recruited and interviewed, exploring their
negative experiences of birth. A framework analysis was used to interpret the data, identifying
key triggers for birth trauma, focused on interpersonal interactions with maternity healthcare professionals. These findings were then compared against studies included in the metaethnography. Following these stages an innovative educational programme focused on birth trauma and PTSD was developed and evaluated. Key findings from the meta- ethnography and the empirical interviews informed the content of a filmed childbirth scenario that was embedded within a critical pedagogical framework. The scenario was delivered to participants’ using virtual reality (VR) technology, forming part of a 90- minute educational programme, in which maternity
professionals view the scenario iii from a first-person perspective. Other elements of the education programme involved providing statistical evidence on birth trauma and PTSD, a presentation of qualitative data collected during empirical phases, critical reflections and the development of actionable practice points to change/influence care practice, for self and others. Ten maternity professionals participated in the evaluation, with pre/post questionnaires and a follow-up session used to assess participants attitudes, knowledge and experiences prior, during and following attendance. Findings suggest the immersive educational programme increased participants understanding and knowledge of birth trauma and PTSD, with the use of VR as a tool for knowledge translation found to enhance critical reflection and facilitate praxis. While further research to test the efficacy of the educational programme on women’s birth experiences is needed, simulated first person realities, embedded within a critical pedagogical framework, offer
a unique and innovative approach to addressing interpersonal care in maternity and wider health- related contexts of care.

Twitter: @ClaireHooks

An exploration of student midwives’ attitudes toward substance misusing women following a specialist education programme.

Substance Misuse, Pregnancy, Attitudes, Education

Substance misuse is a complex issue, fraught with many challenges for those affected. Whilst the literature suggests that pregnancy may be a ‘window of
opportunity’ for substance misusing women, it also suggests that there are barriers to women engaging with health care. One of these is fear of being judged and
stigmatised by healthcare professionals, including midwives. Previous research indicates midwives have negative regard toward substance users and that this in turn may lead to stigmatising behaviours and consequential substandard care provision. Midwives however, stress that they do not have appropriate training to effectively provide appropriate care for substance misusers. Research suggests that education is needed in this area to improve attitudes. In this study, the role of education in changing attitude toward substance use in pregnancy was explored using case study methodology. The case was a single delivery of a university degree programme distance learning module ‘Substance Misusing Parents,’ undertaken by 48 final year student midwives across 8 NHS Trusts. The research was carried out in 3 phases, using a mixture of Likert style questionnaires (Jefferson Scale of Physician Empathy and Medical Condition Regard Scale), Virtual Learning Environment discussion board qualitative data and semi structured interviews. The findings of the questionnaires showed empathy toward pregnant drug using women significantly improved following the module (p=0.012). Furthermore, exploration of the students’ experiences of the module demonstrated the importance of sharing and reflecting on practice; the experiences of drug users, both positive and negative; and having an opportunity to make sense of these experiences, as key in influencing their views. Furthermore, the findings indicated value in the mode of delivery, suggesting e-learning to be an effective approach. This research
demonstrates the potential of education in this area but also offers suggestions for educational delivery to reduce stigma in other areas of practice.

Twitter: @ljenkinsmidwife

Recovering the clinical history of the vectis: the role of standardised medical education and changing obstetric practice.

Vectis Education Practice

This thesis explores the use, and later non-use, of the vectis – an instrument invented in the seventeenth century by the Chamberlen family, along with its sister instrument, the forceps. Both instruments were designed to deliver a living baby when birth was obstructed by the head, but their histories were very different. In Britain, the forceps came into the public domain in 1733, the vectis in 1783, after which their respective merits were debated for over a century. Throughout that time, it was clear that both instruments were effective in sufficiently skilled hands, yet the forceps took over so decisively that by the early twentieth century the vectis had disappeared not only from clinical use, but also from the historiography of obstetric instruments. The central question addressed by the thesis is: why did the vectis disappear from clinical use? The thesis argues that the answer to that question is to be sought in the characteristics of clinical practice, skills and training. The vectis required a subtle set of manual skills, and the teaching of such skills was best favoured by individual apprenticeship; the use of the forceps was more easily reduced to rigid rules, and could therefore be taught in large classes. Thus, the shift to such classes around the middle of the nineteenth century favoured the forceps. To reconstruct that shift, this thesis explores the developing debates around medical education in the first half of the nineteenth century, bringing out the hitherto-neglected theme of the importance of midwifery training as a desideratum for the reformers. The link between pedagogic processes and clinical practice reflects the co-construction of users and technology of the Social Construction of Technology (SCOT) model, but requires some modification of that model, not least because the technological consequences of pedagogic change were entirely unintended.

Engaging with the ‘modern birth story’ in pregnancy: A hermeneutic phenomenological study ofwomen’s experiences across two generations

Birth stories, Hermeneutic phenomenology, Heidegger, idle talk

This study considered how women from two different generations came to understand birth inthe context of their own experience but also in the milieu of other women’s stories. For thepurposes of this thesis the birth story (described as the ‘modern birth story’) encompassedpersonal oral stories as well as media and other representations of contemporary childbirth, allof which had the potential to elicit emotional responses and generate meaning in theinterlocutor. The research utilised a hermeneutic phenomenological approach underpinned bythe philosophies of Heidegger and Gadamer. Phenomenological conversations with theparticipants took place in the iterative circle of reading, writing and thinking. This revealed theexperience of ‘being-in-the-world’ of birth for the two generations of women and the way ofcommunicating within that world. From a Heideggerian perspective, the birth story wasconstructed through ‘idle talk’ (the taken for granted assumptions of how things are which comeinto being through language) and took place across a variety of media accessed by women, aswell as through face-to-face conversations. The data revealed that the lifeworld of birth beingsustained in stories (for both generations) was one of product and process, concentrating on thestages and progression of labour and the birth of a healthy baby as the only significantoutcome. This thesis revealed that the information gleaned from birth stories did not in factcreate meaningful knowledge and understanding about birth for these women. The workhighlights a need for further research to qualify the relationship between what women see andhear about birth and their expectation and consequent experience of birth. Further itdemonstrates that women should be given help and guidance to ‘unpack’ and understandnegative stories and portrayals of birth to mitigate the damaging effects of expectant fear.

Twitter: @DrAngelaK

Care of obese women during labour: The development of a midwifery intervention to promote normal birth.

Obesity, Normal birth, Labour, Intervention

Normal birth, defined as birth without induction of labour, anaesthetic, instruments or caesarean section conveys significant maternal and neonatal benefits. Currently one-fifth of women in the United Kingdom are obese. There is evidence of the detrimental effects obesity has on intrapartum outcomes. There is a lack of research on how to minimise the associated risks of obesity through non-medicalised interventions and how to support obese women to maximise their opportunity for normal birth. This thesis aims to provide evidence to address this and develop an evidence-based intervention to promote normal birth. Using a methodological approach aligned with pragmatism, this research was conducted in four parts and underpinned by the MRC framework for the development of complex interventions. Part one was a national survey involving 24 maternity units. Part two was a qualitative study of the experiences of 24 health professionals and part three involved 8 obese women. The final part was a multi-disciplinary workshop that used consensus decision-making to design the intervention. Collectively, the findings suggest that intrapartum care of obese women is medicalised. Health professionals face challenges when caring for obese women but many strive to optimise the potential for normal birth by challenging practice and utilising ‘interventions’ to promote normality. The findings demonstrate that obese women have an intrinsic fear of pregnancy and birth, have a desire for normal birth and ‘obese pregnancy’ presents a window of opportunity for change. The intervention consists of three component parts: an educational aspect, a clinical aspect and a leadership aspect. Whilst acknowledging the importance of safety, increasing intervention during labour for obese women may further increase the risk of complications, with detrimental effects. Addressing intrapartum management of obese women through non-medicalised interventions is of paramount importance to promote normality, maximise the opportunity for normal birth and reduce the associated morbidities.

Las matronas en el Jaén del siglo XX. El caso de la Comarca de Sierra Mágina

Matronas, Género, Historia de las Profesiones Sanitarias

Con la aproximación que hacemos en esta investigación a las matronas, parteras y cultura de nacimiento de la Comarca de Sierra Mágina hemos pretendidocontribuir al estudio de la historia de las mujeres en general, al de las matronas y parteras en particular y recuperar para siempre la historia de la cultura delnacimiento más reciente de la Comarca estudiada, una parcela del saber que estaba en peligro de ser enterrada por la propia actualización científica de lapráctica profesional. Nos hemos acercado a la dimensión socio-familiar, académica, profesional y humana de unas mujeres que jugaron un papel muyimportante en la salud de las mujeres y hombres de la provincia de Jaén. Este acercamiento lo hemos hecho a través de quienes configuraron su espacio derelaciones. El estudio de mujeres, parteras y matronas desde los grupos de discusión, la entrevista en profundidad, las visitas a los pueblos de la Comarca, y lainmersión en documentación archivística nos ha permitido, recoger de cerca, para después contar de lejos, con la objetividad que permiten estosinstrumentos, la experiencia individual de cada matrona y las relaciones que configuraron como consecuencia de su práctica profesional. La segunda parte deesta tesis aborda la cultura popular de nacimiento en una Comarca andaluza de la España rural de mediados del siglo XX.

Experiences of Women and Other Birthing People Who Make Non-Normative Choices in Childbearing: A Constructivist Grounded Theory

Non-Normative, Choice, Autonomy, Outside-Guideline

The thesis aimed to explore why and how participants construct non-normative choices in the context of pregnancy and childbearing, alongside the underlying social processes participants navigate within UK maternity systems. Non-normative choices include outside-of-guideline care, declining routinely offered care and interventions or requesting care outside sociocultural norms. Such choices represent a critical test against which claims of women centred care and authentic informed decision-making can be tested. To date, emphasis on empirical research in this area has primarily focussed on clinician-based understandings of supporting non-normative choices and women’s experiences of more extremely positioned, mostly intrapartum choices. These have often excluded service users’ voices within more nuanced choices across the childbearing continuum, situated firmly within consent, autonomy, and agency issues. By exploring these issues, the thesis will present a constructivist grounded theory exploring the social processes experienced by and affecting women’s experience in making non-normative choices, offering a substantive theory to explain how women’s reproductive identity shapes and informs non normative choice-making. I present how non-normative choices represent a strategy by which, in the presence of institutional and systemic identity threat, reproductive identity is expressed, reinforced, or defended through common strategies, represented in the QuEEN model of common strategies for reproductive identity reinforcement and defence. The thesis will argue that contrary to choices being seen as ‘non-normative’ within contemporary maternity care, women view their choices as normative within their unique contexts and that a paradigm shift is required to reframe how non-normative choices are viewed. Rigid, risk-based systems of care designed to categorise women throughout their pregnancy journey work directly against aspirations for personalised care planning and frameworks of choice, reinforcing the urgent ongoing need for emphasis on personalised care within the UK maternity system to achieve equitable and safe perinatal outcomes in the presence of facilitative choice and relational care models.

Twitter: @jayneemarshall

Informed consent during the intrapartum period: an observational study of the interactions between health professionals and women in labour involving consent to procedures.

Informed consent, Medical personnel and patient, Communication on the labour ward, Women in labour

This ethnographic study using participant observation, aimed to explore the issue of informed consent to procedures undertaken during the intrapartum period. It involved recruiting 100 healthy women, who went into labour spontaneously at term, at the point they were admitted to the labour ward. The data collection took place in a large teaching hospital in an East Midlands city from April 1997 until December 1999. The subjects (health professionals and women) were observed throughout the labour until the woman and baby were transferred to the postnatal area. Follow-up interviews were conducted with the woman and midwives, within24 hours, using a semi-structured format based on the observations. The study revealed that it was difficult to obtain informed consent during labour. Contrary to professional belief, not all women wanted to be fully informed about intrapartum care and procedures, or wanted anything other than a pain free and easy labour that they perceived the western medical-technocratic model of care would offer them. Although the midwives' knowledge of legal and ethical issues concerning consent was variable and limited in the majority of cases, they attempted to empower women to make intrapartum choices. However, this was often constrained by the culture of the labour ward environment and the extent to which they adhered to policies and procedures. In cases where medical intervention became necessary, a minority of midwives felt personally disempowered. The obstetricians and paediatricians observed, appeared to be less effective communicators than anaesthetists, often leaving it to the midwife to explain issues to the woman. It is envisaged that these findings, as well as the stereotypical models of the labouring woman and the attending midwife that developed, and the resulting recommendations, be used in partnership between maternity service and education providers to ensure that health professionals not only have effective communication and interpersonal skills, but also are more conversant with the legal and ethical implications of consent.

Voicing the silence: the maternity care experiences of women who were sexually abused in
childhood

Childhood sexual abuse, Maternity Care, Feminist research, Narrative

Childhood sexual abuse is a major but hidden public health issue estimated to affect approximately 20% of females and 7% of males. As most women do not disclose to healthcare professionals, midwives may unwittingly care for women who have been sexually abused. The purpose of this study was to address the gap in our understanding of women’s maternity care experiences when they have a history of childhood sexual abuse with the aim of informing healthcare practice. This narrative study from a feminist perspective, explored the maternity care experiences of women who were sexually abused in childhood. In-depth interviews with women, review of their maternity care records and individual and group interviews with maternity care professionals were conducted. The Voice-centred Relational Method (VCRM) was employed to analyse data from the in-depth interviews with women. Thematic analysis synthesised findings, translating the women’s narratives into a more readily accessible form. The main themes identified were: narratives of self, narratives of relationship, narratives of context and the childbirth journey. Medical records provided an additional narrative and data source providing an alternative perspective on the women’s stories. Silence emerged as a key concept in the narratives. This thesis contributes to ‘Voicing the silence’. The particular contribution of the study is its focus on the women’s voices and the use and development of VCRM to listen to them. It highlights where those voices are absent and where they are not heard. Women want their distress to be noticed, even if they do not want to voice their silence. The challenge for those providing maternity care is to listen and respond to their unspoken messages and to hear and receive their spoken ones with sensitivity.

Using a birth ball in the latent phase of labour to reduce pain perception, a randomised controlled trial.

Birth ball, Latent labour, Pain

Hospital admission in the latent phase of labour is associated with higher rates of obstetric intervention, with increased maternal and fetal morbidity. Women sent home from hospital in the latent phase to 'await events' feel anxious and cite pain as their main drive to seeking hospital admission. Using a birth ball to assume upright positions and remain mobile in the latent phase of labour in hospital is associated with less pain and anxiety. However, no research has examined the effect of using birth balls at home in the latent phase on pain perception, hospital admission or obstetric intervention. An animated infomercial was developed to promote birth ball use at home in the latent phase of labour to enhance women's self-efficacy, in order to reduce their pain perception. As a pragmatic randomised controlled single centre trial, 294 low risk women were randomly allocated to two groups. At 36 weeks’ gestation the Intervention Arm accessed the infomercial online and completed a modified Childbirth Self- Efficacy Inventory before and after viewing. They were also offered the loan of a birth ball to use at home. The Control Arm received standard care. On admission to hospital in spontaneous labour, all participants were asked to provide a Visual Analogue Scale score. Both groups were followed up six weeks postpartum with an online questionnaire. Data were analysed on an Intention To Treat basis. A significant increase was found in Outcome Expectancy and Self-efficacy Expectancy after accessing the infomercial and Intervention Arm participants were more likely to be admitted in active labour. No significant differences were found between the VAS scores, or intervention rates. Most respondents (89.2%) described the birth ball as helpful and reported high satisfaction, with comfort, empowerment and progress. The birth ball is a promising intervention to support women in the latent phase. Further research should consider a randomised cluster design.

Life history theory : how the childhood environment affects humans' later life outcomes such as reproductive and marriage behavior, educational attainment and income

Life history theory, Fertility, Female Reproductive Behavior

Human fertility behaviour and reproductive decision-making is highly influenced by social and economic factors and is expected to be driven also by evolutionary processes. The present thesis is looking at human fertility behaviour through the evolutionary lens and therefore provides novel insights to what extent biological, ecological and socio-economic factors shape fertility patterns and reproductive decision-making in different stages of the demographic transition and how they interfere with each other. The first study tests if exposure to high mortality within the natal family in
early childhood leads to faster and riskier reproductive strategies in pre-industrial European society. The results reveal that women who were exposed to high mortality cues within the natal family
were at a greater risk to reproduce earlier and outside a stable union. Giving birth to an illegitimate child served as a proxy for risky sexual behaviour. Further, the study shows that the risk of giving
birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in marital reproductive timing are influenced more by family-level effects than by individual mortality experience. The second study therefore investigates the impact of famine-related high mortality and social factors on union formation in a pretransitional/ transitional
European population. The results show that individuals accelerate their transition to marriage when they were exposed to high mortality cues during early childhood. These results further stress the importance of individual’s early life conditions on their life-history trajectory. The third study considers the findings that fertility behaviour and reproductive decision-making varies across social classes and sheds some light on sex-biased parental investment in a post-transitional Western population. The study reveals that parents bias their parental investment/support depending on their social class towards the sex with the higher expected reproductive success. Low status parents invest more in their daughters’ higher education, whereas high status parents invest more in their sons’ higher education.

Models of maternity care for women with low socioeconomic status and social risk factors: what works, for whom, in what circumstances, and how? A realist synthesis and evaluation

Social risk, models of care, inequality, continuity

Background Factors associated with poor childbirth outcomes and experiences of maternity care include; Black and minority ethnicity, poverty, young motherhood, homelessness, difficulty speaking or understanding English, domestic violence, mental illness and substance abuse. These women struggle to access and engage with services. It is not known what aspects of maternity care work to improve outcomes and experiences for women with social risk factors.

Methods This research aimed to uncover the mechanisms that lead to improved experiences and outcomes through an evaluation of two specialist models of maternity care. One model of care takes a local approach and was placed within an area of significant health inequality. The other was based within a hospital setting and provides care for women based on an inclusion criteria of social risk factors. Using a realist approach a synthesis of qualitative literature and focus groups with midwives working in the specialist models was conducted to develop preliminary theories regarding how, for whom and under what circumstances the model of care is thought to work. Quantitative data on birth outcome and service use measures for 1000 women accessing different models, including standard care, group practice and specialist models of care at two large, inner-city maternity services were prospectively collected analysed using multinominal regression. Longitudinal interviews with 20 women with social risk factors were conducted to refine the theories.

Results The specialist models of care appeared to mitigate the effects of inequality and revealed no adverse outcomes compared to other models of care. Women receiving the specialist models of care were significantly more likely to use water for pain relief in labour, have skin to skin contact with their baby shortly after birth, and be referred to social care and support services. Maternity care based in the community setting was associated with a significant decrease in induction of labour, preterm birth and low birth weight. A subgroup analysis found that the improved preterm birth outcome was particularly significant for women with the highest level of social complexity. The qualitative analysis highlighted possible mechanisms for these findings that were related to access, interpreter services, education, information and choice, continuity of care, social, emotional and practical support and stigma, discrimination, and perceptions of surveillance. Women experienced substandard care when they were not in the presence of a known healthcare professional. Women described the benefits of seeing a known healthcare professional during pregnancy and particularly valued not having to repeat often difficult social and medical histories. They described feeling able to disclose difficult circumstances to a known and trusted midwife. Women in the hospital-based model described a lack of local, community support and had difficulty integrating into unfamiliar support services.

Conclusions Carefully considered place-based care with a focus on continuity can create safe spaces for women and identify their specific needs. The quantitative data highlighted interesting relationships between all community-based models of care and neonatal outcomes that require further testing in future research. The identification of specific mechanisms will allow those developing maternity services to structure models of care around local need without losing the core aspects that lead to improved outcomes.

Mothers Mood Study: women’s and midwives’ experiences of perinatal mental health and service provision

Perinatal mental health, Women

Background: Existing research on poor perinatal mental health largely focuses on recognition and treatment of postnatal depression. Consequently, there is a need to explore antenatal mental health. Aim: To assess poor mental health prevalence in pregnancy, its relationship to sociodemographic characteristics, self-efficacy and perceived support networks. To understand experiences and barriers preventing women with mental health problems from receiving help and explore midwives’ understanding of their role.

Method: Questionnaires were completed by women in early pregnancy. A subset identified to have mental health problems, were interviewed in late pregnancy to explore their experiences and barriers to receiving care. Midwives completed questionnaires exploring their experiences of supporting women with mental health problems and focus groups further discussed the issues raised.

Results: Amongst participants (n=302), the Edinburgh Postnatal Depression Scale (EPDS) identified 8.6%, and the Generalised Anxiety Disorder Assessment (GAD-7) 8.3%, with symptoms of depression or anxiety respectively. Low self-efficacy (p=0.01) and history of previous mental health problems (p<0.01) were most strongly associated with anxiety or depression. Thematic analysis of interviews with women (n=20) identified three themes: ‘past present and future’; ‘expectations and control’; and ‘knowledge and conversations’. Questionnaires were completed by 145 midwives. The three themes identified from the focus groups with midwives were: ‘conversations’; ‘it’s immensely complex’; and ‘there’s another gap in their care’.

Conclusion: Prevalence rates of anxiety and depression amongst women in early pregnancy were found to be similar to those reported in the literature. Low self-efficacy and previous poor mental health were significant predictors of anxiety and depression. Continuity and more time at appointments were suggested by midwives and women to improve discussions regarding mental health. Midwives were keen to support women but lacked knowledge and confidence. Consistent reference was made to the need for training regarding the practical aspects of supporting women’s mental health.

Determinants of late stillbirth Auckland 2006-2009

Stillbirth, Epidemiology, New Zealand

Stillbirth is a devastating and too common outcome of pregnancy; globally there are approximately three million deaths after 28 weeks‟ gestation every year. In New Zealand, as in other high income countries, more than 1 in 200 babies die before birth, and around 1 in 300 die in the last three months of pregnancy. During the mid twentieth century there was a dramatic decline in the rate of stillbirth, however this improvement has not been sustained in recent years. Previous studies have identified certain causes and risk factors for late stillbirth, but over a third of the deaths remain unexplained. The current variation in the rate of stillbirths both across and within high income countries suggests that it is possible to make further improvements in stillbirth rates. We hypothesised that there would be modifiable, but as yet unidentified risk factors for late stillbirth. The Auckland Stillbirth Study was the first case control study to select women with ongoing pregnancies as gestation matched controls. This study found that the disparity in rates of late stillbirth in women from different ethnicities in New Zealand could be attributed to associated factors such as high parity, high body mass index and social deprivation. Regular utilisation of antenatal care was found to be protective, and women who attended at least 50% of recommended antenatal visits had a lower risk of stillbirth compared to those who did not. Antenatal identification of sub-optimal fetal growth was found to be a possible aspect of the benefit of regular antenatal attendance. Maternal perception of fetal movements was also identified as an area of importance, with women who perceived their baby's movements to decrease in the last two weeks of the pregnancy being at greater risk of experiencing a stillbirth. In addition this study found an association between maternal sleep practices and risk of late stillbirth. Most strikingly, the study found that women who went to sleep on their left side on the last night (prior to stillbirth/interview) were half as likely to experience a late stillbirth compared to women who went to sleep in any other position. This study has added a New Zealand perspective to the existing literature on certain known risk factors for late stillbirth (such as high body mass index). It has also identified novel factors that present new possibilities for further research and for the potential for future reductions in the incidence of late stillbirth.

Twitter: @TabibM2

A Different Way of Being The Influence of a Single Antenatal Relaxation Class on Maternal Psychological Wellbeing and Childbirth Experience An Exploratory Sequential Mix-Method Study

Relaxation, Perinatal Psychological Wellbeing, Childbirth Experience, Antenatal Education

Background: Perinatal mental health problems are prevalent, have a wide range of adverse effects on the mother and her child, and are predictors of negative childbirth experiences. Therefore, improving perinatal mental health is a global public health priority and developing services that could promote it must be a priority for maternity services. There is growing evidence that antenatal education incorporating hypnosis or guided imagery techniques may have the potential to promote perinatal mental health and positive childbirth experiences. However, high-quality research in the field is lacking. Aim and objectives: This study aimed to explore the influence of a single 3- hour Antenatal Relaxation Class (ARC), incorporating theory on childbirth physiology, hypnosis and guided imagery, on maternal psychological wellbeing and childbirth experiences. The objectives of the study were to: a) identify the aspects of maternal psychological wellbeing and childbirth experiences that may be influenced by ARC, b) understand ‘why’ and ‘how’ any influence may occur, c) identify the factors that may mitigate the influence of ARC during labour and birth, and d) test the significance of any influence over time.

Methods: The study took an exploratory sequential mixed-method approach. In the initial qualitative phase, a purposive sample of 17 women and 9 birth partners participated in either individual (8 women) or joint (9 women and their birth partners) semi-structured in-depth interviews. The data were analysed using descriptive qualitative and reflexive thematic analysis. The follow up quantitative phase was a prospective longitudinal cohort study that used surveys to further examine childbirth experiences and measure psychological wellbeing in a sample of 91 women at three time points: pre-class, post-class, and post-birth.

Findings: Attending ARC was associated with increased childbirth self-efficacy, reduced fear of childbirth and state and trait anxiety, as well as improved mental wellbeing. These changes were significant and lasted over time, until after the birth. Attitudes towards childbirth changed after attendance at ARC, which motivated wide use of relaxation techniques as a self-care behaviour during pregnancy, labour, birth and beyond. Use of relaxation techniques was perceived to positively influence women’s childbirth experiences and choices including a decline in choice of epidural use for labour pain. The efficacy of the learned techniques in the management of labour pain, however, depended on the ‘birth space’ which encompassed the physical environment, interactions with birth attendants and the clinical picture of the experience.

Conclusion: Incorporating theory on childbirth physiology, hypnosis and guided imagery in childbirth education can enhance perinatal psychological wellbeing and childbirth experiences. Providing relevant education for birth practitioners may contribute to a salutogenic model of childbirth care in which practitioners can facilitate childbirth education as well as a birth space that is conducive to experiencing an altered state of consciousness as a health promoting state.

Unsafe Abortion and Unsupervised Births: Understanding the Challenges of Pregnancy and Childbirth in the Rural Highlands of Papua New Guinea

Unsafe Abortion, Unsupervised Births, Access to Care

Papua New Guinea (PNG) has one of the highest maternal mortality ratios in the world. Postpartum haemorrhage and sepsis related to childbirth and unsafe abortion are the leading causes of death. In PNG around 60% of women give birth unsupervised. This study was conducted the Eastern Highlands of PNG and used a mixed methods approach. This thesis is divided into two themes: unsafe abortion and community experiences and perceptions of pregnancy and childbirth; and describes a community-based intervention to improve maternal health outcomes. Unsafe abortion to end an unwanted pregnancy resulting in severe, acute morbidity was identified among young women presenting to the Eastern Highlands Provincial Hospital. Compared to those women who presented following a spontaneous abortion, those presenting following an induced abortion were significantly more likely to be younger, unmarried and a student (either at school or university). Obtained illegally, misoprostol was the most frequently used method to end pregnancy. Despite knowledge relating to complications that can occur during childbirth, many women continued to give birth, unsupervised in the community. Women faced numerous challenges in accessing care, particularly during childbirth. The implementation of a community-based package of interventions, providing clean birth kits and misoprostol for self-administration was feasible and highly acceptable in this setting. Through review of the findings identified in this thesis, one key factor emerged that influenced maternal health outcomes: access to health care. This key factor underpins the uptake of appropriate health care for two vulnerable groups of women: women with poorly timed pregnancies; and women during pregnancy and childbirth.

Competence and expertise in physiological breech birth

Physiological breech birth, Competence, Delphi, Grounded theory

This doctoral thesis by prospective publication aims to provide pragmatic, evidence-based guidance for the development and evaluation of physiological breech skills and services within the context of contemporary maternity care. The research uses multiple methods to explore development of professional competence and expertise. While skill and experience are acknowledged in multiple national guidelines as important safety factors in vaginal breech birth, prior to this research no guidance existed about how skill and experience should be defined, developed and evaluated. The thesis begins with an integrative review of the efficacy of current breech training methods, highlighting a lack of evidence associating any training methods with improved outcomes for breech births. Following this are two papers reporting the results of a Delphi consensus technique study involving a panel of breech experienced obstetricians, midwives and service user representatives. The first outlines standards of competence, training components and volume of experience recommended to achieve competence and maintain proficiency in upright breech birth. The second outlines principles of practice for physiological breech birth, rooted in relationship and response, and divergent from medicalised practices based on prediction and control. Following this is a grounded theory paper exploring the deliberate acquisition of breech competence among midwives and obstetricians with moderate upright breech experience. The paper reports a theoretical model that can inform development of breech teams and training programmes. The final paper reports a mixed methods analysis of data from the Delphi and grounded theory studies concerning breech expertise. The results present a model of generative expertise, underpinned by affinity, flexibility and relationship, which may function to increase the availability and safety of vaginal breech birth. Each paper is followed by critical analysis and reflection. The thesis ends with a discussion of the implications for practice and research in light of the overall body of work.

The Use of Telemetry to Monitor the Fetal Heart during Labour: A mixed methods study

Labour, telemetry, wireless monitoring, Control

Background: Wireless fetal heart rate monitoring (telemetry) is increasingly being used by maternity units in the UK. Guidelines from the National Institute for Health and Care and Excellence recommend that telemetry is offered to any woman who needs continuous monitoring of the fetal heart in labour. There is no contemporary evidence on the use of telemetry in the UK.

Aims: To gather in-depth knowledge about the experiences of women and midwives using telemetry to monitor the fetal heart in labour and to assess any impact that the use of telemetry may have on clinical outcomes, mobility in labour or control and satisfaction.

Study design: A convergent parallel mixed methods design was chosen.

Methods: Qualitative methods included in-depth interviews with 10 women, 2 partners, 12 midwives and one student midwife from two NHS Trusts in the Northwest of England. A constructivist grounded theory methodology was employed for this phase and used both purposive and theoretical sampling. All interviews were audio-recorded and transcribed verbatim. The quantitative phase recruited 161 women from both sites and compared clinical outcome and mobility data from 74 women who used telemetry during labour and 87 women who had conventional wired monitoring. Women also were asked to complete a questionnaire in the postnatal period on control and satisfaction during labour and birth. Questionnaire data was analysed from 128 women, 64 who used telemetry and 64 who had conventional wired monitoring. Both sets of data were integrated to give an overall broad understanding of telemetry use.

Findings: The grounded theory core category was ‘Telemetry: A Sense of Normality’ and was described by three sub-categories. ‘Being Free’ described women being more mobile when using telemetry in labour and experiencing greater feelings of control, normality, and support. Telemetry also increased dignity for women as they were able to use the bathroom independently and with ease. ‘Enabling and facilitating’ described midwives facilitating the use of telemetry, encouraging mobility and using midwifery skills including caring for women in a birth pool. ‘Culture and Change’ described the different maternity unit cultures and how this impacted on the use of telemetry. Telemetry was viewed as increasing choice and equity for women with more complex pregnancies. Within the quantitative phase there was no difference in the aggregate scores for either the Perceived Control in Childbirth (PCCh) scale or the Satisfaction with Childbirth (SWCh) scale. Sub-group analysis found that women who used telemetry for the majority of the time the fetus was continuously monitored in labour scored a higher aggregate score for perceived control during labour (mean ± SD; 5.3 ±0.8 telemetry vs. 4.9 ± 0.9 wired, p = 0.047). Mobility data found that women using telemetry spentmore time off the bed in labour and adopted more upright positions for birth.

Conclusions: Both qualitative and quantitative findings confirmed that women were more mobile in labour when using telemetry to monitor the fetal heart and integrated findings also found that telemetry increased feelings of control in labour. The use of telemetry had a positive impact on women who required continuous monitoring in labour and engendered a sense of normality for both women and midwives. The use of telemetry contributes to humanising birth for women requiring more complex care in labour and birth.

Keeping the balance: promoting physical activity and healthy dietary behaviour in pregnancy

Motivational Interviewing, Self Determination Theory, Behaviour Change, Pregnancy

Gaining large amounts of weight during pregnancy may contribute to development of obesity and is associated with poor outcomes. Therefore managing gestational weight gain is important to reduce the risk of complications. This thesis aims to explore clinical and personal management of gestational weight gain and to discover how pregnant women can be best supported to maintain physical activity and healthy dietary behaviours. This is achieved through a programme of research comprising three related studies. Study One explored the antenatal clinical management of weight and weight gain through one-to-one interviews with Antenatal Clinical Midwifery Managers across Wales (n=11). Findings showed wide variation in management of weight from unit to unit. Although midwives believed pregnancy to be a perfect opportunity to encourage healthier behaviours, many identified barriers preventing them discussing weight with women. In Study Two semi-structured interviews with pregnant women (n=15) investigated views on personal weight management during pregnancy. Again pregnancy was seen as an ideal time to improve health behaviours due to a perceived increase in motivation and many women identified specific goals. However, in the face of various barriers, it was apparent that the motivation which initially identified healthy lifestyle goals was unable to sustain this behaviour throughout the pregnancy. Finally Study Three looked at the feasibility and acceptability of a midwife-led intervention informed by the two preliminary studies. The ‘Eat Well Keep Active’ intervention programme designed to promote healthy eating and physical activity in pregnant women (n=20) was based upon the Self Determination Theory framework for enhancing and maintaining motivation and utilised motivational interviewing. Results indicated that the intervention was received well by participants who reported that it positively influenced their health behaviours. The ‘Eat Well Keep Active’ programme may be a suitable intervention to encourage and facilitate women to pursue a healthier lifestyle throughout their pregnancy.

An investigation of subsequent birth after Obstetric Anal Sphincter Injury

OASI, Perineal Trauma, Subsequent birth

Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth with a reported average worldwide incidence of 4%-6%. They are a recognised major risk factor for anal incontinence resulting in concern amongst women who sustain such injuries when considering the most suitable mode of birth in a subsequent pregnancy. This thesis contains three studies; a systematic review and meta-analysis of the published literature exploring the impact of a subsequent birth and it’s mode on bowel function and/or QoL for women with previous OASIS, a follow-up study on the long-term effects of OASIS on bowel function and QoL and finally a prospective cohort study of women with previous OASIS to assess the impact of subsequent birth and its mode on change in bowel function. The work in this thesis demonstrated an increase in incidence of bowel symptoms in women with previous OASIS over time and that short-term bowel symptoms were significantly associated with bowel symptoms and QoL. This thesis also showed that the mode of subsequent birth was not significantly associated with bowel symptoms or QoL and for women with previous OASIS who have normal bowel function and no anal sphincter disruption a subsequent vaginal birth is a suitable option.

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As a midwifery student, you will be required to write your dissertation . Although the dissertation is a mandatory task, students need to complete this work if they want to pursue midwifery as an occupation. Before starting your dissertation, find a suitable topic that might interest you and write about it in detail. The challenge in this process is identifying the best dissertation topics in midwifery . Every student must have a clear understanding of this step of dissertation writing. So, let's start with the basics of midwifery.

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What Does Midwifery Mean? | Significance in the Real World

In this blog, we're going to look at midwifery and where it fits in with our society today. As you may know, there's still some debate about its meaning. We'll dive into the best midwifery dissertation titles .

The word "midwife" is a little hard to define. It's derived from the Latin word "mater," which means "mother." Midwives are those who offer maternity care and health services. Midwifery is a caring occupation that strives to preserve natural childbirth, prevent maternal death, reduce maternal morbidity and mortality, and improve perinatal outcomes.

Some still use it about a woman who gives birth, while others use it as a slang term for childbirth education and training. It can be unclear because many women wish to become midwives even though they still need formal educational credentials.

Midwives are one of the oldest professions in human history. They care for women, children, and families through childbirth every year. The definition of midwifery means "midwife." The Greeks first used this term to describe women who helped with birth and prenatal care. This fact can be easily used in the dissertation structure to make it more realistic and trustworthy.

Midwives remain vital to our society because they help women maintain their dignity during labour. And help them make healthy decisions throughout their pregnancy.

All these facts about the oldest profession attract students to pursue it as a profession. They are so inspired that the most challenging job of finding midwifery dissertation topics and writing a dissertation is easy for them. It is because they follow a proper procedure to do so. In the next section, you will learn more about that procedure.

While writing a dissertation on midwifery, it's important to remember that time is of the essence. You need to make sure that you complete and prepare a perfect dissertation on time and in an efficient manner that also makes it meaningful.

Here are some tips for students who want to write their midwifery dissertation. Or they can also seek a lot of help from these tips and tricks to improve dissertation writing skills .

Writing an outline is the first step of any dissertation writing. Starting with this sections of your dissertation will make it easily formatted.
Create a timeline. The timeline should include all the significant steps and milestones you must pass to complete your midwifery dissertation on time.
Each section should be divided into smaller subsections, each with clear midwifery dissertation topics UK and a relevant purpose for your research.
When you have your outline, you can begin writing. One of the best ways to get started is by writing down everything that comes to mind about each section. Then begin with the formal content planning.
Now, look at the resources available on your midwifery dissertation topics : books written about it, articles published in journals or magazines, and videos or documentaries about caregivers.

Try using a checklist before starting this dissertation phase so you remember essential steps to include in the content!

Now that you have all these tips and tricks, it's time to start finding suitable and interesting midwifery dissertation topics . With a little bit of planning and some effort, you'll be able to complete this on time!

21 Latest Midwifery Dissertation Topics for Undergraduate

We have listed some of the best midwifery dissertation ideas to help you find a good topic that suits your research.

Midwife experiences with asylum seekers' maternity care
What causes pregnancy fear, and how can midwives help women?
Uses, expectations, perspectives, and experiences with birth plans
Pregnancy, childbirth, and IPV relationships
Increasing normalcy with midwifery care: aquatic births
Fathers' postnatal depression
Antidepressants and postnatal depression
During the postnatal period, it reduces pain and infection and promotes healing of the sutured perineum
Enhanced maternal safety in the Philippines
Pediatric, obstetric, and clinician-indirect home interventions for the Medicare population
Nurses and midwives manage hypoglycemia in healthy-term newborns
A comprehensive assessment of the qualitative literature on the experiences of health workers in acute hospital settings with teamwork education
A comprehensive assessment of the experiences of midwives and nurses working together to offer childbirth care
How have "care pathway technologies" affected integrating services in stroke care? And how strong is the evidence for their success in this area?
Our nation has a midwifery culture
Knowledge of gender in midwifery
Early midwives among the Native Americans: the art of midwifery
Midwifery trends happening in the nursing practice
What role does midwifery play in society?
Relationship between women and midwives and childbirth education in your nation.
Midwives have experience with difficult deliveries

Choose dissertation topic from the above-mentioned examples and make your efforts worthwhile. After a deep analysis, our expert has curated these ideas for you to save time. You are only required to pick the one that interests you and start working on it. if still, these 21 titles are not as per your expectation, then below are more dissertation topics in midwifery available for your help.

Also Read: How Long Should a Dissertation Be?

22 Trending Midwifery Dissertation Topics for Students

We understand how difficult it is to research a suitable topic for academic dissertation writing. Keeping that in mind, we have asked our team of professional writers with years of experience to create some of the most sensible midwifery dissertation topics UK with the help of trends. These will give you a good idea of the current issues confronting midwifery.

The cause of recurrent miscarriage
The cultural perspective on male midwives
Effectiveness of DNA testing in diagnosing a child's hereditary condition
Surgical success in treating an umbilical hernia
What hereditary factors contribute to miscarriage?
The importance of eating well and being nourished when pregnant
Treatment for a ruptured hernia
Midwives' treatment of postpartum depression
Miscarriages' underlying mechanisms
Trends involving males who work as midwives
What are the differences between pregnant women's expectations and birthing experiences?
What dangers lurk in-home abortions?
Why do umbilical cord hernias occur?
What part do infections play in miscarriages?
Techniques for promoting a normal birth during the second stage of labour
Management of perinatal depression
Perinatal treatment for disabled women
Obese women are still able to give birth typically, right?
Describe the variables that prevent natural birthing.
How practical are the WHO perinatal recommendations?
Taking care of hepatitis B while pregnant
The right to pick one's birthplace

These interesting midwifery dissertation topics can impress your faculty and get you instant approval, as experts pick them personally. So, if you're having trouble with your dissertation, seek professional assistance and leave all of your worries to those who have done it before.

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Writing a dissertation in midwifery is a tough job that requires tremendous concentration, so it is always advisable to engage the services of a professional writer who can complete your dissertation on time. We do not just offer midwifery, but we also provide many other benefits on several subjects. You can also find assistance for Nursing dissertation topics or Nursing assignment help . So if you want help from experts, make sure you go to the Assignment Desk and only pay a nominal fee.

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You cannot ignore the importance of midwives in today's world. A Midwifery dissertation topics will provide valuable insight into the field. If you have difficulty finding resources for your dissertation, remember that we are here to help! We create a multitude of dissertations from scratch just for you.

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Midwifery refers to the health consciousness of childbearing women and infants from pregnancy to post-birth. Midwifery is an important academic subject in developed societies. Research in this field helps find ways to avoid maternal and infant mortality, which is crucial for the protection of children during pregnancy. Thus, medical students need to choose quality midwifery dissertation topics for their dissertation modules.

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Midwife Experiences of Maternity Care for Asylum Seekers

Info: 10937 words (44 pages) Dissertation Published: 22nd Feb 2022

Reference this

Tagged: Nursing Health and Social Care Healthcare Midwifery

Purpose: The purpose of this dissertation is to investigate midwives’ experiences of providing maternity care to women seeking asylum. This dissertation concentrates on the experiences and view of midwives and women to determine areas requiring development and improvement.

Method: A systematic literature review of databases British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE, Cochrane Library. Inclusion and exclusion criteria were applied to narrow the search results. Five Key papers were identified and critiqued using the Critical Appraisal Skills Programme.

Findings: Midwives felt unprepared to support these women in a culturally appropriate holistic way. Training, advice and support was lacking and that which was received was often outdated and inconsistent, resulting in many women accessing care later in pregnancy, sometimes not until the point of delivery

Conclusions: Women seeking asylum during pregnancy need to be able to access holistic care and support earlier in their pregnancy to improve outcomes. The barriers faced by these women are contributing to traumatic negative experiences leaving them feeling unsupported, ignored, traumatised. Midwives need to be able to access up to date information about rights, entitlements, communication methods and other support to provides holistic care to these already vulnerable women.

Chapter 1: Introduction……………………………………………………… Page 5

Chapter 2: Methodology……………………………………………………. Page 7

Chapter 3: Critical Review…………………………………………………. Page 10

3.1 Barriers to communication…………………………………………… Page 10

3.2 Barriers to the access of maternity care…………………………… Page 15

Chapter 4: Service Improvement………………………………………… Page 19

4.1 Aim………………………………………………………………………. Page 20

4.2 Measures………………………………………………………………… Page 20

4.3 Ideas……………………………………………………………………… Page 21

4.4 Plan, Study, Do, Act cycle……………………………………………. Page 22

4.5 Conclusion……………………………………………………………… Page 23

Reference list………………………………………………………………… Page 24

Appendix 1 …………………………………………………………………. Page 32

Appendix 2 ………………………………………………………………… Page 33

Appendix 3 ………………………………………………………………… Page 34

Introduction

The refugee council (1951) define a refugee as “a person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it.”

Pregnant women seeking asylum in the United Kingdom have been recognised as a group of vulnerable women, as identified in the confidential enquiry into maternal and child health (CEMACH, 2011). They often face complex social factors, Poor maternal health and undiagnosed medical and mental health conditions and additional need in pregnancy (NICE, 2010), Much of this relates to suffering from the physical and psychological effects of fleeing from persecution and traumatic circumstances.

All women seeking or granted asylum in the UK are entitled to receive free maternity care. However, there are many barriers preventing this disadvantaged group from accessing and participating with maternity services. These include, communication (RCOG, 2010), knowledge of the NHS and entitlements (Department of Health, Social Services and Public Safety of Northern Ireland, 2004), dispersal by the United Kingdom border agency (UKBA) (Feldman, 2013), and cultural differences and discrimination (Tobin, Murphy-Lawless and Beck, 2013)

Simultaneously midwives providing care are also face challenges such as the complexity of the asylum system and legislation, Lack of training in cultural awareness, poor communication skills, insufficient time and access to interpreters. Midwives describe the care they provide as Substandard and unsatisfactory.

In (2010) the National Institute for Health and Care Excellence (NICE) implemented guidelines which aimed to improve maternity services for women with complex social factors. Woman centred care holistic approach was promoted. However, seven years later asylum seeking women’s needs are not being met. Poor antenatal care and communication difficulties are impacting on their experiences. The (2010) nice guidelines recommended training for midwives to improve their understanding of asylum seekers specific needs and how to meet them. However, the 2015 government spending review cut the Department of Health budget for non frontline services including medical by 1.5 billion. The evidence suggests there are inadequacies in care. This dissertation aims to review and critique the most current research and will conclude with a recommendation for achievable and sustainable service improvement.

Methodology

This chapter aims to look at the approach used to complete a thorough systematic critical literature review. Rees (2011, p77) states “A review of the literature is the systematic and critical examination of a defined selection of published literature on a particular topic or issue”. Research is a means of assessing and evaluating what we do as midwives, and in order to complete this, midwives are required to be able to appraise and synthesise the research available and evaluate evidence about the effectiveness of their practice and healthcare interventions (NMC, 2008)

The approach used to achieve a systematic review was to identify a topic of interest and understand the issues surrounding it. Before a search of databases was performed I began by looking into the availability and experiences of access to maternity care for pregnant women seeking asylum in the UK. Through this initial search I found some organisations and secondary sources of information. Among these were UK border Agency, Asylum Aid, Maternity Action, UK Government Asylum Support, City of Sanctuary and the Royal College of Obstetrician and Gynaecologists (RCOG). These sources assisted my wider reading and understanding around the topic. They enabled me to look at the policies and guidelines which provide instruction to those caring for women seeking asylum in pregnancy from border agencies to health care practitioners and have allowed me to assess the care being provided and delivered.

A mind map was produced to to allow exploration of the topic and clarify the issues and my personal understanding at this point. (Appendix 1) The next step was to perform an online search of The University of the West of England (UWE) library using the phrase ‘asylum seekers experiences of accessing maternity care’ this returned 869 results. Refining the search to peer reviewed and full online text reduced the results to 179. By further restricting the filters to the last 5 years and peer reviewed returned 82 results.

To help to identify further appropriate research papers a literature search strategy table was produced (Appendix 2) using synonyms this identified key search terms to be used in database searches. Databases relevant to the question and health and social care were searched including OVID maternity and infant care a key information resource used by maternity health care professionals and student midwives worldwide to support their research, BNI, PubMed, Psycinfo, science direct, CINAL and The Cochrane Library all of which are recommended by the RCM (2014)

The following Key terms were used interchangeably to investigate the objectives of the literature review; ethnic minorities, Asylum seeker, refugee, experiences, barriers, obstacles, feelings, maternity, care, access, antenatal, postnatal, labour, pregnancy and birth. Boolean operators (AND, OR) were used to define logical relationships between the search terms and refine the process (Bettany-Saltikov, 2012).Truncation* was used to search for all alternatives to words which are closely related, this ensured a through search of multiple forms of the key words (Rees, 201 1) The search also included the process of back chaining through a reference lists of relevant articles to search for other relevant primary sources ( Rees, 2015) Saturation was reached once no new articles were found (Polit et al, 2001).

Exclusion and inclusion criteria was also included in the literature search strategy table. Inclusion criteria included primary research which explored women’s experiences of access to maternity care in the UK whilst seeking asylum. This focused on qualitative research focusing on interviews, questionnaires and surveys. Inclusion also included Research which has been published and peer reviewed. Studies were excluded if they explored aspects other than women’s experiences to accessing maternity care during the asylum process or if they were not written in English. Exclusion also applied if they were from countries without a comparable demographic to the UK and Papers older than 10 years to ensure the evidence presented is the most up to date and related to practice (Moule and Goodman, 2014)

Five qualitative primary research studies were selected for critical analysis of the contents using the Rees framework for critiquing qualitative research tool (Appendix 3) (Rees, 2011) three themes stood out throughout the critical analysis of the papers. These are

Communication
Lack of cultural understanding

These will be explored in more detail in the next chapter.

Chapter 3 – Critical review

In 2010 the National Institute for Health and Care Excellence (NICE) published guidelines for antenatal care of women with complex social factors. The guideline acknowledges asylum seekers and refugees as one of the most vulnerable groups as identified in the Confidential Enquiry into Maternal and Child Health (CEMACH, 2011) report. The NICE (2010) guideline recommends asylum seekers and refugees should be provided with an interpreter (a link worker or advocate, not a family member) who can communicate in the woman’s preferred language.

This chapter will evaluate and synthesise the evidence of the two themes identified from the available evidence. ‘Barriers to communication’ and ‘Barriers to access of health care’. The themes will concentrate on how midwives can improve maternity care experiences for asylum seekers in the United Kingdom (UK).

3.1 Barriers to Communication

For those seeking asylum in the UK communication is one of the most challenging barriers (RCOG, 2010). Effective communication between midwives and women is essential, allowing the midwife to provide an individualised care plan, build a relationship and to provide healthcare promotion and education. According to Ameh and Broek (2008), good communication is the key to assisting midwives in improving maternity care and the lives of pregnant asylum seekers in the UK. Lyons (2008) suggests communication issues are the most common difficulty faced by midwives when caring for ethnic minority women. These women are not able to provide a full medical history, which results in inappropriate clinical decision-making and increased morbidity/mortality as recognised by the Mothers and Babies Reducing Risks through Audits and Confidential Enquiries (MBBRACE) 2015 report.

This theme will look at the barriers asylum seekers face when communicating with health professionals. Three studies were identified which all looked at the impact of communication and the barriers faced when communicating with health professionals whilst accessing maternity care. Philmore (2014), Feldman (2013) and Tobin and Lawless (2014).

Philmore (2014) undertook a qualitative mixed methods study which aimed to explore the reason new migrants do not access antenatal care. Non probability purposive sampling was used, this enabled the researchers to select women who had recently moved to the UK and utilised maternity services. A semi structured questionnaire was completed via interviews. When designing a questionnaire, the researcher should ensure that they are “valid, reliable and unambiguous (Zohrabi, 2013) . This was achieved through co designing the questionnaire with maternity professionals and migrant women. The study does not state if the maternity professionals involved in the design of the questionnaire are specialists within this area of maternity care, this would impact on the validity and reliability of the study.

82 questionnaires were completed respondents were identified through children’s centres and community groups, using a snowballing approach existing study participants recruit further participants from their acquaintances (Rees, 2012). This method would omit women from the sample who are isolated or who choose not to attend groups. The scale of coverage shows this method is more likely than other approaches to obtain data, based on a representative sample, therefore being transferable to a population. However, the data produced is likely to lack depth. The responses were themed using a systematic thematic analysis, enabling the researchers to move their analysis from a broad reading of the data towards discovering patterns and developing themes (Braun and Clarke, 2006).Thirteen women were then identified with different characteristics from the larger group. These women were asked to participate in, in depth interviews, the narratives provided data which matched and clarified the themes identified through the questionnaire.

Triangulation of the results was achieved through 18 in-depth interviews with maternity professionals, via email or telephone. This enabled the researchers to look at different perspectives and explore specific experiences. Rees (2011) states Triangulation permits the researcher consolidate and confirm the findings of the data collection, increasing the credibility and validity of the research . Polit and Beck, (2008) suggest ‘telephone interviews are a convenient method of collecting data if the interview is short, specific and not too personal. Nonetheless telephone interviews can be subject to interruption’s and loss of continuity, they also rely upon the midwife’s memory recall and small pieces of information which form the whole picture can be missed. The lack of visual cues via phone interviews results in a loss of context and compromises building rapport, probing and interpretation (Novick, 2008).

Ethical approval was given prior to the research study and Informed consent was achieved by discussing the nature and purpose of the study. Participants were given the opportunity to ask questions but the study does not specify if the participants were given the right to withdraw, how the information was anonymised, or how the data was secured. (Wood and Ross-Kerr, 2006) This would have would have strengthened the credibility of the study.

Philmore (2014)findingshighlighted a lack of inadequate interpreting and the use of family as interpreters.Philmore acknowledged women were failing to access maternity services because of their limited ability to communicate with midwives. They felt unsupported and vulnerable as access to language translation services was often poor and when available was associated with many issues which deterred its use. Interpreter services such as ‘Language Line’ and the ‘Big Word’ are frequently required but the services appear to be limited or unreliable in many areas, resulting in difficulty in accessing them. (Gerrish et al 2004; MacFarlane et al 2009; Hadziabdic et al 2010). Family were frequently used as interpreters, excluding women from conversations about their own care.

Feldman (2013)aimed to explore the experiences of asylum seeking women dispersed during pregnancy and the impact on their maternity care. The qualitative research used semi structured in-depth interviews. Semi structured interviews combine standard questions asked to all participants with the opportunity for the interviewer to explore the topic further, allowing for a richer in-depth data through spontaneity of both parties (Rees, 2011). The sample consisted of 20 women who had been dispersed or held in accommodation centres by the United Kingdom Border Agency (UKBA). Women were invited to participate through local refugee support organisations ensuring the sample was representative of the population required. Interpreters were provided to enable women with limited or no English to participate in the research when they may otherwise be excluded. Squires (2009) suggests Interpreters personal experiences can influence the way they translate and interpret the responses they receive. Some medical terminology can be difficult to translate into other languages, making it difficult to convey the meaning from one language to another. Therefore, the interpreter is not unbiased and this needs to be taken into account when analysis occurs (Temple, 2002).

Feldman (2013) study echoed Philmore (2014) who also interviewed midwives as part of the study. Interviews conducted via telephone, aimed to explore the midwifes’ experiences of caring for asylum seekers and refugees. The reliability of the interviews would be subject to similar themes as discussed previously leaving the validity of the results questionable. The reliability of study by Feldman (2013)could also be questioned as structured interviews are easy to replicate and quantify ensuring the results being reliable. However, there is no room for spontaneity from the participant and the data collected may not be as rich (Rees, 2011).

Feldman (2013)concluded failure to use interpreters added further stress, anxiety and burden on women. Therefore, maternity services are failing to meet the complex, health and social needs of these women. The NICE(2010) guidelines Pregnancy and complex social factors set out what healthcare professionals as individuals and antenatal services as a whole, can do to address these needs and improve pregnancy outcomes. The report highlights the extreme level of misunderstandings which, woman may face. The use of interpreters is crucial to supporting women and helping prevent their experiences from becoming traumatic and preventing future mental health problems

Tobin and Lawless (2014)undertook a qualitative study which aimed to explore midwives’ experiences of providing maternity care to women seeking asylum. A purposive sample of 10 midwives was selected. Purposive sampling can be used to produce maximum variation within a sample (Rees, 2011). This captures a range of perspectives allowing the researcher to identify common themes which are evident across the sample. It can provide bias results but the method aims to achieve the opposite by ensuring it provides the researcher with a detailed understanding of the person’s experiences. (Rees, 2011).

The sample of midwives in the study was small and therefore the findings could not be generalised. The findings do however provide an understanding of women’s needs which must to be met to improve the care midwives provide to this vulnerable population.The data was analysed using content analysis which reviews the narrative and identifies themes. This provided the researcher with an ecological validity as the participants are talking about their experiences and feelings, but this can be time consuming (Sutton and Austin, 2015). The researchers field notes and journals, offer an audit of decision making and allow the researcher to be conscious of their own bias, reactions and emotions to the data. Clinical supervision was used throughout and transcripts were examined by another researcher to confirm the findings. This ensures validity to the researcher.

Tobin and Lawless (2014) findings highlighted Language barriers as major cause for concern. Lack of access to professional interpreters caused a variety of problems. A reliance on family to interpret was emphasised as a problematic for both the midwives and the women. NICE ( 2010) recommend health professionals should be aware of the potential ethical and legal implications of their use. The use of family or friends as interpreters carries its own advantages, they are free, readily available and accessible and are familiar with the patient and their medical history (Phelan and Parkman, 1995). However, the woman’s confidentiality is compromised and this can leave her feeling vulnerable, embarrassed and uncomfortable. It can also have negative effects on relationships through misunderstandings, misinterpretation and the information can be adapted to suit the woman’s partner or family and support their agenda. This can impact upon the treatment and increase risks (Gerrish et al, 2004). Reliability to translate information correctly can occur, resulting in misconceptions of the information due to language barriers or dialect. This study was small and therefore cannot be generalised to the Larger population but could be transferable to another setting to allow findings to inform future provision of maternity care to asylum seekers (Polit and Hungler, 1997)

Philmore 2014; Feldman, 2013; Tobin and Lawless, 2014; studies all acknowledged communication as a barrier to asylum seekers and refugees accessing maternity care. Each study indicated the reoccurring vulnerability women felt due to the lack of accessible interpreters. This is confirmed by Ali and Burchett (2004) in their small scale qualitative research study investigating Muslim women’s experience of maternity services. Health professionals who participated in the focus groups identified communication as the most important barrier to providing effective maternity care. Philmore 2014; Feldman, 2013; Tobin and Lawless, 2014 similarly explored the experiences of midwives within their studies and all of these suggested that midwives are not always using interpreter services when communicating with asylum seekers and refugees, this was often due to the poor service, appropriateness of the service and lack of time and cost. Philmore and Feldman both used telephone interviews as a mean of obtaining data. therefore, compared to Tobin and Lawless (2014) the validity of their studies could be questioned, as the possibility of interruptions would be high consequently effecting the midwives recall of memory. The validity of all three studies would therefore be dependant upon the researcher and how they respond to the participants through their voice tones, emotion and body language (Anderson, 2010). Philmore (2014) used triangulation to combine interviews and questionnaire data, this addresses the issue of internal validity. Producing similar findings from different methods provides validation and assurance (Rees, 2011). The finding of all three studies do provide an insight into the communication barriers faced by asylum seekers and refugees accessing maternity care, it also gives food for thought about how these services need to be improved.

3.2 Barriers to the access of Maternity care

Asylum seekers and refugees face many complex social factors and additional need in pregnancy (NICE, 2010). These include difficulty accessing care and registering with health professionals, cultural differences, dispersal in pregnancy, discrimination and awareness of entitlements.

Tobin, Murphy-Lawless and Beck (2013) was a qualitative narrative analysis study using in-depth unstructured interviews. Unstructured interviews are particularly relevant in midwifery studies as they allow the participant voice to be heard and to gain an understanding of their perspective (Holloway and Wheeler, 2010) The aim of the study was to gain an insight into women’s experiences of childbirth in Ireland while in the process of seeking asylum. A purposive sample of 22 women was used these permitted researchers to select women who had experienced pregnancy and childbirth in the asylum process (Rees, 2011). Purposive sampling can be difficult to assess if the researcher has biased ideas about the participants (Bryman, 2012).The researcher must therefore rationalise how and why they have selected the participants (Burns, 2009). Ethical approval was obtained and participants were informed of the voluntary nature of participation and their right to withdraw at any time during the study. This ensures the safe guarding of vulnerable participants. The Nursing and Midwifery code (2015) stresses the importance of non maleficence and ensuring participants wellbeing during data collection. The Participants were reassured taking part in the study would in no way influence their application for asylum. Confidentiality was assured at every stage of the process, however there is no information about how the data was stored to protect the autonomy of the participants and ensure others did not have access to the data (Wood, and Ross-Kerr, 2006).

In-depth interviews took place in a variety of locations, this was decided by the participants. Allowing the participants to choose their environment ensures they feel comfortable, therefore allowing for richer data. Ensuring the reliability and validity of the study (Taylor et al., 2015). Interpreters were provided if required this echoed the study by Feldman (2013) which discusses the use of interpreters to allow all women to participate but talks about the way in which interpreters can influence the information in the way they translate and interpret the information. Therefore, effecting the validity and reliability of the study. Participants were engaged in the study over a period of three years and trustworthiness was assured through relationship building over this time period. Transcripts were returned to the participants for the purpose of editing or clarifying information. However, this can result in bias if the participant chooses to remove any valuable data effecting the reliability and validity of the study (Hagen, Dobrow and Chafe, 2009). Similar to the study by Feldman (2013) the researchers field notes and and journals, provided an audit of decision making and allowed the researcher to be aware of their own bias, reactions and emotions to the data. The transcripts were also examined by a second researcher experienced in analytical methods to confirm the findings and ensure validity of the data.

Tobin, Murphy-Lawless and Beck (2013) findings highlighted the medical model of care in the UK as a barrier to asylum seekers and refugees accessing care in the UK. Women felt increased sense of fear, isolation and vulnerability. Women seeking asylum or refugee status are often not familiar with the westernised midwifery model of care and often come from cultures where there is a belief that medical care or intervention is only required when there is a problem and normally in their country care would only be accessed in labour (National collaborating centre for women’s and children’s health, 2010). It is important asylum seeking and refugee women are given information on how to access care and understand how care is organised and what to expect. NICE (2010) pregnancy and complex social factors guidelines offer advice and guidance to midwives on how to address these issues and improve pregnancy outcomes in this vulnerable group.

Tobin and Murphy-Lawless (2014) conducted unstructured in-depth interviews. The aim of the study was to explore Irish midwife’s experiences of providing maternity care to women seeking asylum. A purposive sample of ten midwives was drawn from two clinical sites. The purposive sample allowed the researcher to ensure the participants had experience of providing care to women in the asylum process, ensuring that the research returns relevant information and avoids wasting time, taking samples that have nothing to do with the topic (Rees, 2012).

Unstructured interviews were audio recorded and transcribed verbatim. Unstructured interviews allow the participant to express the important aspects of their experiences and elaborate on these, increasing the validity (McLeod, 2014). However, this requires skill from the researcher knowing when to probe, it also generates a lot of data to be analysed and coded, thus being time consuming and costly (Rees, 2012). All participants were informed about the voluntary nature of participation in the study. Assurance of confidentiality was given, ensuring the researcher does not allow unauthorised people access to the data (Burns and Grove, 2009). Informed consent was obtained from participants and ethical approval was granted through a local ethical committee. This ensures ethical principle are adhered to and and participants are protected from harm. Data was analysed using content analysis to identify prominent themes.

Tobin and Murphy-lawless (2014) Concluded the concept of cultural care as an emerging strong theme. Four midwives had received varying levels of training; some had received no training at all. The women had come from culturally diverse backgrounds but had been viewed as having the same needs and requirements. This led to feelings of ignorance and stigmatisation. The study further highlighted the need for improved education in cultural competency, an understanding of the asylum process and how to help and care for women who experience pre and post migratory stress. Horvat, Horey, Romios, Kis-Rigo (2014) suggest embedding cultural competence in healthcare systems enables systems to provide appropriate care to patients with diverse values, beliefs, and behaviours, including meeting patients’ social, cultural and linguistic needs.

Both studies recognised cultural customs and beliefs and the western medicalised model of care as a barrier to accessing maternity care. Asylum seekers and refugees are known to experience some of the worst maternal health outcomes in the UK (The Marmot Review, 2010; Henderson et el., 2013) Reducing health inequalities has long been at the forefront of public health policy in many countries including the United Kingdom (Department of Health, 2012). Both studies attempted to prove midwives endeavoured to provide women centred individualised care, through sensitively responding to the women’s needs. They found this challenging due to their cultural education, beliefs and understanding. However, conflicting expectations could adversely affect the relationship where cultural and religious practices are not understood or met (Aquino, Edge and Smith, 2014). Tobin and Murphy-Lawless (2014) further recommends an evaluation of the cultural competency education programme and training in Ireland.

Four papers critiqued within the literature review have highlighted two themes which could enhance access to maternity care for asylum seekers and refugee in the UK. Philmore (2014), Feldman (2013), Tobin and Lawless (2014) and Tobin, Murphy-Lawless and Beck (2013) all highlighted the need for cultural competency awareness, information, education and training for midwives. Therefore, this theme will be taken forward to chapter 4 to develop a Service Improvement Plan.

Chapter 4: Service Improvement plan

The five studies reviewed in chapter three highlighted the difference or lack of cultural training midwives had experienced even when working with women seeking asylum in pregnancy. Understanding the processes of asylum, women’s entitlements, cultural and linguistic barriers and support given by the midwives were all highlighted as inconsistent therefore preventing and discouraging these women from accessing maternity care. Midwives are the first point of contact, it is therefore vital they are able to provide culturally competent care free from feeling discriminated against, stigmatised and disregarded

It is vital to understand the barriers being faced by midwives and women and use this knowledge to adapt an approach relevant to the problem and implement change through a service improvement plan. It is important to set realistic goals and objectives and define how these will be achieved. Changes made must be measured to ensure they impact upon the service in a positive way (Batalden et al., 2007). Langley et el (2009) ‘Service Improvement (SI) model will guide this process. Langley’s model is divided into two sections. ‘Thinking’ part comes first and consists of three fundamental questions which are essential to guide the process. Then comes the ‘doing part’ this consists of the Plan, Do, Study, Act (PDSA) cycle which helps to make the changes which need to be addressed and implemented.

Stage 1 – Thinking

Initially we need to consider what are we trying to accomplish? The studies in chapter three highlighted women seeking asylum whist pregnant are disadvantage in comparison to other groups in pregnancy, Aspects including; communication difficulties, cultural difference, financial and complex social barriers and dispersal. (Feldman,2013) The research suggests this vulnerable group would benefit from cultural competency awareness, information, education and training for midwives to enable them to enhanced access to maternity care and improve their experiences.

The aim of this service improvement plan is to provide midwives with the skills and knowledge they need to support pregnant asylum seekers and refugees to access and receive woman centred individualised maternity care. To achieve this SMART (Specific, Measurable, Achievable, Realistic and time bound) objectives have been set;

To create an information book (electronic and hard copy) for midwives which will set out information about the process of seeking asylum, rights, entitlements, support, contact telephone numbers and complex factors to consider and cater for when caring for refugees or women seeking asylum during pregnancy.
The book will be distributed to all Bristol National Health Service (NHS) trusts for further dissemination to the trust dependencies.
To be reviewed and audited using Langley (2009) PDSA cycle, every 6-12 months through questionnaires’, focus groups and and annual seminar.

4.2 Measure

To assess if the Service Improvement is successful measurement of change must occur before, during and after the task. This will provide a baseline to measure improvement against and ascertain if change is happening and if the change is making an improvement. (NHS Improvement, 2012). To achieve this current services will need to be reviewed and a baseline measures set out. Baseline measures will include;

Number of refugees or asylum seekers midwives across Bristol trusts which midwives care for.
Number of midwives across Bristol trusts who have knowledge (if any) of the process of seeking asylum, support services, entitlements and rights or complex social factors of the women.
Measure the local mortality and morbidity rates for this group of women.

Post measures;

Number of refugee or asylum seekers, midwives across Bristol trusts care for. (has this improved, are women finding access to care better)
Have refugees or asylum seekers experiences of maternity care improved?
Has the knowledge and understanding of midwives, about how to care for this group of vulnerable women improved?
Has the local mortality and morbidity rates of this group improved?

To establish if the services midwives give to refugees and asylum seekers have improved their care reduced judgements, discrimination, anxiety and improved the midwife woman relationship will involve women giving feedback about their care. This could be achieved through a questionnaire similar to the current NHS initiative ‘Friends and family test (2012). This would involve all women receiving assessment questionnaires to complete via email or post. A disadvantage of this method would be the low response rate (Nakash et al., 2006) a questionnaire about the care and support they have received to gauge if they have benefited from the services. A questionnaire would need to be available in many different languages, dialect and wording would need to be considered so this may become a costly method of gaining feedback. Women centred small focus groups with an interpreter may prove to be a better option they have proved particularly good at those who are disadvantaged (The Health Foundation, 2013). This would allow for the women to comment of the services and their experiences and to help develop future improvement plans. However, these may not prove as efficient as individual interviews which would be timely and expensive (The Health Foundation, 2013)

The idea for the change is to improve the care, experiences and outcomes of refugees and asylum seekers through improved knowledge understand and training of the midwives caring for them. During the first year the book should be disseminated across Bristol trusts and their dependencies. This can be done electronically and via hard copy. A contact email for ownership of the document will be available for midwives using the document to communicate any known amendments or improvements they are aware of; this will provide version control of the service improvement being used.

4.4 Plan, Do, Study, Act (PDSA) cycle

Plan ; Online documents are often seen as good tools to implement changes in practice. The NHS Institute for Innovation and Improvement (2008) states to implement new changes in service delivery, it is important that pilot studies are undertaken. The document will provide a resources which can be easily updated, accessible and used over and over. When planning the Service Improvement, factors which will influence its success such as; professional’s awareness of the document, the format and layout of the document, the motivation of midwives to use the document, must be considered. Trust should promote the up coming document via the intranet and trust newsletters. Managers in trust dependency areas should deliver training on the book and discuss the use of it operation with their staff.

DO; When designing the document Trusts taking ownership must consider the use of focus groups, this should include specialists in the area of asylum, support services, midwives, and women who have received maternity care whilst in the asylum process. Thus ensuring the information within the book is up to date, relevant and useful. The document when finalised should be circulated around the focus group members for the purpose of editing and clarifying information and to ensure agreement on the final document. Inviting midwives to the participation of the design of the document will inspire them to feel ownership which will encourage the use of the document. This will improve the success of the implementation plan. Circulation of book should be done electronically and via hard copy allowing for easy and repeated use.

Study; six to twelve months after implementation of the document the focus group will need to come together to review it. This period of time will allow for the implementation of the document, its information and processes to be embedded into practice areas. After this time period analysis will occur. Staff involved in using the document will be invited to participate in the evaluation via questionnaires. Questionnaire’s are useful for evaluation of service improvement. The analysis of the questionnaire data would then be taken forward to an After Action Review (AAR) a tool used to facilitate assessments. The design focus group would come back together using the AAR tool to discuss the document, reflect upon how it has changed practice, evaluate the document, looking at how effective the document has been and if the document has led to positive changes making improvements in the service. (Cronin and Andrews, 2009).

Act; the next step is to continue to review the document on a regular basis to enable changes in practice and policy to be amended. The NHS institute for innovation and improvement (2008) states multiple cycles of the PDSA cycle are required to highlight adaptions which are profound after the first cycle. Providing further training to staff may be required, but this would be costly to the trust in terms of money and time.

4.5 Conclusion

In conclusion the experiences of pregnant women seeking asylum in the UK are poor. Midwives receive very little formal training in caring for this vulnerable group. Training is costly in money terms and time to NHS trusts. Midwives endeavour to provided women centred individualised care but find this challenging due to their lack of awareness of NHS entitlements, cultural training, personal beliefs and understanding. These experiences cause avoidance in interaction with maternity services resulting in poor outcomes and higher rates of morbidity and mortality. This service improvement plan was designed to meet the needs of midwives providing maternity care to pregnant women seeking asylum and also to improve the experiences of this vulnerable group of women. By considering the needs of the women and the Midwives caring for them holistically this document will improve the quality of the service provided and better equip the midwives to manage the service in an appropriate way.

Ali, N., Burchett, H., (2004). Experiences of Maternity Services: Muslim Women’s Perspectives. London: The Maternity Alliance.

Ameh, C. A. and van den Broek, N. (2008) Clinical governance- Increased risk of maternal death among ethic minority women in the UK . [online] Available from: http://onlinelibrary.wiley.com/store/10.1576/toag.10.3.177.27421/asset/toag.10.3.177.27421.pdf;jsessionid=2452CDA304E4E4CE9876CDB1CF31DF54.f02t02?v=1&t=izr46e7r&s=5ca94725e5acc2234f0050ed593aeb50d502d99f [accessed on 1 March 2017]

Anderson, C., (2010) Presenting and Evaluating Qualitative Researc h [online] Available from; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987281/ [Accessed on 5 March 2017].

Aquino M.R.J.V., Edge, D., Smith, D.M. 2014. Pregnancy as an ideal time for intervention to address the complex needs of black and minority ethnic women: Views of British midwives. [Online] Available from; http://www.sciencedirect.com.ezproxy.uwe.ac.uk/science/article/pii/S0266613814002617 [Accessed on 1 April 2017]

Batalden, P. B., (2007) What is “quality improvement” and how can it transform healthcare? Quality & Safety in Health Care [Online] Available from; http://dd6lh4cz5h.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=What+is+%22quality+improvement%22+and+how+can+it+transform+healthcare%3F&rft.jtitle=Quality+%26+Safety+in+Health+Care&rft.au=Paul+B+Batalden&rft.au=Frank+Davidoff&rft.date=2007-02-01&rft.pub=BMJ+Publishing+Group+LTD&rft.issn=1475-3898&rft.eissn=1475-3901&rft.volume=16&rft.issue=1&rft.spage=2&rft_id=info:doi/10.1136%2Fqshc.2006.022046&rft.externalDocID=4011420741¶mdict=en-UK [Accessed online 4 th April 2017].

Bettany-Saltikov, J. (2012). How to do a systematic literature review in nursing: a step-by-step guide. Maidenhead: Open University Press.

Braun, V., Clarke, V. (2006) Using thematic analysis in psycholo gy. Qualitative Research in Psychology 3 (2) : 93.

Briscoe, L., Lavender, T., (2009) Exploring Maternity Care for Asylum Seekers. [online] Available from; http://www.magonlinelibrary.com/doi/citedby/10.12968/bjom.2009.17.1.37649 [Accessed on 28 March 2009

Bryman, A. (2012) Social Research Methods . 4 th ed. Oxford: Oxford University Press.

Burns, N., Grove, S.K. (2009) T he practice of Nursing Research. Appraisal, Synthesis and Generation of Evidence . 6 th ed. USA: Saunders Elsevier Ltd

Centre for Maternal and Child Enquires (CMACE) (2011), Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer : 2006–2008.BJOG: An International Journal of Obstetrics & Gynaecology, 118 pp. 1–203.

Cronin, G., Andrews, S. (2009) After Action Review: A model for learning. Emergency Nurse. 17 (3), pp 32-35. [Online] Available from; http://dd6lh4cz5h.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=After+action+reviews%3A+a+new+model+for+learning&rft.jtitle=Emergency+nurse+%3A+the+journal+of+the+RCN+Accident+and+Emergency+Nursing+Association&rft.au=Cronin%2C+Gerard&rft.au=Andrews%2C+Steven&rft.date=2009-06-01&rft.issn=1354-5752&rft.eissn=2047-8984&rft.volume=17&rft.issue=3&rft.spage=32&rft_id=info%3Apmid%2F19552332&rft.externalDocID=19552332¶mdict=en-UK [Accessed 4 th April 2017]

Department of Health, (2012). Health Profile . [Online]. Available from; http://www.apho.org.uk/resource/view.aspx?RID=117023 [accessed on 31 March 2017]

Feldman R (2012) When maternity doesn’t matter: Dispersing pregnant women seeking asylum. Available from: www.refugeecouncil.org.uk/assets/0002/6402/When_Maternity_Doesn_t_Matter_-_Ref_Council__Maternity_Action_report_Feb2013.pdf [Accessed 4 April 2017]

Gaudion, P., Allotey, P., (2008) Maternity care for asylum seekers and refugees in Hillingdon , [online] available from: http://www.thepolyannaproject.org.uk/documents/Needs_assessment_in_Hillingdon.pdf [Accessed on 2.3.2017

Gerrish, K, Chau, R, Sobowale, A, Birks, E, (2004) Bridging the language barrier: the use of interpreters in primary care nursing. Health Social Care Community 12(5): 407–13

Gov UK. (2015) Spending Review and Autumn Statement 2015 . Available from; https://www.gov.uk/government/publications/spending-review-and-autumn-statement-2015-documents/spending-review-and-autumn-statement-2015 [Accessed on 4 April 2017]

Hadziabdic, E., Albin, B., Heikkila, K., Hjelm, K. (2010) Healthcare staff ’s perceptions of using interpreters. Primary Health Care Research & Development 11(3): 260–70

Hagens, V., Dobrow, M. J., & Chafe, R. (2009). Interviewee transcript review: assessing the impact on qualitative research. BMC Medical Research Methodology, 9, 47. doi:10.1186/1471-2288-9-47

Henderson, J., Gao, H., Renshaw, M. 2013. Experiencing maternity care: the care received and perceptions of women from different ethnic groups BMC Pregnancy and Childbirth. 2013 Vol 13 , PP. 196.

Holloway, I., Wheeler, S., 2010. Quantitave research for nurses . Third edition. Wiley- Blackwell, Chichester

Horvat, L., Dell, H., Romios, P., Kis-Rigo, J. (2014). Cochrane database of systematic reviews: Cultural competence education for health professionals. [online] Available from;

http://dd6lh4cz5h.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Cultural+competence+education+for+health+professionals&rft.jtitle=The+Cochrane+database+of+systematic+reviews&rft.au=Horvat%2C+Lidia&rft.au=Horey%2C+Dell&rft.au=Romios%2C+Panayiota&rft.au=Kis-Rigo%2C+John&rft.date=2014&rft.eissn=1469-493X&rft.issue=5&rft.spage=CD009405&rft_id=info%3Apmid%2F24793445&rft.externalDocID=24793445¶mdict=en-UK [Accessed on 1 April 2017].

Langley, G. J. (2009) The improvement guide: A practical approach to enhancing organizational performance [online] Available from; https://www.dawsonera.com/abstract/9780470430880 [Accessed on 4 th April 2017]

Lyons SM, O’Keeffe FM, Clarke AT, Staines A. (2008) Cultural diversity in the Dublin maternity services: the experience of maternity service providers when caring for ethnic minority women. Ethnic Health. 2008; 13:261–276. [ PubMed ]

McLeod, S., (2014) Simple Psychology: Questionnaires. [online] Available from; https://www.simplypsychology.org/questionnaires.html [Accessed on 1 April 2017]

MAMTA (2017) CHILD & MATERNAL HEALTH PROGRAMME FOR BME WOMEN IN COVENTRY [Online] Available from; http://www.fwt.org.uk/www.fwt.org.uk [Accessed on 3 March 2017].

Moule, P., Goodman, M. (2014) Nursing Research: An Introduction. London: SAGE Publications Ltd.

MacFarlane A, Dzebisova Z, Karapish D, Kovacevic B, Ogbebor F, Okonkwo E (2009) Arranging and negotiating the use of informal interpreters in general practice consultations: Experiences of refugees and asylum seekers in the west of Ireland . Soc Sci Med 69(2): 210–4. doi: 10.1016/j.socscimed.2009.04.022

Nakash, R., Hutton, J., Jorstad-Stein, E., Gates, S. and Lamb, S. (2006) Maximising Response to Postal Questionnaires – A systematic Review of Randomised Trials in Health Research . BMC Medical Research Methodology [online]. 6 (5). [Accessed 04 April 2016].

National Collaborating Centre for Women’s Health (2010). Pregnancy and complex social factors . [online] Available from;

http://www.ncc-wch.org.uk/guidelines/guidelines-programme/guidelines-programme-published/pregnant-women-complex-social-factors/ [Accessed on 1 April 2017]

National Institute for Health and Care Excellence (2010a) Pregnancy and Complex Social Factors: A model for service provision for pregnant women with complex social factors. Nice Clinical Guideline 110. www.nice.org.uk/cg110 [Accessed on 4 April 2017]

NHS Improvement (2012) First Steps towards Quality Improvement: A Simple Guide to Improving Services . Available From: http://www.nhsiq.nhs.uk/media/2591385/siguide.pdf [Accessed 03 April 2016].

NHS (2012 ) Friends and family Test: Implementation [Online} Available from; https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213047/NHS-Friends-and-Family-Test-Implementation-Guidance-v2.pdf [Accessed on 6 April 2017

NHS institute for innovation and Improvement (2008) Quality and Service improvement tools: Plan, Study, Do, Act (PDSA). [Online] Available from: http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_serv [Accessed on 4th April 2017]

Nursing and Midwifery Council (2008) The Code for nurses and midwives . [online]. Available from: https://www.nmc.org.uk/standards/code/ [Accessed on 3 March 2017]

Nursing and Midwifery Council (2015) The Code . [online] Available from: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed 30 March 2017]

Novick. G, (2008) Is There a Bias Against Telephone Interviews in Qualitative Research? [Online] Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238794/ [Accessed on 2 March 2017]

Office of National Statistics (2016) Asylum Seekers and Pregnancy. [Online] Available from; https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/asylumseekersandpregnancy , [Accessed on 1 March 2107]

Phelan, M., Parkman, S., (1995) How to work with an interpreter . BMJ; 311: 7004, 555-557

Philmore, J. (2015). Migrant maternity in an era of superdiversity: New migrants’ access to, and experience of, antenatal care in the West Midlands, UK. Social Science and Medicine 2016; Vol 148, PP 152-159.

Polit, D. F. and Beck, C. T. (2010) Essentials of Nursing Research. Seventh Edition: Appraising Evidence for Nursing Practice. London: Lippincott Williams and Wilkins

Polit, D.F., Hungler, P., (1997). Essential of Nursing Research Methods , Appraisals and Utilization (fourth edition) Lippincott: Philadelphia.

Rees, C. (2012) Introduction to Research for Midwives. Third Edition. London: Churchill Livingstone Elsevier

Reeves, S., Kuper, A., Hodges, B., (2008) Qualitative research methodologies: ethnography [online] available from; http://www.bmj.com/content/337/bmj.a1020 [accessed on 2.3.2017]

Squires, A., Methodological Challenges in Cross-Language Qualitative Research: A Research Review. Int J Nurs Stud. 2009, Vol 46, PP 227–287.

Sutton, J., Austin, Z., (2015) Qualitative Research: Data Collection, Analysis, and Management . [Online] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485510/ [Accessed on 29 March 2017].

Temple, B., (2002) Crossed wires: Interpreters, Translators, and Bilingual Workers in Cross-Language Research . Qual Health Res. 2002; 12:844–854. doi: 10.1177/104973230201200610

Taylor, S.J., Bogdan, R. and DeVault, M.L. (2015) Introduction to Qualitative Research Methods: a guidebook and resource . 4 th ed. New Jersey: John Wiley and Sons

The Health Foundation (2013) Measuring Patient experience. Available from; http://www.health.org.uk/sites/health/files/MeasuringPatientExperience.pdf [Accessed on 4th April 2017]

The Marmot Review. 2010. Fair Society. Healthy Lives. [online] Available from;

http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review/fair-society-healthy-lives-full-report [Accessed on 1 April 2017]

The Refugee Council (2017) The Truth about Asylum . Available from: http://www.refugeecouncil.org.uk/policy_research/the_truth_about_asylum/the_facts_about_asylum [Accessed on 4th April 2017]

The Royal College of Midwives (2014) Databases [online] Available from;

https://www.rcm.org.uk/learning-and-career/learning-and-research/databases [Accessed on 3 March 2017]

The Royal College of Obstetricians and Gynaecology (2010) Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. [Online] London: Royal College of Obstetricians and Gynaecology . Available from: http://www.nice.org.uk/nicemedia/live/13167/50861/50861.pdf [Accessed on 4 April 2017].

The Royal College of Obstetricians and Gynaecology (2010) Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. [Online]. Available from: http://www.nice.org.uk/nicemedia/live/13167/50861/50861.pdf [Accessed on 1 March 2017].

Tobin, C., Murphy-Lawless, J., Beck, CT. (2013) Childbirth in exile: asylum seeking women’s experience of childbirth in Ireland. Volume 30, Issue 7 , July 2014, Pages 831–838 Available from: http://www.sciencedirect.com.ezproxy.uwe.ac.uk/science/article/pii/S0266613813002179 [Accessed on 4 April 2017]

Tobin CL, Murphy-Lawless J. Irish midwives’ experiences of providing maternity care to non-Irish women seeking asylum. International Journal of Women’s Health. 2014;6:159-169.

Wood, M., Ross-Kerr, J., (2006). Basic steps in planning nursing research: from question to proposal. Sixth ED, Jones and Bartlett, Sudbury.

Zohrabi (2013). Mixed Method Research: Instruments, Validity, Reliability and Reporting Findings [online] Available from; http://www.academypublication.com/issues/past/tpls/vol03/02/06.pdf [Accessed on 5 March 2013]

Planning Mind Map.

Maternity	Experiences	Ethnic minorities
Midwife	Views	Asylum Seekers
Obstetric	Improvements	Refugees
Childbirth	Barriers	Non English speaking women
Birth	Obstacles	Migrants
Pregnant	Opinions
Antenatal/ Postnatal	Feelings
Post-partum	Judgements
Labour
Labor
Childbearing

Ovid Maternity and Infant Care, MEDLINE, The Cochrane Library and ASSIA:

CINAHL Plus- I searched the four first words in each category as it only allowed twelve in the advanced search function.

PsycInfo- originally same words as those searched in CINHAL but because no relevant research appeared, only ‘maternity’, ‘experiences’, ‘asylum seekers’ and refugees were used.

Authors	Three Dr’s all have PHD and are all associated with university lecturing in the nursing, midwifery and sociology field. Published in BMJ 2014, relevant to topic of interest.
Focus	Looking at the connection, communication and cultural understanding and how this impacts on the women’s health
Background	Poorly organised maternity services complicated by lack of training and cultural awareness have proved to have a detrimental effect on already vulnerable traumatised group of women. Implications for practice need to focus on how care providers can meet the needs of these women.
Aim	To gain an insight into women’s experiences of childbirth in Ireland while in the process of seeking asylum.
Methodology/approach	Qualitative in-depth unstructured interviews
Method of data analysis and presentation	Data was analysed using the Burkes dramatistic pentad to identify narrative agents
Tool of data collection	Women were invited to participate through attending information sessions and workshops held within their accommodation centres.
Sample	Purposive sample of 22 women who had experienced pregnancy and childbirth while seeking asylum or refuge in Ireland
Ethical considerations	Ethical approval was sought and gained emphasis was placed on voluntary participation due to the nature of the the study and interviewers were provided with an interpreter if required.
Main findings	The study found 3 main findings lack of connection, communication and cultural understanding was evident in all 22 participants. Communication and connection were barriers to adequate care this further impacted on the health and wellbeing of the women. Women were entirely reliant on interpreters and this proved to be a scares resource with restricted accessibility. The medicalised environment heightened the women’s sense of isolation, fear and vulnerability. Lack of cultural understanding and insight into the women had a detrimental effect on their mental health
Conclusions and recommendations	Poor organised care for asylum seeking women has thus far had a detrimental effect upon connection, communication and cultural awareness. Community based services with staff who have Training in cultural competency, access to interpreters and leaflets in various languages during the antenatal period will improve the access and services for this group.
Overall strengths and limitations	Research is dependant on the skills of the researcher The volume of data and transcribing is time consuming Not always as well understood and quantitave research and not always as well accepted

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Midwifery Dissertation Topics: A Comprehensive Guide

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Table of Contents

Introduction

Are you pursuing a degree in midwifery and looking for a dissertation topic that will stand out? Crafting a compelling dissertation is a crucial part of your academic journey. In this guide, we’ll explore what midwifery entails, the steps to writing a dissertation, current research topics, and provide valuable external resources to aid your research.

What Does Midwifery Mean?

Midwifery is a healthcare profession centered around supporting women during pregnancy, childbirth, and the postpartum period. Midwives provide care that encompasses the physical, emotional, and social well-being of the mother and her newborn. Their role often includes providing prenatal care, assisting with labor and delivery, and offering guidance on newborn care and breastfeeding.

What Are the Steps to Writing a Midwifery Dissertation?

Topic Selection : Choose a topic that aligns with your interests and the current trends in midwifery research.
Literature Review : Conduct a thorough review of existing literature to understand the background and context of your chosen topic.
Research Methodology : Determine the research methodology you will use, whether it’s qualitative, quantitative, or mixed methods.
Data Collection : Collect relevant data through methods such as surveys, interviews, or observations.
Data Analysis : Analyze the collected data using appropriate statistical or qualitative analysis techniques.
Discussion and Conclusion : Discuss your findings, draw conclusions, and propose recommendations for future research or practice.

Do you do a dissertation for midwifery?

Yes, a dissertation is typically a requirement for completing a degree in midwifery. It allows students to demonstrate their understanding of key concepts, research skills, and ability to contribute to the field through original research. Click here to place an order on midwifery Dissertation at 25% Discount.

What are the current research topics in midwifery?

Midwifery, often mistakenly confined solely to pregnancy, is a remarkably expansive field encompassing various critical aspects. It extends beyond the perimeters of pregnancy to include post-pregnancy care, labor, and other multifaceted dimensions.

The breadth and depth of midwifery’s scope are reflected in the current hot topics within the field. These hot topics in midwifery cover a spectrum of issues, ranging from postnatal care to labor experiences, highlighting the diverse and dynamic nature of midwifery practices.

Here are 150+ broad trending dissertation topics in midwifery research:

The impact of midwifery-led care on maternal and neonatal outcomes.
Cultural competency in midwifery practice.
Addressing health disparities in maternal and infant health.
The role of midwives in promoting breastfeeding initiation and duration.
Integrating technology into midwifery practice for improved patient care.
Exploring the experiences of women of color in maternity care.
Midwifery interventions for reducing preterm birth rates.
The effects of maternal obesity on pregnancy and birth outcomes.
Midwifery-led models of antenatal care.
Supporting women with substance use disorders during pregnancy.
The role of midwives in providing perinatal mental health support.
Enhancing cultural safety in midwifery education and practice.
Exploring the impact of COVID-19 on maternity care and midwifery practice.
Midwifery-led interventions for reducing cesarean section rates.
Addressing the needs of marginalized communities in maternity care.
The effectiveness of midwifery-led birth centers.
Strategies for improving maternal nutrition during pregnancy.
Midwifery care for women with high-risk pregnancies.
The importance of continuity of care in midwifery practice.
Promoting maternal mental well-being during the postpartum period.
The role of midwives in addressing obstetric violence.
Exploring the impact of midwifery care on maternal satisfaction.
Integrating doula support into midwifery practice.
Midwifery-led interventions for reducing maternal mortality rates.
The ethics of midwifery practice in a multicultural society.
Addressing implicit bias in maternity care.
The role of midwives in supporting women with disabilities during pregnancy and birth.
Midwifery education and training in low-resource settings.
The impact of midwifery care on the reduction of unnecessary interventions in childbirth.
Exploring the experiences of LGBTQ+ individuals in maternity care.
The role of midwives in advocating for reproductive justice.
Addressing disparities in access to midwifery care.
Integrating complementary and alternative therapies into midwifery practice.
Midwifery care for women with previous traumatic birth experiences.
The importance of informed consent in midwifery practice.
Exploring the experiences of immigrant and refugee women in maternity care.
Midwifery-led interventions for promoting physiologic birth.
The impact of midwifery care on reducing unnecessary medical interventions.
Strategies for improving midwifery education and training.
Midwifery care for women with perinatal loss.
The role of midwives in promoting reproductive autonomy.
Exploring the experiences of midwifery students during clinical placements.
The impact of midwifery care on reducing maternal morbidity rates.
Addressing environmental factors in maternity care.
The role of midwives in providing culturally sensitive care to indigenous communities.
Midwifery care for women with gestational diabetes.
Exploring the experiences of midwives working in rural areas.
The impact of midwifery care on breastfeeding success.
Addressing obstetric violence in marginalized communities.
Midwifery-led interventions for reducing infant mortality rates.
The role of midwives in promoting reproductive health education.
Exploring the experiences of midwives during emergencies and disasters.
The impact of midwifery-led group prenatal care.
Addressing maternal health disparities in urban settings.
Midwifery care for women with maternal infections.
The role of midwives in advocating for maternity care policy reform.
Exploring the experiences of midwifery preceptors and mentors.
The impact of midwifery care on reducing racial disparities in maternal health.
Addressing obstetric fistula through midwifery interventions.
Midwifery-led interventions for reducing postpartum hemorrhage rates.
The role of midwives in providing care to incarcerated women.
Exploring the experiences of midwives working in humanitarian settings.
The impact of midwifery care on reducing neonatal mortality rates.
Addressing barriers to midwifery care in rural communities.
Midwifery-led interventions for promoting maternal nutrition.
The role of midwives in supporting women with traumatic birth experiences.
Exploring the experiences of midwifery students in clinical simulations.
The impact of midwifery care on reducing disparities in access to prenatal care.
Addressing gender-based violence in maternity care.
Midwifery care for women with multiple pregnancies.
The role of midwives in providing care to adolescent mothers.
Exploring the experiences of midwives in interdisciplinary healthcare teams.
The impact of midwifery care on reducing maternal readmission rates.
Addressing barriers to midwifery care for LGBTQ+ individuals.
Midwifery-led interventions for promoting perinatal mental health.
The role of midwives in supporting women with postpartum depression.
Exploring the experiences of midwives providing care during emergencies.
The impact of midwifery-led water birth on maternal outcomes.
Addressing disparities in access to midwifery care for women with disabilities.
Midwifery care for women with substance use disorders during pregnancy.
Redefining Post-Pregnancy Care: A Comprehensive Analysis of Maternal Well-being
Navigating Cultural Sensitivities in Midwifery Practices: A Global Perspective
Exploring Alternative Approaches to Pain Management During Labor
Midwifery in Crisis Settings: Challenges and Opportunities for Maternal Health
The Impact of Technology on Contemporary Midwifery Practices: A Critical Examination
Integrating Mental Health Support into Midwifery Care: Addressing the Psychological Well-being of Mothers
Assessing the Efficacy of Holistic Midwifery Models: A Comparative Study
Reducing Disparities in Maternal Healthcare Access: The Role of Midwifery Services
Midwifery-Led Continuity of Care: Examining its Impact on Birth Outcomes
Innovations in Midwifery Nursing Education: Meeting the Evolving Needs of Future Practitioners
Smartphone technology as a mediated educational tool used by midwifery students: a descriptive analysis.
Midwifery care during the transition from subfertility to pregnancy: studying the perceptions of the clients involved.
Attitudes regarding midwifery among physician trainees: an interview-based approach.
A comparative analysis of midwifery in Netherlands and Canada.
Midwifery students: investigating the attitudes towards gender roles – review of literature.
Midwifery practice: role played by nutritional counseling in the field.
Midwifery care for documented versus undocumented women in the Netherlands: a systematic approach.
Studying the relation between midwifery practice and normality during childbirth.
Stillbirth and neonatal deaths: how midwifery graduates cope with their primary cases? An interview-based study.
Maternity emergencies and midwifery: a systematic analysis.
Midwifery practice: role played by gender in the field – a systematic study.
A comparative analysis of the midwifery training programs in developed versus developing countries of the world.
Midwifery practice and gap in the care of women after successful infertility treatments: a review of the literature.
Midwifery research: challenges and interventions being used.
Women with intellectual disabilities: pregnancy and midwifery care in UK hospitals.
Attitudes towards abortion in pregnant adolescents: perspectives from the field of midwifery.
Continuity of care and midwifery: development of a hypothetical model.
Investigating the satisfaction levels of midwifery students at university levels: a study based on Turkey.
Midwifery as a primary health care strategy: uncovering the challenges and interventions available.
Midwifery Belonging Scale: assessing perceptions of midwifery graduates for their profession.
Studying the relation between needs satisfaction, mental health, work-related characteristics and motivation in the field of midwifery: a quantitative study.
Investigating the attitudes of midwifery students towards the utilization of emergency contraceptives: a descriptive study.
Studying the impacts of counseling programs on the academic performance of midwifery students.
History of midwifery in Australia: connecting the past with the present.
Investigating the impacts of continuity of midwifery care on postnatal depression.
Alcoholic pregnant women and midwifery care: a systematic study.
Studying the cooperation between midwifery and social work for illegal women in the UK.
Politics of midwifery: comparing Australia with the Netherlands.
Post-traumatic stress disorder and midwifery: a review of literature.
Ethical practices in midwifery: comparing developed countries with the developing countries of the world.
Perceptions of midwifery graduates on the utilization of forceps and vacuum extraction during pregnancy.
Challenges in midwifery practices in Tanzania.
More Nursing Dissertation Topics

When considering midwifery dissertation topics, it becomes evident that these encompass far more than just pregnancy-related aspects. The research landscape in midwifery offers opportunities to explore and contribute to the understanding of diverse facets associated with female reproductive health.

Choosing a midwifery dissertation topic requires careful consideration of current trends, your interests, and the impact you want to make in the field. By following the steps outlined in this guide and exploring the diverse range of research topics, you can embark on a meaningful journey toward advancing knowledge in midwifery.

External Resources

Reading Resource Link : Midwifery Today
Example Dissertation Download Link : Midwifery Dissertation Examples

Feel free to explore the provided resources for further insights and inspiration for your midwifery dissertation journey.

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63 Best Midwifery Dissertation Topics

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Also, students who seek help in finding topics have a high chance of scoring better grades than those who find their research questions independently.

Why Should You Select Our Midwifery Dissertation Topics?

There many are many reasons why you should select a dissertation topic from our platform:

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Sometimes you need help : Realistically, you cannot do every task independently. No matter how active you are in your studies, sometimes it becomes mind-boggling to find suitable topics and complete your project on time. That is why we provide you with midwifery research topics for free and project writing at an affordable fee.

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Qualities of an Excellent Midwifery Dissertation Topic

You should select a topic that fascinates you. After selecting the midwifery dissertation topic, check if it has the following qualities:

Clarity : Your midwifery research topic should be easy to understand. Also, the topic should be straightforward and easily understandable to your audience.

Complex: Your midwifery dissertation topic should be analytic and argumentative. The topic should not be answerable by yes or no.

Focused: Your dissertation topic should be focused and debatable. Also, it should be narrow and that it can be answered thoroughly.

Your performance depends on the dissertation topic you pick. It would be best to prepare your research on time. But when you have a short deadline, contact us to help you.

Good Dissertation Research Topics

Are you looking for good dissertation topics in midwifery? We have some for you:

An attitude of midwives towards women in their care
Effects of improving midwifery in developing countries
Gender knowledge on midwifery
Global plans on midwifery improvement
History of midwifery
Improvement of active birth in women with continuous electronic fetal monitoring
Obstetric violence
The art of midwifery: early midwives in native America
The culture of midwifery in your country
The midwifery model of care
The perspective of family-centered care
Trends in midwifery
What is the social meaning of midwifery
Women relationship with midwives
Women-centered care

Interesting Midwifery Dissertation Topics

Finding interesting midwifery dissertation topics can be a hassle. But we have some top recommendations to relieve you the burden:

Aspects of preparation that students go through before practice
Case study of women who give birth at home
Challenges of learning for students midwives
Childbirth education in your country
Compare cesarean rates in two countries
Compare child care models in hospitals in your country
Compare Experiences of women who give birth at home, birth center, or in labor wards
Ethnography of labor wards
How can students cope with traumatic episodes in labor wards?
Midwives care in labor wards
Midwives experiences on traumatic childbirth
Midwives experiences that facilitate normal birth in your country
Obstetric procedures to facilitate normal birth
Right to choose a place of birth
What is the role of nurses in family-centered care?

Best Midwifery Research Topics

If you are looking for the midwifery dissertation topics to earn you top grades, you go through this list:

Advancement of gynecology and obstetrics
Are perinatal services linked to perinatal care services?
Association of fetal Zika virus exposure with visual and hearing loss
Can women with obesity have normal childbirth?
Effects of chronic Hepatitis B during pregnancy
Experiences of women taking care of children with disabilities
Explain the factors that inhibit normal childbirth
Hepatitis B during pregnancy: Challenges and opportunities
How effective are minerals and vitamins supplement during pregnancy?
How practical are the WHO perinatal guidelines?
Hygiene practices and urogenital infection in women from rural areas
Managing Hepatitis B during pregnancy
Perinatal care for women with disabilities
Perinatal depression management
Techniques in second stage labor that promotes normal childbirth

Excellent Midwifery Research Topics

If you need excellent midwifery dissertation topics, we hope you find a suitable one in the list below:

Causes of recurrent miscarriage
Cultural perspective towards male midwives
Effectiveness of DNA screening in identifying genetic problems in children
Effectiveness of surgery in repairing an umbilical hernia
Explain the genetic aspects of miscarriage
Explain the role of midwifery in decision-making in the second stage of labor
Importance of nutrition and healthy food consumption during pregnancy
Management of hernia rupture
Management of postpartum depression among midwives
Mechanisms behind miscarriages
Relationship between intrauterine fetal death and diarrhea
Trends concerning men practicing midwifery
Trends in midwifery research
What are the differences between women’s expectations and experiences during pregnancy and birth?
What are the risks of home abortions
What causes umbilical cord hernia
What is the role of infections in miscarriage?

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Midwifery Dissertation Topics List (30 Examples) For Your Research

Mark Dec 14, 2019 Jun 5, 2020 Midwifery , Nursing No Comments

As a student, if you are finding Midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on new and emerging concepts and ideas. You can choose any of the […]

As a student, if you are finding midwifery dissertation topics, you have visited the right site. We offer a wide range of midwifery dissertation topics and project topics on midwifery. As the field has evolved, the research topics on midwifery are based on the new and emerging concepts and ideas.

You can choose any of the give topic for your research in midvfery and our team can offer quality dissertations according to your requirements.

A list Of midwifery dissertaton topics

Emerging trends in midwifery and obstetrical nursing.

Modern trends of the N education in midwives and modern methods in practical training.

The impact of delayed umbilical cord clamping after birth.

How the cell-free DNA screening is helpful in identifying genetic problems in the baby?

Limiting interventions during low-risk labor.

The concept of cost containment in healthcare deliver.

The importance of family centred care and natural childbirth environment.

An interpretive research on the disparity between women’s expectations and experience during childbirth.

Systematic literature review on the extrauterine life management focusing on lung functions in new born.

To analyse the role of perinatal care to pregnant women.

Studying the treatment alternatives for urogenital infections in rural women.

Conducting a systematic review on how midwifery students plan their career.

Strategies adopted by midwives to advise pregnant women about nutritional values and healthy food consumption.

Studying the impact of Hepatitis B in pregnant women.

Analysing how frequent miscarriages are linked with higher anticardiolip antibodies.

Studying the relationship between perinatal mortality rates and physical activity levels.

How can nurses recommend preventive strategies to avoid sexual transmission of Zika virus to new born?

Evaluating the attitude of women related to the implementation of basic immunisation programs in village.

Analysing the modern trends of the education in midwives and new methods in practical training.

To study the advance trends in gynaecology and obstetrics.

The role of midwives in saving the lives of unborn foetus.

Exploring the global trends in nursing and midwifery education.

Analysing the role of optimal midwifery decision-making during second-stage labour.

To study the integration of clinical reasoning into midwifery practice.

A literature review on labouring in water.

Exploring the experiences of mothers in caring for children with complex needs.

An ethnography of independent midwifery in Asian countries.

To explore the perceptions of control in midwifery assisted childbirth.

Analysing the decision-making between nurse-midwives and clients regarding the formulation of a birth plan.

The role of Vitamin D supplementation during pregnancy .

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example of midwifery dissertation

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Midwifery Dissertation Topics

Midwifery Is A Good Fit for the Following:

Midwifery Dissertation Topics With Research Aim

Topic:2 Alcohol Abuse

Topic:3 Birth Planning

Topic:4 Community midwifery

Topic:5 Contraception

Topic:6 Electronic fetal monitoring

Topic:7 Family planning

Topic:8 Foetal and newborn care

Topic:9 Foetal well being

Topic:10 Gender-based violence

Topic:11 Health promotion

Topic:12 High-risk pregnancy

Topic:13 HIV infection

Topic:14 Human Rights

Topic:15 Infection prevention and control

Topic:16 Infertility and pregnancy

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List of Midwifery dissertations Topics and Some Tips for Selecting Better Dissertation Topics in Midwifery

What is Midwifery?

Tips for Selecting Midwifery Dissertation Topics

Prenatal Care:

Postpartum Care:

Labor and Delivery:

Maternal Health:

Neonatal Care:

Women’s Health:

Family Planning:

Midwifery Education and Training:

Midwifery Ethics and Legal Issues:

Mental Health in Pregnancy and Childbirth:

Integrative Medicine in Midwifery Practice:

Technology in Midwifery:

LGBTQ+ Inclusive Care:

Global Health and Midwifery:

Midwifery and Public Health:

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A never-ending love story : a narrative exploration into the experiences of men who provide care in the context of dementia

Alcohol use and alcohol-related harms: Exploring risk and protective factors among young people living in urban disadvantage

An action research study evaluating the effect of an action learning programme on healthcare professionals' knowledge, attitudes and practice

An exploration of mothers' experiences in caring for children with complex needs

An exploration of stigma towards depression in rural Ireland : a mixed methods study

An exploration of the respite needs and experiences of parents caring for a child with a life-limiting condition requiring palliative care

An exploration of women's expectations of and preferences for childbirth experiences : a mixed methods study

Anxiety during pregnancy and at three months postpartum: prevalence, variations and associated factors in a cohort of nulliparous women

Attenuating anxieties : mental health nurses' responses to suicidal behaviour: a grounded theory study

Attitudes and perceptions of medical and nursing staff to an emergency nurse practitioner service

Breaking bad news: a phenomenological study into the giving and receiving of a cancer diagnosis

Breastfeeding support groups in Ireland: a mixed methods investigation from a cultural historical activity theory perspective

Bullying and work related post traumatic stress in nurses

Caesarean section in nulliparous women: a mixed methods study of factors influencing decision-making and outcomes for women - the MAMMI Study Caesarean Section Strand

Change and entrenchment in Irish maternity care policies and antenatal practices: An Institutional Ethnography

Characteristics of Social Frailty among Older Adults with Intellectual Disability

Childbirth in exile : refugee and asylum seeking women's experience of childbirth in Ireland

Children who live in disadvantaged areas: a case study of the health and well-being perceptions and experiences of school-aged children and their families

Children's and Parents' Experiences and Expectations of their Roles in Hospital-A Constructivist Grounded Theory study

Cognitive Dissonance and Depression: An Exploration Using Mixed Methods