https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60789-3.pdf

Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60930-2.pdf

Improvement of maternal and newborn health through midwifery

Background
Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider’s perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs) from providing quality of care.

/pdf/what-prevents-quality-midwifery-care-a-systematic-mapping-of-3smjkd6e2l.pdf

What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective

Caseload midwifery reduces childbirth interventions and increases women’s satisfaction with care. It is therefore important to understand the impact of caseload midwifery on midwives working in and alongside the model. While some studies have reported higher satisfaction for caseload compared with standard care midwives, others have suggested a need to explore midwives’ work-life balance as well as potential for stress and burnout. This study explored midwives’ attitudes to their professional role, and also measured burnout in caseload midwives compared to standard care midwives at two sites in Victoria, Australia with newly introduced caseload midwifery models. All midwives providing maternity care at the study sites were sent questionnaires at the commencement of the caseload midwifery model and two years later. Data items included the Midwifery Process Questionnaire (MPQ) to examine midwives’ attitude to their professional role, the Copenhagen Burnout Inventory (CBI) to measure burnout, and questions about midwives’ views of caseload work. Data were pooled for the two sites and comparisons made between caseload and standard care midwives. The MPQ and CBI data were summarised as individual and group means. Twenty caseload midwives (88%) and 130 standard care midwives (41%) responded at baseline and 22 caseload midwives (95%) and 133 standard care midwives (45%) at two years. Caseload and standard care midwives were initially similar across all measures except client-related burnout, which was lower for caseload midwives (12.3 vs 22.4, p = 0.02). After two years, compared to midwives in standard care, caseload midwives had higher mean scores in professional satisfaction (1.08 vs 0.76, p = 0.01), professional support (1.06 vs 0.11, p <0.01) and client interaction (1.4 vs 0.09, p <0.01) and lower scores for personal burnout (35.7 vs 47.7, p < 0.01), work-related burnout (27.3 vs 42.7, p <0.01), and client-related burnout (11.3 vs 21.4, p < 0.01). Caseload midwifery was associated with lower burnout scores and higher professional satisfaction. Further research should focus on understanding the key features of the caseload model that are related to these outcomes to help build a picture of what is required to ensure the long-term sustainability of the model.

/pdf/comparing-satisfaction-and-burnout-between-caseload-and-134cfpt2st.pdf

Comparing satisfaction and burnout between caseload and standard care midwives: findings from two cross-sectional surveys conducted in Victoria, Australia.

Australian midwives' intentions to leave the profession and the reasons why.

https://opus.lib.uts.edu.au/bitstream/10453/17021/1/2010004660.pdf

Factors that contribute to midwives staying in midwifery: A study in one area health service in New South Wales, Australia

https://opus.lib.uts.edu.au/bitstream/10453/18485/1/2011006135.pdf

Barriers to developing midwifery as a primary health-care strategy: A Jordanian study

Early postnatal discharge is itself not a new concept. Its first recorded use was in New Orleans, 1942, when postnatal mothers were discharged soon after birthing to relieve pressure on crowded hospital situations. Since then, the effects of early postnatal discharge on mothers and babies have been widely studied, but the research has primarily focused on the safety to mothers and babies of going home early. Lock’s study took as its focus the experience of mothers who elected early discharge. The women who participated in that study (a mixed group of first-, second- and third-time mothers), had chosen to take early discharge before they went into hospital. The project tracked their experiences, and provided a reflective evaluation made about six weeks after coming home. Much of the focus in early childhood and community settings is on the health of the infant. While this is clearly important, the physical, emotional and social needs of the mother must not be overlooked. This paper will briefly describe some of the common physical problems and social stresses experienced in the first six months after birth. Whilst recognising that some of the issues highlighted in this paper are often discussed in relation to postnatal distress and depression, this paper does not attempt to provide a comprehensive coverage of those aspects of women’s health in the first six months. There are many materials available that specifically address postnatal distress and depression.

Early postnatal discharge: what the mothers say and women's health in the first 6 months after birth

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Factors that contribute to midwives staying in midwifery: A study in one area health service in New South Wales, Australia

Barriers to developing midwifery as a primary health-care strategy: A Jordanian study

Early postnatal discharge: what the mothers say and women's health in the first 6 months after birth