Workforce to profession : an exploration of New Zealand Midwifery's professionalising strategies from 1986 to 2005

University of Technology, Sydney. Faculty of Nursing, Midwifery and Health.Over the last twenty years New Zealand midwives have worked to reclaim their professional autonomy and scope of practice in order to promote a women-centred and midwife-led maternity service. In order to achieve these aims New Zealand midwifery engaged in several key professionalising strategies that have proved successful in developing midwifery as a recognised profession with a social mandate to provide autonomous midwifery care to women throughout pregnancy, labour, birth and the postnatal period. These strategies were integrated but can be defined separately as: partnership relationships with women; leadership through the professional organisation; education for midwifery autonomy, and self-regulation within midwifery professional frameworks. Through an exploration of key midwifery professionalising strategies this doctorate identifies the unique characteristics and development of midwifery in New Zealand and critically reflects on the success and ongoing challenges of its integrated professionalising strategies

The relationship between the physical environment and learning: A blind spot in New Zealand early childhood education discourse?

Although the design, layout and space in ECE environments influences children’s learning, New Zealand’s minimum standards for physical space compare poorly with other OECD countries and there is a paucity of NZ research in this area. This paper argues that the relationship between physical environments and learning is a ‘blind spot’ in NZ ECE discourse. In identifying why this blind spot may have occurred, aspects of the ECE sector’s history are described. In particular it is argued that the sector's status as the ‘cinderella’ of the education system has led to political struggle for government recognition, improved qualifications, adult:child ratios, and funding, and that these issues have necessarily dominated ECE sector discourse. In addition it is argued that historical disparities within the sector have meant that concerns about physical space are not necessarily shared across the sector. In describing why the relationship between physical environments and learning should be of growing concern, this paper argues that bulk funding and minimum standards for physical space, rather than pedagogy, appear to be influencing the design of ECE physical environments, particularly in corporate ECE which is the fastest growing part of the sector. The paper ends by challenging the government and the ECE sector to redress the lack of attention paid to the impact of the physical environment on children’s learning

Alien knowledge: Preparing student midwives for learning about infant feeding-Education practice at a UK university

Infant feeding education forms a key element in undergraduate midwifery education in the UK. Students must be prepared to provide women with support and information to make appropriate health choices for themselves and their infants. However, student midwives may already have developed opinions about infant feeding prior to commencing a midwifery education programme. The education literature suggests that existing attitudes may present a barrier to learning for some students. This particularly applies to learning in relation to sensitive or emotionally laden subjects. A review of the literature was undertaken to identify potential teaching approaches which might help students to overcome barriers to learning. Following this the evidence was utilised at a UK university to develop activities which prepare student midwives for effective learning around infant feeding. Students enrolled in the midwifery education programme were introduced to a number of activities aimed at encouraging them to accommodate unfamiliar ideas or 'alien knowledge'. These included placing students in situations which challenged their ideas, as well as engaging in group discussions and reflective exercises. The impact of these educational interventions was identified through formative and summative assessment, and through evaluation of the teaching strategy at the end of the programme. This demonstrated that, amongst those students with previously negative attitudes towards infant feeding, there was a move towards more positive attitudes and a greater confidence in providing evidence based information to parents

Women’s views on partnership working with midwives during pregnancy and childbirth

This is the Accepted Manuscript version of the following article: Sally Boyle, Hilary Thomas, and Fiona Brooks, ‘Women׳s views on partnership working with midwives during pregnancy and childbirth’, Midwifery, Vol. 32: 21-29, January 2016, which has been published in final form at: https://doi.org/10.1016/j.midw.2015.09.001. This manuscript version is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License CC BY NC-ND 4.0 ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.Objective: To explore whether the UK Government agenda for partnership working and choice was realised or desired for women during pregnancy and childbirth. Design: A qualitative study was used to explore women’s experience of partnership working with midwives. Data was generated using a diary interview method throughout pregnancy and birth. Setting: 16 women were recruited from two district general hospitals in the South East of England. Findings: Three themes emerged from the data: organisation of care, relationships and choice. Women described their antenatal care as ‘ticking the box’, with midwives focusing on the biomedical aspects of care but not meeting their psycho-social and emotional needs. Time poverty was a significant factor in this finding. Women rarely described developing a partnership relationship with midwives due to a lack of continuity of care and time in which to formulate such relationships. In contrast women attending birth centres for their antenatal care were able to form relationships with a group of midwives who shared a philosophy of care and had sufficient time in which to meet women’s holistic needs. Most of the women in this study did not feel they were offered the choices as outlined in the national choice agenda (DoH, 2007). Implications for Practice: NHS Trusts should review the models of care available to women to ensure that these are not only safe but support women’s psycho-social and emotional needs as well. Partnership case loading models enable midwives and women to form trusting relationships that empowers women to feel involved in decision making and to exercise choice. Group antenatal and postnatal care models also effectively utilise midwifery time whilst increasing maternal satisfaction and social engagement. Technology should also be used more effectively to facilitate inter-professional communication and to provide a more flexible service to women.Peer reviewe

Living in this space: Case studies of children's lived experiences in four spatially diverse early childhood centres

Consistent with international trends, many children in Aotearoa New Zealand (NZ) spend the majority of their waking day in an early childhood centre [ECE]. Drawing on children’s and teachers’ perspectives in four spatially diverse, all-day ECE centres in NZ, this study investigated the relationship between ECE centre built environments and children’s lived experiences in light of characteristics of ‘child-friendly’ environments (Chatterjee 2005, Kennedy, 1991). Situated at the intersection of children’s geography and childhood sociology, this thesis used case-study methodology to foreground the experiential aspects of children’s spatial interactions, including their feelings of wellbeing and privacy, their mobility and social interactions. Conceptually, this study draws on a constructionist paradigm derived from Lefebvre’s (1991) theorisation of space as a product of the social-material relations, and from his notion of rhythmanalysis (2004); combining the two Lefebvrian concepts with Gibson’s (1979) theory of affordances provides a novel approach for understanding the agency of children and teachers in the process of the production of space. Research strategies were primarily ethnographic and included naturalistic observation, video records, child-led tours, photography, bookmaking, spatial mapping, focus groups, and measurement of noise levels. The findings revealed that space and its materiality matters for children’s lived experiences as well as for children’s and teachers’ agency. Opportunities for child-friendly lived experiences were influenced by the extent to which diverse rhythms and activities could coexist harmoniously in each physical space, with larger and more complex spaces offering greater affordances. The size of each centre’s activity space added a layer of dynamics to spatiality by narrowing or expanding these opportunities. Additionally, open-plan space afforded highly mobile younger children opportunities to exercise agency through collaboration. The rules and norms that governed children’s spatial practices were influenced by teachers' decisions and actions and these were enabled or constrained by spatial affordances. My findings suggest that, in addition to the ‘iron triangle’ of adult:child ratios, group size, and qualifications, space is an affordance that can create the conditions for quality practices, rich lived experiences, and teachers’ and children’s agency. A number of theoretical, conceptual and empirical contributions are made to our understandings of young children’s lives in group based ECE settings