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Introduction
Publications
Publications (69)
Background:
midwifery workforce issues are of international concern. Sustainable midwifery practice, and how resilience is a required quality for midwives, have begun to be researched. How these concepts are helpful to midwifery continues to be debated. It is important that such debates are framed so they can be empowering for midwives. Care is re...
Purpose:
the broad aim of this study was to examine the lived-experience of women who birth without a midwife or other health-care professional in the United Kingdom; the specific purpose of this paper is to examine risk discourse as experienced by these women.
Research design:
reflective lifeworld research, a phenomenological approach was used...
Many thousands of articles and press reports about the changing NHS have appeared before and since March, 2012 when the Health and Social Care Act was passed. The volume of writing reflects the reality that the shift in status of the NHS, embodied in the Act, has struck a fearsome chord with a public who are feeling increasingly beset and marginali...
The interactions of the hormones of pregnancy, labour and birth are complex and subtle and their effects are far reaching. Within these complex interactions beta endorphin (beta-end) has a key balancing function, being a hormone of relationship and a stress hormone. As well as helping the mother cope with labour, beta-end enhances relationships wit...
An earlier matched cohort study in the United Kingdom found a significantly higher perinatal mortality rate for births booked under an independent midwife compared with births in National Health Service units (1.7% [25/1,508] vs 0.6% [45/7,366]). This study examined independent midwives' management and decision making in the 15 instances of perinat...
This paper seeks to explain how bulimic mothers accommodated infant feeding demands in conjunction with managing their disordered eating practices.
Eating disorders are chronic and disabling illnesses primarily affecting women. There are few qualitative studies describing bulimia in the context of motherhood.
The study employed an inductive qualita...
Ethnicity and racialised identity have been salient themes in USA research and policy on teenage parenthood, in contrast with the UK context. This article presents findings from interviews with professionals in support services for young parents, with three main conclusions. Firstly, appropriate data collection systems are not in place to establish...
This paper explores sexual decision making in relation to early parenthood amongst black and minority ethnic (BME) young parents in England. It is based on research funded by the Teenage Pregnancy Unit (formerly in the Department of Health) at the Department for Education and Skills in England. Data were collected using focus groups and semi-struct...
This paper explores sexual decision making in relation to early parenthood amongst black and minority ethnic (BME) young parents in England. It is based on research funded by the Teenage Pregnancy unit (formerly in the Department of Health) at the Department for Education and Skills in England. Data were collected using focus groups and semi-struct...
Debates about infant-feeding methods have intensified in recent years with increasing pressures on women living in industrialized nations to breastfeed their infants. This paper, based on a qualitative study of 16 childbearing women with a pre-existing eating disorder living in the north of England, examines participants' motivations for, and under...
The objective of this study was to describe understandings that mothers and midwives have of ethnicity, and to explore barriers to the successful implementation of an ethnicity screening question for sickle cell/thalassaemia. Observation was made of 121 first antenatal interviews between midwife and mother in four contrasting areas of sickle cell p...
The paper explores the phenomenon of early parenthood in minority ethnic communities in England. The data were collected using focus group interviews, in-depth semi-structured interviews and a telephone survey. The sample consisted of 139 participants (41 service providers, 10 grandmothers, 88 young parents). The findings map out the complexity and...
In 2004, the National Midwifery Recruitment Retention and Return to Practice Project was launched to co-ordinate recruitment into and retention within the midwifery workforce. Findings from the Why do Midwives Leave? study (Ball, Curtis and Kirkham 2002) provide insights into the employment choices that midwives made when they ceased to practice as...
Concern for the organization of working hours was widespread among respondents to the Why do Midwives Leave study (Ball, Curtis and Kirkham, 2002). This was especially important to midwives who gave ‘family commitments’ as their main reason for leaving. Managers in the Talking to Manager study (Curtis, Ball and Kirkham 2003) reported the availabili...
A large minority of respondents to the Why do Midwives Leave (WML) study (Ball, Curtis and Kirkham, 2002) reported that they had experienced bullying or horizontal violence, either from their managers or from their clinical colleagues. Certain factors, including clinical grade, level of experience, health status and familiarity with the practise en...
In 1999, a framework for government policy on teenage pregnancy was created with a major report from the Social Exclusion Unit. Young mothers from minority ethnic backgrounds were considered to be at particular risk of exclusion, although there was little detailed research on their experiences. Findings on social support for young parents in genera...
Findings from the Why do Midwives Leave? (WML) study evidenced divisions between midwives and their managers. In the Talking to Managers (TTM) study (Curtis, Ball and Kirkham 2003), these horizontal divisions were also acknowledged by managers. However, other ‘fault-lines’ are also visible within midwifery. Distinctions between midwives were made o...
This paper, the second in a series of six, brings together the findings from the Why do Midwives Leave? study and a subsequent study, Why do midwives leave: talking to managers (TTM). The TTM study was commissioned to explore managers’ perceptions of issues affecting satisfaction with practise and their perspectives on recruitment and retention. Ma...
This article, the first in a series of six, presents findings from the Why do Midwives Leave? study which explored leavers’ reasons for ceasing to practise. For many midwives, making the decision to leave had been a protracted and difficult process. Although there were five main reasons given for leaving, the largest single group of leavers compris...
The material in this series of articles is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). This article, the last in the series, outlines some of the strategies midwives adopted in order to juggle a variety of competing needs. Many midwives expended considerable energy atte...
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). In this paper we discuss the use of stereotyping as a defence mechanism which appeared to assist midwives in coping with the pressures of contemporary professional life. Midwives someti...
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). The ‘inverse care law’ was first described over 30 years ago (Hart, 1971) and this paper reveals how little has changed in respect to the pregnancy and related health needs of the poore...
to describe the extent to which women using maternity services perceive that they have exercised informed choice.
twelve maternity units in Wales.
postal survey of women using maternity services, covering women's views of the extent to which they exercised informed choice overall, and at eight decision points during their care.
1386 women at approx...
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). Many women in this study expressed their disappointment when midwives behaved like doctors in placing more emphasis on clinical tasks rather than on the facilitative and listening skill...
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). This paper analyses some of the behaviours and responses observed during interactions between midwives and childbearing women during antenatal consultations. In the majority of consulta...
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). The focus of this paper is on midwives’ use of language and the ‘packaging’ of verbal and non-verbal information during antenatal consultations. Midwives were observed making very littl...
To examine the use of evidence based leaflets on informed choice in maternity services.
Non-participant observation of 886 antenatal consultations. 383 in depth interviews with women using maternity services and health professionals providing antenatal care.
Women's homes; antenatal and ultrasound clinics in 13 maternity units in Wales.
Childbearin...
To assess the effect of leaflets on promoting informed choice in women using maternity services.
Cluster trial, with maternity units randomised to use leaflets (intervention units) or offer usual care (control units). Data collected through postal questionnaires.
13 maternity units in Wales.
Four separate samples of women using maternity services....
The material in this series of papers is derived from a Department of Health funded evaluation of the MIDIRS Informed Choice leaflets (Kirkham and Stapleton, 2001). The focus of these papers is on the role of the midwife in disseminating information to, and facilitating informed decision-making with, women in her care. Although health professionals...
Midwives’ support needs as childbirth changes
This paper reports on midwives’ support needs as they were described by midwives in a large study of the supervision of midwives in England. The data are derived from six sites: five, very different, National Health Service (NHS) sites, and one composed of midwives outside the NHS. In-depth, ethnographi...
The culture of midwifery in the National Health Service in England
The culture of midwifery in the National Health Service was examined in order to foster understanding of the context of midwifery practice. In‐depth interviews were conducted with midwives in five, very different, sites across England. The culture which emerged was one of service an...
We welcome the opportunity Denis Walsh's editorial offers to discuss and debated the neglected areas of postnatal health, but we feel the direction of his argument is misleading.
Midwives are exhorted to reflect on practice but reflection has received tittle critical examination within midwifery. Personal and professional defence mechanisms make it difficult to see our work as clients or colleagues see it Techniques for achieving this change in viewpoint are suggested: debriefing clients and work with stories can be particu...
A good working knowledge of haemoglobinopathies is essential if midwives are to provide an equitable service. Almost half of the respondents had received no training in this area. Where training had been received, it was usually during basic midwifery education. Few had received haemoglobinopathies training since qualification as a midwife. Trainin...
In the absence of mandatory guidelines on antenatal screening for haemoglobinopathies, this article considers the responsibilities of midwives in antenatal clinics, the educational prerequisites of an effective service and the implications of identified areas of deficit in haemoglobinopathy knowledge.
to examine midwives' and senior student midwives' knowledge concerning sickle-cell anaemia and beta-thalassaemia.
survey using the 'Dyson' questionnaires.
study days on 26 sites across England over three months.
850 questionnaires were completed by a convenience sample of midwives and senior students: 401 on sickle-cell anaemia and 449 on beta-thal...
When a midwife and a woman are together there is always communication, though the midwife will not always be seeking to give information. The midwife may communicate her busyness, her attention may be primarily focused on the monitor, the computer or the notes. The woman may receive a clear message of, ‘I am concentrating, do not disturb’, and act...
Women’s dissatisfaction with the lack of information available to them emerges repeatedly from studies of consumers’ views of maternity care (Cartwright, 1979; Oakley, 1980; Garcia, 1982). As a midwife I became increasingly aware of the misfit between midwifery care and many of women’s needs and expectations in this respect. I therefore wanted to e...