Iranian midwives’ lived experiences of providing continuous midwife-led intrapartum care: a qualitative study

BACKGROUND & OBJECTIVE: Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives’ lived experiences of delivering continuous midwife-led intrapartum care. METHODS: This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected. RESULTS: “Wanting to lead continuous woman-centered care but being unable to” was identified as an overarching theme. Three other themes “emphasis on the non-interventional care”, “midwifery-specific focus” and “barriers and challenges of midwifery care” were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous ‘woman’-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a ‘triangle of trust’ in care. CONCLUSION: Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran

Investigating the Relationship between the General Health of Mothers and their Maternal Performance following Vaginal Childbirth

BackgroundBirthing parents need to use specialized skills as the first caregivers of the newborn. Several factors may affect maternal performance, the general health of the birthing parent (e.g., mother) being one of them. Yet, there is a paucity of research in this area, particularly in Iran, and evidence remains inconsistent. Consequently, this study aimed to determine any correlations between maternal performance and the general health of mothers following vaginal childbirth in the context of Iran.MethodsThis cross-sectional study was conducted with people identifying as mothers (n = 450) who had given birth (&lt; two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the Barkin maternal performance and general health questionnaire. To investigate the relationship between maternal performance and the general health of the mothers, an independent t-test analysis was conducted . The level of statistical significance was set at p &lt; 0.05.ResultsThe mean age of participants was 26.78, and the mean total score of maternal performance was 91.04 (0 - 120). The highest and lowest scores related to the ‘maternal competence’ and the ‘maternal needs’ domains, respectively. Overall, 76.89% of participants had a favorable general health condition (a score of less than 3.5 is considered favorable). There was no statistically significant difference identified in terms of maternal performance scores between those with a favorable and those with an unfavorable general health status.ConclusionAlthough the results of the present study did not show a significant relationship between the general health of mothers and maternal performance, this research builds on a growing body of evidence in the context of Iran. Despite recording high maternal performance scores in this sample, it will be important to enhance and maintain good mental health in all childbearing people, particularly following vaginal childbirth, as it is this which will enhance care and outcomes overall.<br/

Characteristics of Strong Midwifery Leaders and Enablers of Strong Midwifery Leadership: An International Appreciative Inquiry

Objectives This research aimed to identify the characteristics of strong midwifery leaders and explore how strong midwifery leadership may be enabled from the perspective of midwives and nurse-midwives globally. Design In this appreciative inquiry, we collected qualitative and demographic data using a cross-sectional online survey between February and July 2022. Setting Responses were received from many countries (n=76), predominantly the United Kingdom (UK), Australia, the United States of America (USA), Canada, Uganda, Saudi Arabia, Tanzania, Rwanda, India, and Kenya. Participants An international population (n=429) of English-speaking, and ethnically diverse midwives (n=211) and nurse-midwives (n=218). Measurements Reflexive thematic analysis was used to make sense of the qualitative data collected. Identified characteristics of strong midwifery leadership were subsequently deductively mapped to established leadership styles and leadership theories. Demographic data were analysed using descriptive statistics. Findings Participants identified strong midwifery leaders as being mediators, dedicated to the profession, evidence-based practitioners, effective decision makers, role models, advocates, visionaries, resilient, empathetic, and compassionate. These characteristics mapped to compassionate, transformational, servant, authentic, and situational leadership styles. To enable strong midwifery leadership, participants identified a need for investment in midwives’ clear professional identity, increased societal value placed upon the midwifery profession, ongoing research, professional development in leadership, interprofessional collaborations, succession planning and increased self-efficacy. Key conclusions and implications for practice This study contributes to understandings of trait, behavioural, situational, transformational and servant leadership theory in the context of midwifery. Investing in the development of strong midwifery leadership is essential as it has the potential to elevate the profession and improve perinatal outcomes worldwide. Findings may inform the development of both existing and new leadership models, frameworks, and validated measurement tools