References

Anderson T. Feeling safe enough to let go: the relationship between a woman and her midwife during the second stage of labour, 2nd edn. In: Kirkham M. (ed). London: Palgrave Macmillan; 2010

Arundell F, Mannix J, Sheehan A, Peters K. Workplace culture and the practice experience of midwifery students: A meta-synthesis. J Nurs Manag. 2018; 26:(3)302-313 https://doi.org/10.1111/jonm.12548

Benner P. From novice to expert: Excellence and power in clinical nursing practice, Commemorative edn. Upper Saddle River (NJ): Prentice Hall; 2001

Deery R, Hunter B. Emotion work and relationships in midwifery, 2nd edn. In: Kirkham M (ed). London: Palgrave Macmillan; 2010

Fenwick J, Hammond A, Raymond J Surviving, not thriving: a qualitative study of newly qualified midwives' experience of their transition to practice. J Clin Nurs. 2012; 21:(13-14)2054-63 https://doi.org/10.1111/j.1365-2702.2012.04090.x

Freeman LM, Adair V, Timperley H, West SH. The influence of the birthplace and models of care on midwifery practice for the management of women in labour. Women Birth. 2006; 19:(4)97-105 https://doi.org/10.1016/j.wombi.2006.10.001

Gibbs G. Learning by doing: A guide to teaching and learning methods [Ebook].Oxford: Oxford Centre for Staff and Learning Development, Oxford Brookes University; 1988

Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations on Western Australian women's perceptions of their birth experience. Midwifery. 2007; 23:(3)235-247 https://doi.org/10.1016/j.midw.2006.02.002

Henderson R. Why are student midwives afraid to question practice?. Br J Midwifery. 2008; 16:(1) https://doi.org/10.12968/bjom.2008.16.1.27931

Hermansson E, Mårtensson L. Empowerment in the midwifery context—a concept analysis. Midwifery. 2011; 27:(6)811-816 https://doi.org/10.1016/j.midw.2010.08.005

Hobbs JA. Newly qualified midwives' transition to qualified status and role: assimilating the ‘habitus’ or reshaping it?. Midwifery. 2012; 28:(3)391-399 https://doi.org/10.1016/j.midw.2011.04.007

Hunter B. Conflicting ideologies as a source of emotion work in midwifery. Midwifery. 2004; 20:(3)261-272 https://doi.org/10.1016/j.midw.2003.12.004

Hunter B. Emotion work and boundary maintenance in hospital-based midwifery. Midwifery. 2005; 21:(3)253-266 https://doi.org/10.1016/j.midw.2004.12.007

Hunter B. ‘Mixed Messages': midwives’ experiences of managing emotion. In: Hunter B, Deery R. (eds). Basingstoke: Palgrave Macmillan; 2009

Hunter L. Being with woman: Claiming midwifery space. The Practising Midwife. 2015; 18:(3)20-22

Ibrahim SAEA. Factors affecting assertiveness among student nurses. Nurse Educ Today. 2011; 31:(4)356-360 https://doi.org/10.1016/j.nedt.2010.07.006

International Code of Ethics for Midwives.London: ICM; 2011

Jefford E, Fahy K. Midwives' clinical reasoning during second stage labour: Report on an interpretive study. Midwifery. 2015; 31:(5)519-25 https://doi.org/ 10.1016/j.midw.2015.01.006

The Midwife-Mother Relationship, 2nd edn. In: Kirkham M (ed). Basingstoke: Palgrave Macmillan; 2010

Kirkham M, Deery R. Supporting midwives to support women, 2nd edn. In: Page LA, McCandish R (eds). Philadelhia (PA): Churchill Livingstone; 2006

Burn-out research among midwives. 2014. http://www.newmedicine.pl/wp-content/uploads/2015/01/newmed_2014_146-150.pdf (accessed 21 June 2019)

Lundgren I, Berg M. Central concepts in the midwife?woman relationship. Scand J Caring Sci. 2007; 21:(2)220-228 https://doi.org/10.1111/j.1471-6712.2007.00460.x

McCourt C, Stevens T. Relationship and reciprocity in caseload midwifery. In: Hunter B, Deery R (eds). Basingstoke: Palgrave Macmillan; 2009

Better Births: Improving Outcomes of Maternity Services in England.London: NHS England; 2016

The Code: Professional standards of practice and behaviour for nurses and midwives.London: NMC; 2018

Standards for competence for registered midwives.London: NMC; 2014

Parsons M, Griffiths R. The effect of professional socialisation on midwives' practice. Women Birth. 2007; 20:(1)31-34 https://doi.org/10.1016/j.wombi.2006.09.003

Potts C, Potts S. Entitled to Respect: How to be confident and assertive in the workplace.Oxford: How to Books; 2010

Sully P, Dallas J. Essential communication skills for nursing and midwifery, 2nd edn. St Louis (MO): Mosby Elsevier; 2010

Timmins F, McCabe C. Midwives' views of their assertive behaviour in the workplace-implications for midwifery education and practice. J Adv Nurs. 2005; 51:(1)38-45 https://doi.org/10.1111/j.1365-2648.2005.03458.x

Walsh D. Evidence and Skills for Normal Labour and Birth: A Guide for Midwives, 2nd edn. Abingdon: Routledge Publishing; 2012

Zhang J, Haycock-Stuart E, Mander R, Hamilton L. Navigating the self in maternity care: How Chinese midwives work on their professional identity in the hospital setting. Midwifery. 2015; 31:(3)388-94 https://doi.org/10.1016/j.midw.2014.11.013

Never be afraid to question practice: the professional dilemma of a student midwife

02 August 2019
Professional
02 August 2019
Volume 27 · Issue 8

Abstract

As a third-year caseloading student midwife, I experienced a professional dilemma during an intrapartum placement while working on a busy obstetric unit: to use vaginal examination to confirm full dilatation (a medical approach) or advocate normality and a woman-centred approach. This article explores the three influential forces that contributed to the dilemma: the culture of obstetric units, the midwife-woman relationship, and the importance of assertive behaviours to achieve autonomy. Through reflection and use of Gibbs' (1988) reflective cycle, I highlighted the need to develop my assertive skills, which also led me to make amendments to my own practice; this helped me transition from student to a newly qualified midwife.

Midwives must be autonomous practitioners, a stipulation of the Nursing and Midwifery Council (NMC, 2018). This article will present a case study in which I was presented with the challenge of conforming to a medicalised approach to care, or upholding my values and philosophies as a student midwife and using a non-interventionist approach to achieve autonomy. It was therefore essential for me to consider my skills and attributes as a student midwife, reflecting on and analysing key factors that determined my decision-making in practice. Throughout this article, I will refer to the woman I cared for as ‘Faye’.

I first met Faye when she arrived at the obstetric unit for triage in suspected labour. I had already begun building a trusting relationship with Faye and she requested my care when admitted to the unit in established labour two days later. Faye had previously experienced a traumatic birth and described feelings of powerlessness and loss of control; she hoped that this labour would be positive and I was aware that she trusted me to help her.

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Vaginal examination
Student midwife
Midwife-woman relationship
Assertive behaviours
Autonomy
Culture of obstetric units