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Midwifery students’ perceptions and experiences of learning in clinical practice: a qualitative review protocol

Yang, Zhihui 1 ; Li, Xinxin 2 ; Lin, Huanhuan 2 ; Chen, Fanfan 2 ; Zhang, Lili 1 ; Wang, Ning 1

1 PR China Southern Centre for Evidence-based Nursing and Midwifery Practice: A JBI Centre of Excellence, Guangzhou City, Guangdong Province, PR China

2 School of Nursing, Southern Medical University, Guangzhou City, Guangdong Province, PR China

Correspondence: Ning Wang, [email protected]

The authors declare no conflict of interest.

Objective: 

This systematic review aims to investigate and synthesize qualitative evidence related to midwifery students’ perceptions and experiences of learning in clinical practice.

Introduction: 

Midwifery students are required to develop strong competencies during pre-registration education for future practice. Clinical placements provide a good opportunity for students to build essential practice capacities. Understanding the perceptions and experiences of midwifery students in clinical practice helps develop effective midwifery clinical educational strategies. A qualitative systematic review is therefore proposed to improve midwifery clinical education.

Inclusion criteria: 

This proposed review will consider qualitative studies that have explored midwifery students’ perceptions and experiences of learning in clinical practice in all degrees. The search will be limited to English-language published and unpublished studies to the present.

Methods: 

This review will follow the JBI approach for qualitative systematic reviews. A three-stage search will be conducted to include published and unpublished literature. Databases to be searched include PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, American Nurses Association, Google Scholar, ProQuest Dissertation & Theses, and Index to Theses in Great Britain and Ireland. Identified studies will be screened for inclusion in the review by two independent reviewers. Any disagreements will be resolved through discussion. Data will be extracted using a standardized tool. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be used to inform midwifery education.

Systematic review registration number: 

PROSPERO CRD42020208189

Introduction

Due to strong advocacy for improved health and safety of pregnant women and their babies globally, many countries have made significant progress in increasing the proportion of pregnant women who give birth at health care facilities. 1 However, such effort has not led to the expected level of reduction in maternal and newborn mortality and stillbirths, 2 which can be caused by inadequacies in the quality of care provided in the health care facilities. 3

The delivery of quality and safe midwifery practice requires that health professionals develop strong competencies and high-level accountabilities. Evidence shows that well educated, regulated, and licensed midwives are associated with improved quality of care and rapid and sustained reduction in maternal or neonatal morbidity and mortality. 4 Pre-registration education is an important stage for midwifery students to develop the fundamental professional knowledge, skills, and judgment essential for their future practice. Clinical practice programs as a significant component of midwifery education provide a valuable opportunity for midwifery students to build hands-on capabilities that integrate with classroom theories, and to be socialized into their chosen profession. 5 Specifically, it helps students develop the required professional competencies for registration and ideas about their career preference, as well as smoothly transit to their future career. 6,7 It has been found that education undertaken through clinical placements provides up to 50% of the learning experience for students in pre-registration midwifery courses. 8

Midwifery refers to “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum throughout pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life.” 9 (p.1130) Midwifery practice involves a wide scope of care activities that are undertaken to pursue the overall well-being of pregnant women. This includes providing continuous support to the women during their antenatal, intrapartum, and postpartum periods, being responsible for conducting births, caring for the newborns, and preventing and managing complications in pregnancy and childbirth. 10 These require that midwives are highly competent in undertaking various work tasks in partnership with the women and to cope with the complex and dynamic nature of the practice environments. 11 To face such challenging learning requirements, midwifery students can become frustrated when they first enter a practice setting. Literature shows that student health professionals often face challenges and experience a high level of stress during their clinical placements, 12,13 and midwifery students experience more stress compared to students in other professions. 14,15 Research has found that the midwifery students’ clinical stress was either due to their low confidence in undertaking care and a fear of making mistakes, or their relationships with clinical educators and colleagues. 16 Negative clinical experiences perceived by the student midwives can pose a potential threat to their effective learning and recognition of their future professional career. 17-19

As a key part of successful midwifery education, a well-designed practice program with a supportive environment is essential for fostering students’ confidence and passion to pursue a future midwifery career and for building competencies for entry to their registrations. 7,20 Students’ perceptions and experiences about their clinical learning are considered a hallmark of quality education. 21 While there is a growing body of knowledge reported in the literature about these elements, a systematic aggregation of such evidence should identify implications for the educational and clinical faculties to develop appropriate and effective clinical training strategies and provide required support to the students. Our literature search has identified three reviews about student professionals’ learning experiences; however, these reviews have focused on the learning experiences of undergraduate nursing rather than midwifery students, 22 a setting other than clinical placements, 23 or the relationship between workplace culture and the practice experience. 24 This review addresses a gap in the literature by aggregating evidence about midwifery students’ perceptions and experiences of learning in clinical settings. The ultimate aim is to improve midwifery educators’ understanding of their students’ clinical experiences.

Review question

What are the perceptions and experiences of midwifery students’ learning in clinical practice?

Inclusion criteria

Participants.

This review will consider qualitative studies that focus on midwifery students’ perceptions and experiences of learning in clinical practice settings. There will be no limitation regarding age, gender, grade or year, or ethnicity of participants.

Phenomena of interest

The phenomena of interest will be midwifery students’ perceptions and experiences of learning in clinical practice settings.

This review will consider studies conducted in any settings identified as a clinical practice, including clinical placement or internship, in acute care, community care, or simulated learning environments.

Types of studies

This review will consider English-language qualitative studies that describe the perceptions and experiences of midwifery students in their clinical practice. These studies will focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, and action research. Qualitative data from mixed method studies will also be included.

The proposed systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. 25 The review has been registered in PROSPERO (CRD42020208189).

Search strategy

The search strategy aims to locate both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of PubMed will be undertaken followed by analysis of the text words contained in the titles and abstracts, and of the index terms used to describe the articles. This preliminary search in PubMed will be used to develop a search strategy for this review that will include other databases. A second search using identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. A sample search strategy for PubMed is detailed in Appendix I. There is no date limit for the studies included in this review.

The databases to be searched for published studies include: MEDLINE (PubMed), Science Direct, Web of Science, EBSCO (CINAHL), and EBSCO (PsycINFO). The search for unpublished literature will include Google Scholar, American Nurses Association, ProQuest Dissertation & Theses Database, and Index to Theses in Great Britain and Ireland.

Study selection

Following the search, all identified citations will be collated and uploaded into EndNote v.9 (Clarivate Analytics, PA, USA) and duplicates removed. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant studies will be retrieved in full and their citation details will be imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI; JBI, Adelaide, Australia). 26 The full text of selected citations will be assessed in detail against the inclusion criteria by the two independent reviewers. Reasons for exclusion of full-text studies that do not meet the inclusion criteria will be recorded and reported in the systematic review. Any disagreements that arise between the reviewers at each stage of the study selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final systematic review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. 27

Assessment of methodological quality

Papers selected for retrieval will be assessed by the two independent reviewers for methodological quality prior to inclusion in the review using the standard JBI critical appraisal checklist for qualitative research. 25 Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Authors of primary studies will be contacted with questions on missing information or if clarification is needed. The results of the critical appraisal will be reported in narrative form, as well as in a table. All studies, regardless of the results of their methodological quality, will undergo data extraction and synthesis.

Data extraction

Qualitative data will be extracted from studies included in the review by the two independent reviewers using the standardized JBI qualitative data extraction tool for qualitative evidence (JBI SUMARI). The data extracted will include specific details about the participants, context, geographical location, study methods, and the phenomena of interest relevant to the review question and specific objectives. Findings will be verbatim extractions of the authors’ analytic interpretations, along with relevant illustrations. Each finding will be assigned a level of validity or credibility. Findings will be described as “unequivocal” or “credible,” as recommended in the JBI Manual for Evidence Synthesis . 25 All “unsupported” findings will be excluded from the review. Any disagreements relating to credibility that arise between the reviewers will be resolved through discussion or by a third reviewer.

Data synthesis

Qualitative research findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach. 28 This will involve aggregation or synthesis of findings to generate a set of statements that represents the aggregation, through assembling and categorizing these findings on the basis of similarity in meaning. These categories will then be subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. The categories and synthesized findings will be agreed by discussion among the reviewers to ensure they support the meaning of the data. Where textual pooling is not possible, the findings will be presented in narrative form.

Assessing certainty in the findings

The final synthesized findings will be graded according to the ConQual 29 approach for establishing confidence in the output of qualitative research synthesis and presented in a Summary of Findings. The Summary of Findings includes the major elements of the review and details how the ConQual score is developed. Included in the Summary of Findings will be the title, population, phenomena of interest, and context for the specific review. Each synthesized finding from the review will then be presented along with the type of research informing it, score for dependability and credibility, and the overall ConQual score.

Acknowledgments

The library staff at Southern Medical University for their guidance and support on literature retrieval.

Appendix I: Search strategy

Medline (pubmed).

Search conducted August 2020

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So you have been asked to complete a literature review, but what is a literature review?

A literature review is a piece of research which aims to address a specific research question. It is a comprehensive summary and analysis of existing literature. The literature itself should be the main topic of discussion in your review. You want the results and themes to speak for themselves to avoid any bias.

The first step is to decide on a topic. Here are some elements to consider when deciding upon a topic:

• Choose a topic which you are interested in, you will be looking at a lot of research surrounding that area so you want to ensure it is something that interests you. 
• Draw on your own experiences, think about your placement or your workplace.
• Think about why the topic is worth investigating.  

Once you have decided on a topic, it is a good practice to carry out an initial scoping search.

This requires you to do a quick search using  LibrarySearch  or  Google Scholar  to ensure that there is research on your topic. This is a preliminary step to your search to check what literature is available before deciding on your question. 

The research question framework elements can also be used as keywords.

• Think about who the population/ sample group. Are you looking for a particular age group, ethnicity, cultural background, gender, health issue etc.
• What is the intervention/issue you want to know more about? This could be a particular type of medication, education, therapeutic technique etc. 
• Do you have a particular context in mind? This could relate to a community setting, hospital, ward etc. 

It is important to remember that databases will only ever search for the exact term you put in, so don't panic if you are not getting the results you hoped for. Think about alternative words that could be used for each keyword to build upon your search. 

Build your search by thinking about about synonyms, specialist language, spellings, acronyms, abbreviations for each keyword that you have.

Inclusion & Exclusion Criteria

Your inclusion and exclusion criteria is also an important step in the literature review process. It allows you to be transparent in how you have  ended up with your final articles. 

Your inclusion/exclusion criteria is completely dependent on your chosen topic. Use your inclusion and exclusion criteria to select your articles, it is important not to cherry pick but to have a reason as to why you have selected that particular article. 

• Search Planning Template Use this template to plan your search strategy.

Once you have thought about your keywords and alternative keywords, it is time to think about how to combine them to form your search strategy. Boolean operators instruct the database how your terms should interact with one another. 

Boolean Operators

• OR can be used to combine your keywords and alternative terms. For example "Social Media OR Twitter". When using OR we are informing the database to bring articles continuing either of those terms as they are both relevant so we don't mind which appears in our article. 
• AND can be used to combine two or more concepts. For example "Social Media AND Anxiety". When using AND we are informing the database that we need both of the terms in our article in order for it to be relevant.
• Truncation can be used when there are multiple possible word endings. For example Nurs* will find Nurse, Nurses and Nursing. 
• Double quotation marks can be used to allow for phrase searching. This means that if you have two or more words that belong together as a phrase the database will search for that exact phrase rather than words separately.  For example "Social Media"

Don't forget the more ORs you use the broader your search becomes, the more ANDs you use the narrower your search becomes. 

One of the databases you will be using is EBSCOHost Research Databases. This is a platform which searches through multiple databases so allows for a comprehensive search. The short video below covers how to access and use EBSCO. 

A reference management software will save you a lot of time especially when you are looking at lots of different articles. 

We provide support for EndNote and Mendeley. The video below covers how to install and use Mendeley. 

Consider using a research question framework. A framework will ensure that your question is specific and answerable.

There are different frameworks available depending on what type of research you are interested in.

Population - Who is the question focussed on? This could relate to staff, patients, an age group, an ethnicity etc.

Intervention - What is the question focussed on? This could be a certain type of medication, therapeutic technique etc. 

Comparison/Context - This may be with our without the intervention or it may be concerned with the context for example where is the setting of your question? The hospital, ward, community etc?

Outcome - What do you hope to accomplish or improve etc.

Sample - as this is qualitative research sample is preferred over patient so that it is not generalised. 

Phenomenon of Interest - reasons for behaviour, attitudes, beliefs and decisions.

Design - the form of research used. 

Evaluation - the outcomes.

Research type -qualitative, quantitative or mixed methods.  

All frameworks help you to be specific, but don't worry if your question doesn't fit exactly into a framework. 

There are many critical appraisal tools or books you can use to assess the credibility of a research paper but these are a few we would recommend in the library. Your tutor may be able to advise you of others or some that are more suitable for your topic.

Critical Appraisal Skills Programme (CASP)

CASP is a well-known critical appraisal website that has checklists for a wide variety of study types. You will see it frequently used by practitioners.

Understanding Health Research

This is a brand-new, interactive resource that guides you through appraising a research paper, highlighting key areas you should consider when appraising evidence.

Greenhalgh, T. (2014) How to read a paper: The basics of evidence-based medicine . 5 th edn. Chichester: Wiley

Greenhalgh’s book is a classic in critical appraisal. Whilst you don’t need to read this book cover-to-cover, it can be useful to refer to its specific chapters on how to assess different types of research papers. We have copies available in the library!

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• 20 August 2024

How a midwife became a neuroscientist to seek a cure for her son

• Elizabeth Landau 0

Elizabeth Landau is a science writer based in Washington DC.

You can also search for this author in PubMed   Google Scholar

Terry Jo Bichell (pictured in her laboratory) was part of a 2016 campaign in which scientists shared their inspirational stories. Credit: Wes Duenkel

Working scientist profiles

This article is part of an occasional series in which Nature profiles scientists with unusual career histories or outside interests.

Terry Jo Bichell sensed there was something different about her fifth, youngest child when he was just a baby. At first, doctors and friends told her that she was being neurotic, that there was nothing wrong. But when the boy, Lou, couldn’t sit up properly at the age of one, a paediatrician decided to run some tests.

A blood test revealed that Lou had Angelman syndrome, a rare developmental disorder with symptoms such as impaired motor function, limited or no speech, seizures and difficulty in sleeping. It affects one in 12,000 to one in 20,000 individuals, and there is no known cure.

Bichell heard about this diagnosis in 2000 in San Miguel de Allende, Mexico, where she was teaching at a midwifery school at the time. She remembers that, soon after, she walked half an hour to get to an Internet-connected computer to learn more.

But merely reading about Angelman syndrome didn’t satisfy Bichell. She wanted to help to find a cure, or at least a treatment — even if it meant becoming a scientist herself.

In July 2000, Bichell flew to Finland with her mother and the baby to attend the first major international conference on Angelman syndrome in Tampere. “It was the first time I had really been interested in hard science” as opposed to health care, Bichell remembers. “And it was just fascinating. And it felt like we were on the verge of a treatment, and all we had to do was just reach through the curtain, and we’d be able to figure it out.”

Sleepless nights

Angelman syndrome is named after British physician Harry Angelman, who, in 1965, noted three children with poor muscle control and abnormalities of the brain, skull and eyes, and who frequently laughed. It wasn’t until the late 1990s that scientists identified a mutation in the UBE3A gene, on chromosome 15, as the cause. Most people have both maternal and paternal copies of UBE3A , and the condition is most commonly the result of the maternal copy being absent or damaged. Overexpression of a protein linked to the same gene has been linked to autism spectrum disorders 1 .

At the Tampere conference, Lou’s sleep challenges were exacerbated by jet lag and the long daylight hours near the Arctic Circle, and Bichell would do 3 a.m. walks with him in the hotel lobby. That’s how she got to know Arthur Beaudet, a geneticist at Baylor College of Medicine in Houston, Texas, who helped to establish the connection between Angelman syndrome and UBE3A . Beaudet found himself sleepless at the same time, and the two of them discussed starting a clinical trial in San Diego, California, where Bichell was then based. The idea was to test supplements called folate and betaine as possible treatments for Angelman syndrome, on the basis that these substances might lessen some of the symptoms. Although the trial proved unsuccessful, it led to Bichell becoming a coordinator and part-time co-investigator for research into the condition.

At that point, Bichell hadn’t trained in medicine, genetics or neurobiology. She had, at first, worked as a documentary film-maker, but her career aspirations changed during a film shoot in Côte d’Ivoire in 1986, when she saw a baby die after a difficult birth. The experience made her determined to become a midwife, and subsequent degrees in nursing and public health equipped her for her new calling.

In 2000, Bichell partnered with Lynne Bird, a clinical geneticist at Rady Children’s Hospital in San Diego, to raise funds for and undertake Angelman research projects, including the folate and betaine trials. In a subsequent study on the natural course of the condition, Bichell interviewed more than 100 families of children with Angelman, work that she continued at Vanderbilt University after her family moved to Nashville, Tennessee, in 2006.

Lou’s sleep difficulties persisted, and Bichell remembers feeling sleep-deprived herself while driving to Vanderbilt to teach pre-literacy skills to children with Angelman. She began to wonder whether the circadian system had some connection to the disorder. “I didn’t think that anyone else in the world would be interested in following up on those hunches,” she says.

Biology homework

Eventually, Bichell decided she couldn’t sit back and await developments that might help Lou. She resolved to train as a neuroscientist and, one day, to determine the direction of research herself. “I was almost 40 when he was born, and that meant that I was probably going to die 40 years before him,” she says. This meant that “somebody else was going to have to take care of him all that time”, so she felt she had better find a treatment for the condition.

Aged 49, she enrolled in a neuroscience PhD programme at Vanderbilt in 2009 and found herself doing homework alongside her teenage daughters, who were also studying biology.

Initially, Bichell worked in a laboratory specializing in Angelman syndrome. But when the principal investigator decided to quit research, she lost her funding to probe the very condition that she had set out to study.

To stay in the programme, she would need to redirect her energy to a topic she knew nothing about for her dissertation. So, Bichell joined the lab of neuroscientist Aaron Bowman to work on Huntington’s disease, an inherited neurodegenerative condition. In retrospect, she appreciates the shift. “It expanded my mind beyond just Angelman syndrome, so then I was able to learn about a lot of other disorders and think more globally,” she says.

But the question of how the circadian system plays a role in Angelman continued to nag at Bichell. At Vanderbilt, she found an ally in Carl Johnson, who specializes in studies of circadian rhythms but knew little about Angelman syndrome. “She basically sucked me into this,” he says. Johnson had a small grant to support her investigations, which led to peer-reviewed papers demonstrating links between circadian rhythms and the condition 2 .

Being a PhD student in her fifties came with challenges. Whereas most graduate students could check on their experiments in the evenings, Bichell needed to pick up her children from school, take them to sporting events and cook their meals. (Lou attended Nashville public schools with the help of an educational assistant.) She would sometimes set an alarm in the middle of the night so that she could have uninterrupted research time on campus. “I would be there in the dark with all those creepy lab sounds going on, and nobody else there,” she says.

One night in 2010, while 11-year-old Lou, his father and two of his sisters slumbered at home, Bichell found herself crying in the lab, unable to wipe her tears off her nose because her hands were in a sterile area. “I just felt like, ‘This is horrible. What am I doing to my family? What am I doing to myself?’”

The mini-lab manager

But Bichell’s schedule became more sustainable when she created what she called a “mini-lab” of undergraduate students to work and study with her. Just as a principal investigator would, she delegated a host of small tasks to the students, but remained in charge of the experiments and analysis. The group learnt as a collective, rather than competing with one another.

“I felt like I was a mum to all my students and grad students. I was feeding the kids dinner, and then I was going back to the lab and feeding the cells,” she says. “It was all the same”, she laughs, just on “a slightly different scale”.

For her dissertation, Bichell investigated the role of manganese — which is essential for cells and yet toxic when overabundant— in mouse models of Huntington’s disease 3 . Exposing the mice to supplemental manganese led to a rebalancing of the natural urea cycle, a crucial process that mediates ammonia’s removal from the bloodstream. Her findings support the idea that the mutation in HTT , the gene that causes Huntington’s, leads to a deficiency of manganese in the brain, which contributes to increases in urea and ammonia, also in the brain. More research is needed to determine whether manganese could be involved in treatment, Bowman says.

Bowman, who now heads the School of Life Sciences at Purdue University in West Lafayette, Indiana, remembers the unusually large audience at Bichell’s thesis defence in September 2016, including the many undergraduates who had worked with her, plus faculty members, other graduate students and her family. “She got a standing ovation,” Bowman says. “I have never seen that before. Usually there’s polite clapping.”

Bichell never had expectations of going into academia after her graduation: “There’s no time for me to have a career like that,” she says. Instead, using the broadened perspectives she gained in her PhD work, she founded COMBINEDBrain, a non-profit body that connects patient-advocacy groups with clinicians, researchers and pharmaceutical companies. Its goal is to speed up research on treatments for rare genetic neurological disorders, including Angelman syndrome.

“She’s a bridge-builder,” Bowman says. Bichell’s diverse experience gave her credibility among both researchers and patient-advocacy communities, and “there are very few people in this world that can stand strong on both sides”, he says.

Combining forces

Today, Bichell’s son Lou is 25 years old. His speech is limited to “mama”, “dada” and a few approximations of other words, but he uses about 25 sign-language adaptations. Through an iPad app designed for non-speaking individuals, he can construct short sentences. He cannot be left alone in a room.

Bichell is confident that in her lifetime, a “disease-changing” treatment for Angelman syndrome will be found, and thinks that such a treatment would need to go hand in hand with widespread screening of newborns for the condition. COMBINEDBrain is one player in a large collaboration that plans to undertake a whole-genome sequencing study among infants aged 3–12 months who show signs of neurodevelopmental disorders.

Bichell is also hopeful that gene therapies will improve the quality of life of people with Angelman syndrome. Lou is currently taking part in an open-label clinical trial, meaning that participants know whether they are receiving an experimental therapy or a placebo. Bichell’s mother, who helped to look after Lou at the conference in Finland more than two decades ago, now assists with caregiving during the treatments in Boston, Massachusetts.

Now that their other children have grown up and moved away, the Bichell family offers rooms in their home to local musicians, who help out with Lou in exchange. Their farm includes a horse, donkey, chickens and bees. Bichell takes care of her grandchildren and teaches a translational neuroscience course at Vanderbilt. To fit everything in, she sometimes works late at night and sleeps only in short spurts, as she did during her graduate studies.

“I always have ten things going on at one time,” she says. “Eight people living in my house, ten animals to take care of, two careers. That’s the only way I really know how to do things.”

doi: https://doi.org/10.1038/d41586-024-02723-9

Khatri, N. & Man, H.-Y. Front. Mol. Neurosci. 12 , 109 (2019).

Article   PubMed   Google Scholar  

Shi, S.-Q., Bichell, T. J., Ihrie, R. A. & Johnson, C. H. Curr. Biol. 25 , 537–545 (2015).

Bichell, T. J. V. et al. Biochim. Biophys. Acta Mol. Basis Dis. 1863 , 1596–1604 (2017).

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Doctoral Thesis Collection

This midwifery PhD thesis collection is an exciting new initiative for the RCM.

The aim of the collection is to provide a platform for midwives to showcase their academic work, and to inspire and support midwives who are considering or who are currently undertaking further academic study. Additionally, the collection will provide a source of open access midwifery generated evidence for everyone to use.

The opportunity for midwives to include details of the resultant publications and their social media details and institutional link, if appropriate will hopefully also support the creation of professional networks related to their academic interests. Authors may have also published articles from their thesis, so please use an author’s contact details to ask about this.

If you are a midwife and have a completed a PhD and would like to include your thesis in this collection, please complete the online form below.

If you would like to search the Thesis Collection, "Control+F" (or "Command+F" on a Mac) is the keyboard shortcut for the Find command. Pressing the Ctrl/Command key + the F key will bring up a search box in the top right corner of your screen. You can then use this to search the Collection for keywords.

Submit details of your doctoral thesis to be included in the RCM collection

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Midwifery Dissertation Topics

Published by Owen Ingram at January 3rd, 2023 , Revised On August 16, 2023

There have been midwives around for decades now. The role of midwives has not changed much with the advent of modern medicine, but their core function remains the same – to provide care and comfort to pregnant women during childbirth.

It is possible to be a midwife in the healthcare industry, but it is not always a rewarding or challenging career. Here are five things you didn’t know about midwifery nursing to help you decide if it could be the right career choice for you.

The profession of midwifery involves caring for women and newborns during pregnancy, childbirth, and the first few days following birth. Registered nurses are trained with four additional years of education along with major research on methods involve in midwifery and writing on midwifery dissertation topics, while midwives provide natural health care for mothers and children.

As a midwife, your role is to promote healthy pregnancies and births while respecting women’s rights and dignity. Midwives provide care to patients at every stage of life, from preconception to postpartum, family planning to home delivery to breastfeeding support.

Important Links: Child Health Nursing Dissertation Topics , Adult Nursing Topics , Critical Care Nursing Dissertation Topics . These links will help you to get a broad experience or knowledge about the latest trends and practices in academics.

Midwifery Is A Good Fit for the Following:

● Those who want to work with women, especially those at risk of giving birth in a                    hospital setting. ● Those who enjoy helping people and solving problems. ● Those who like to be creative and solve complex problems. ● Those who want to help others and make a difference in their lives.

Midwifery is a career with many benefits for both the midwife and the baby. They are well-trained and experienced in caring for pregnant women and newborns and often have access to the exceptional care that other nurses may not have.

Related Links:

• Evidence-based Practice Nursing Dissertation Topics
• Child Health Nursing Dissertation Topics
• Adult Nursing Dissertation Topics
• Critical Care Nursing Dissertation Topics
• Dementia Nursing Dissertation Topics
• Palliative Care Nursing Dissertation Topics
• Mental Health Nursing Dissertation Topics
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• Coronavirus (COVID-19) Nursing Dissertation Topics

Midwifery Dissertation Topics With Research Aim

Topic:1 adolescence care.

Research Aim: Focus on comprehensive medical, psychological, physical, and mental health assessments to provide a better quality of care to patients.

Topic:2 Alcohol Abuse

Reseasrch Aim: Closely studying different addictions and their treatments to break the habit of drug consumption among individuals.

Topic:3 Birth Planning

Research Aim: Comprehensive birth planning between parents discussing the possible consequences of before, between, and after labour.

Topic:4 Community midwifery

Research Aim: Studying different characters in community midwifery and the midwife’s role in providing care for the infant during the early days of the child’s birth.

Topic:5 Contraception

Research Aim: Understand the simplicity of contraception to prevent pregnancy by stopping egg production that results in the fertilization of egg and sperm in the later stages.

Topic:6 Electronic fetal monitoring

Research Aim: In-depth study of electronic fetal monitoring to track the health of your baby during the womb, record construction per minute, and make a count of your baby’s heart rate.

Topic:7 Family planning

Research Aim: Importance to follow the basic rhythm methods for the couple to prevent pregnancy and use protection during the vaginal sex to plan a family without fertility treatments.

Topic:8 Foetal and newborn care

Research Aim: Expansion of the maternal-fetal and newborn care services to improve the nutritional quality of infants after delivery during their postnatal care time.

Topic:9 Foetal well being

Carefully tracking indications for the rise in heart rate of the fetal by weekly checkups to assess the overall well-being of the fetal.

Topic:10 Gender-based violence

Research Aim: Studying the consequences of male desire for a child that results in gender-based violence, harming the child’s physical and mental health.

Topic:11 Health promotion

Research Aim: Working on practices that help in controlling the amount of pollution of people, taking care of their overall health, and improving quality of life through adapting best health practices.

Topic:12 High-risk pregnancy

Research Aim: Calculating the ordinary risks of a high-risk pregnancy and how it affects a pregnant body resulting in a baby with poor health or any by-birth diseases, increasing the chance for complications.

Topic:13 HIV infection

Research Aim: Common causes of HIV infection and their long-term consequences on the body’s immune system. An in-depth study into the acquired immunodeficiency and the results leading to this.

Topic:14 Human Rights

Creating reports on human rights and their link with the freedom of thought, conscience, religion, belief, and other factors.

Topic:15 Infection prevention and control

Research Aim: Practices for infection prevention and control using efficient approaches for patients and health workers to avoid harmful substances in the environment.

Topic:16 Infertility and pregnancy

Research Aim: Evaluating the percentage of infertility and pregnancy, especially those facing no prior births, and who have high chances of infertility and pregnancy complications.

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Midwives are nurses who provide continuous support to the mother before, during, and after labour. Midwives also help with newborn care and educate parents on how to care for their children.

How Much Do Midwives Make?

The salary of a midwife varies depending on the type of work, location, and experience of the midwife. Midwives generally earn $132,950 per year. The average annual salary for entry-level midwives is $102,390.

The minimum requirement for becoming a midwifery nurse is a bachelor’s degree in nursing, with the option of pursuing a master’s degree.

An accredited educational exam can also lead to certification as a nurse-midwife (CNM). The American College of Nurse-Midwives (ACNM) enables you to practice independently as a midwife.

There are many pros and cons to working as a midwife. As a midwife, you have the following pros and cons:

• Midwives have the opportunity to help women during one of the most memorable moments in their lives.
• Midwives can positively impact the health of mothers and their children.
• Midwives can work in many hospitals, clinics, and homes.
• In midwifery, there are many opportunities for continuing education and professional development.
• You will often have to work nights and weekends, which can be mentally draining.
• You will have to travel a lot since most births occur in hospitals or centres in different areas.
• You will have to deal with stressors such as complex patients and uncooperative families.
• You will be dealing with a lot of pain, so you need to be able to handle it without medication or other treatment methods.

A career in midwifery is a great fit for those with a passion for health and wellness, an interest in helping people, and a desire to work in a supportive environment.

It is important to become involved in your local midwifery community if you are contemplating a career in midwifery – the best source of learning is your major research work, along with writing a lengthy thesis document on midwifery dissertation topics that will submit to your university to progress your midwifery career.

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How to find midwifery dissertation topics.

To find midwifery dissertation topics:

• Explore childbirth challenges or trends.
• Investigate maternal and infant health.
• Consider cultural or ethical aspects.
• Review recent research in midwifery.
• Focus on gaps in knowledge.
• Choose a topic that resonates with your passion and career goals.

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A Guide to Postgraduate Midwifery

03 rd February 2023

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Midwifery is a popular subject for postgraduate students, as it can further knowledge and skills involved with being a midwife and open new, fulfilling career paths.  

If you’re looking to study midwifery at university, but aren’t sure where to look for information, we have you covered with our handy Midwifery Subject Guide. This guide features everything you need to know about the subject, how it can be taught, what midwifery jobs are available and more. 

Read on to see why you should do a midwifery degree, how long it could take and where you can study this vital medical specialisation. 

CONTENTS 

• Why do a midwifery degree?
• What qualifications can you get?
• What jobs can you do with a midwifery degree?
• What are the midwifery degree entry requirements?
• What midwifery courses are there?
• What topics does a midwifery degree cover?
• What do you learn in a midwifery degree?
• How will you be taught and assessed?
• How long is a midwifery degree?
• Where can you study midwifery?
• What similar subjects are there to midwifery?

Why do a midwifery degree? 

Becoming a midwife is a lifelong goal for many people interested in a medical career, as it is an immensely important and fulfilling occupation. Midwives help expectant mothers through every step of their pregnancy, and ultimate help to bring new life into the world.  

Taking a postgraduate degree in midwifery can help students who already have a degree move their career in the direction of becoming a midwife. Courses can be approved by the Nursing & Midwifery Council (NMC), and completing an approved course is a necessary step in this journey. 

Some students will already have completed an approved midwifery degree and are looking to further their skills in the area to try and progress their career, which can be done via postgraduate education. 

What qualifications can you get? 

Many students looking to study midwifery at a postgraduate level will likely take a master’s course. There are taught master’s courses like the MSc as well as research-based master’s courses like the MRes available in the subject.  

Some students may choose to further their education with a doctorate or PhD in midwifery. Students on these courses conduct in-depth research into various aspects of the subject and can help issues impacting the community of midwives. 

Shorter courses like PGDips and PGCerts are also available, which some students may opt to take to bolster their existing medical experience and skillset. 

What jobs can you do with a midwifery degree? 

Taking a midwifery postgraduate degree can introduce opportunities for career paths that were not previously available. With the degree in hand, you could look to work as one of these professions... 

• Midwife 
• Neonatal nurse 
• Health visitor 
• Maternity support worker 
• Child nurse 

What are the midwifery degree entry requirements? 

Most postgraduate courses in midwifery will expect you to have a bachelor’s degree with at least a 2:2 grade, though some may want a 2:1 instead. Relevant degrees are often preferred, but are not always necessary.  

What midwifery courses are there? 

There are a variety of midwifery courses available at universities across the UK, some of which will have specialisations within them, or will be pre-registration courses for students who are not already registered with the NMC. Here are a few examples... 

• Midwifery Studies MSc 
• MSc Midwifery (Pre-Registration) 
• Advanced Practice (Midwifery) MSc 
• Midwifery PhD 
• MSc Midwifery and Women’s Health 

What topics does a midwifery degree cover? 

The course syllabus will be different at each university, though most midwifery courses will cover important elements of the role to prepare and develop the skills students need. Modules on midwifery courses could include the likes of... 

• Clinical Examination and Case Management 
• Perinatal Mental Health 
• Social Research Methods 
• Public Health and the Accountable Midwife 
• Pharmacology and Medicines Management 

What do you learn in a midwifery degree? 

Postgraduate midwifery courses will introduce and develop skills needed for helping expectant mothers throughout their pregnancy, from initial scans to postnatal care. The course will also help to bolster the confidence of students through theory sessions and clinical experience.  

There will be broad aspects to the teachings concerning general health, specific situations concerning various complexities in midwifery, and building an understanding of the global perspective of midwifery. Safety and risk assessment will often play a part in most modules too. 

For students who have completed midwifery courses before, postgraduate courses in the subject can help to develop skills that can lead to career advancement into management and leadership roles. 

How will you be taught and assessed? 

Postgraduate degrees in midwifery will be taught through a combination of theory and practical work, giving students the knowledge and experience needed to deliver care for mothers and babies alike. There will often be placements involved, further introducing students to the environment where midwives will work. 

Assessments for these courses can be portfolio-based, presentations, dissertations, practical assessments and written assignments. 

How long is a midwifery degree? 

Midwifery courses will vary in length depending on the qualification they award at the end. Master’s degrees can last between one to two years, while some PGDip and PGCert courses will be shorter. Doctorate and PhD courses can last over three years. Studying part-time can make the course take twice as long. 

Where can you study midwifery? 

There are many universities in the UK offering postgraduate courses in midwifery. To take a look at where you could study this subject, please use our course search tool, which can be filtered by start date, location, course type and more. 

What similar subjects are there to midwifery? 

If you want to consider similar subject to midwifery, you could take a look at these courses... 

• Neonatal nursing 
• Health visiting 
• Women’s health 
• Adolescent, Child and Family Health 

Next: Search for postgraduate midwifery courses

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Msc higher midwifery practice, anglia ruskin university, pg diploma midwifery, london south bank university, msc midwifery, edge hill university, midwifery with registered midwife mmid, kingston university, pgdip advanced clinical practice (midwifery), middlesex university, your next steps.

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Guide for Students to Find the Best Midwifery Dissertation Topics

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• What Does Midwifery Mean? | Significance in the Real World 

What Are the Steps to Writing a Midwifery Dissertation?

• 21 Latest Midwifery Dissertation Topics for Undergraduate
• 22 Trending Midwifery Dissertation Topics for Students

Unsure About Your Midwifery Dissertation Topics? Get Help

Finding the best midwifery dissertation topics is a challenging job for students. To overcome this issue, Assignment Desk experts have prepared this blog. It will provide you with all relevant information on how to choose midwifery dissertation ideas , some good topics to choose from, and how to start writing your dissertation.

As a midwifery student, you will be required to write your dissertation . Although the dissertation is a mandatory task, students need to complete this work if they want to pursue midwifery as an occupation. Before starting your dissertation, find a suitable topic that might interest you and write about it in detail. The challenge in this process is identifying the best dissertation topics in midwifery . Every student must have a clear understanding of this step of dissertation writing. So, let's start with the basics of midwifery.

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What Does Midwifery Mean? | Significance in the Real World

In this blog, we're going to look at midwifery and where it fits in with our society today. As you may know, there's still some debate about its meaning. We'll dive into the best midwifery dissertation titles .

The word "midwife" is a little hard to define. It's derived from the Latin word "mater," which means "mother." Midwives are those who offer maternity care and health services. Midwifery is a caring occupation that strives to preserve natural childbirth, prevent maternal death, reduce maternal morbidity and mortality, and improve perinatal outcomes.

Some still use it about a woman who gives birth, while others use it as a slang term for childbirth education and training. It can be unclear because many women wish to become midwives even though they still need formal educational credentials.

Midwives are one of the oldest professions in human history. They care for women, children, and families through childbirth every year. The definition of midwifery means "midwife." The Greeks first used this term to describe women who helped with birth and prenatal care. This fact can be easily used in the dissertation structure to make it more realistic and trustworthy.

Midwives remain vital to our society because they help women maintain their dignity during labour. And help them make healthy decisions throughout their pregnancy.

All these facts about the oldest profession attract students to pursue it as a profession. They are so inspired that the most challenging job of finding midwifery dissertation topics and writing a dissertation is easy for them. It is because they follow a proper procedure to do so. In the next section, you will learn more about that procedure.

While writing a dissertation on midwifery, it's important to remember that time is of the essence. You need to make sure that you complete and prepare a perfect dissertation on time and in an efficient manner that also makes it meaningful.

Here are some tips for students who want to write their midwifery dissertation. Or they can also seek a lot of help from these tips and tricks to improve dissertation writing skills .

• Writing an outline is the first step of any dissertation writing. Starting with this sections of your dissertation will make it easily formatted.
• Create a timeline. The timeline should include all the significant steps and milestones you must pass to complete your midwifery dissertation on time.
• Each section should be divided into smaller subsections, each with clear midwifery dissertation topics UK and a relevant purpose for your research.
• When you have your outline, you can begin writing. One of the best ways to get started is by writing down everything that comes to mind about each section. Then begin with the formal content planning.
• Now, look at the resources available on your midwifery dissertation topics : books written about it, articles published in journals or magazines, and videos or documentaries about caregivers.

Try using a checklist before starting this dissertation phase so you remember essential steps to include in the content!

Now that you have all these tips and tricks, it's time to start finding suitable and interesting midwifery dissertation topics . With a little bit of planning and some effort, you'll be able to complete this on time!

21 Latest Midwifery Dissertation Topics for Undergraduate

We have listed some of the best midwifery dissertation ideas to help you find a good topic that suits your research.

• Midwife experiences with asylum seekers' maternity care
• What causes pregnancy fear, and how can midwives help women?
• Uses, expectations, perspectives, and experiences with birth plans
• Pregnancy, childbirth, and IPV relationships
• Increasing normalcy with midwifery care: aquatic births
• Fathers' postnatal depression
• Antidepressants and postnatal depression
• During the postnatal period, it reduces pain and infection and promotes healing of the sutured perineum
• Enhanced maternal safety in the Philippines
• Pediatric, obstetric, and clinician-indirect home interventions for the Medicare population
• Nurses and midwives manage hypoglycemia in healthy-term newborns
• A comprehensive assessment of the qualitative literature on the experiences of health workers in acute hospital settings with teamwork education
• A comprehensive assessment of the experiences of midwives and nurses working together to offer childbirth care
• How have "care pathway technologies" affected integrating services in stroke care? And how strong is the evidence for their success in this area?
• Our nation has a midwifery culture
• Knowledge of gender in midwifery
• Early midwives among the Native Americans: the art of midwifery
• Midwifery trends happening in the nursing practice
• What role does midwifery play in society?
• Relationship between women and midwives and childbirth education in your nation.
• Midwives have experience with difficult deliveries

Choose dissertation topic from the above-mentioned examples and make your efforts worthwhile. After a deep analysis, our expert has curated these ideas for you to save time. You are only required to pick the one that interests you and start working on it. if still, these 21 titles are not as per your expectation, then below are more dissertation topics in midwifery available for your help.

Also Read:  How Long Should a Dissertation Be?

22 Trending Midwifery Dissertation Topics for Students

We understand how difficult it is to research a suitable topic for academic dissertation writing. Keeping that in mind, we have asked our team of professional writers with years of experience to create some of the most sensible midwifery dissertation topics UK with the help of trends. These will give you a good idea of the current issues confronting midwifery.

• The cause of recurrent miscarriage
• The cultural perspective on male midwives
• Effectiveness of DNA testing in diagnosing a child's hereditary condition
• Surgical success in treating an umbilical hernia
• What hereditary factors contribute to miscarriage?
• The importance of eating well and being nourished when pregnant
• Treatment for a ruptured hernia
• Midwives' treatment of postpartum depression
• Miscarriages' underlying mechanisms
• Trends involving males who work as midwives
• What are the differences between pregnant women's expectations and birthing experiences?
• What dangers lurk in-home abortions?
• Why do umbilical cord hernias occur?
• What part do infections play in miscarriages?
• Techniques for promoting a normal birth during the second stage of labour
• Management of perinatal depression
• Perinatal treatment for disabled women
• Obese women are still able to give birth typically, right?
• Describe the variables that prevent natural birthing.
• How practical are the WHO perinatal recommendations?
• Taking care of hepatitis B while pregnant
• The right to pick one's birthplace

These interesting midwifery dissertation topics can impress your faculty and get you instant approval, as experts pick them personally. So, if you're having trouble with your dissertation, seek professional assistance and leave all of your worries to those who have done it before.

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Do you want to specialise in midwifery or do you need help with nursing dissertation ? We have a team of experts to help, who can write your dissertation with 100% originality.

As a midwifery student, you may require a dissertation to be written by an expert writer. Moreover, it might be necessary to outline the study and write your dissertation proposal. We can organise all the essential steps for you and provide strong online dissertation help .

Writing a dissertation in midwifery is a tough job that requires tremendous concentration, so it is always advisable to engage the services of a professional writer who can complete your dissertation on time. We do not just offer midwifery, but we also provide many other benefits on several subjects. You can also find assistance for Nursing dissertation topics or Nursing assignment help . So if you want help from experts, make sure you go to the Assignment Desk and only pay a nominal fee.

Anyone interested in learning different ways to write a dissertation and wants to explore its art can also contact us. We offer samples on many levels of assistance, such as assignment help or anything from medicine.

You cannot ignore the importance of midwives in today's world. A Midwifery dissertation topics will provide valuable insight into the field. If you have difficulty finding resources for your dissertation, remember that we are here to help! We create a multitude of dissertations from scratch just for you.

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• Research article
• Open access
• Published: 19 June 2018

Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth

• Lucy Lewis 1 , 2 ,
• Yvonne L. Hauck 1 , 2 ,
• Janice Butt 2 ,
• Chloe Western 2 ,
• Helen Overing 2 ,
• Corrinne Poletti 2 ,
• Jessica Priest 2 ,
• Dawn Hudd 3 &
• Brooke Thomson 1  

BMC Pregnancy and Childbirth volume  18 , Article number:  249 ( 2018 ) Cite this article

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There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. Our aim was to address this gap in evidence and build knowledge around this important topic.

This mixed method study was performed in two phases, between August and December 2016, in the birth centre of a tertiary public maternity hospital in Western Australia. Phase one utilised a cross sectional design to examine perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire. Phase two employed a qualitative descriptive design and focus groups to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth. Frequency distributions were employed for quantitative data. Thematic analysis was undertaken to extract common themes from focus group transcripts.

The majority (85%; 29 of 34) of midwives surveyed returned a questionnaire. Results from phase one confirmed that following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth and the mean waterbirths required to facilitate confidence was seven. Midwives were confident caring for women in water during the first, second and third stage of labour and enjoyed facilitating water immersion for labour and birth. Finally, responses to labour and birth scenarios indicated midwives were practicing according to state-wide clinical guidance.

Phase two included two focus groups of seven and five midwives. Exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth.

Conclusions

This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are integral to sustaining waterbirth as an option for low risk women.

Peer Review reports

The provision of water immersion for labour and birth is facilitated by midwives working within low risk midwifery-led models of care who are deemed competent to provide this method of birth [ 1 , 2 ]. The concept of competence is often aligned with confidence [ 3 ], but distinguishing between these two concepts is important as they are not always synonymous. A midwife may be a competent waterbirth practitioner having met all the professional competency requirements, but becoming confident is an individual journey that is dependent upon trust in clinical guidelines, presence of peer support and the challenge of achieving consistent exposure to waterbirth [ 4 ]. Additionally, midwives with extensive experience of conventional birth on land may be challenged to unlearn old skills and develop new practices required for water immersion in labour and birth. Whilst midwives working within low risk continuity of care models where physiological birth was the norm, researchers concluded that a supportive culture assisted in the development of their confidence, irrespective of clinical experience [ 4 ].

Individual midwives can act as gate keepers to water immersion which is more likely to be accepted into an organisation’s culture when it is supported by midwifery managers and championed by experienced waterbirth practitioners [ 5 ]. These champions can mentor midwives who wish to achieve waterbirth competency [ 5 ]. In this situation, mentors may not always be the most senior midwives who have extensive experience with conventional birth on land. Caution is recommended to recognise and consider ways to minimise the possible hierarchical tensions that may occur when experienced midwives are mentored by junior midwives who have achieved waterbirth competency [ 4 ]. Indeed, promoting and sustaining change in midwives’ waterbirth practice can be challenging. A study, undertaken in the United Kingdom (UK), utilised problem solving workshops to identify interventions that could develop and sustain a waterbirth culture. These interventions included: publishing monthly waterbirth statistics; setting a target of 100 waterbirths per annum; keeping portable birthing pools partially inflated; and appointing a waterbirth champion. Co-ordinators were able to positively influence midwifery practice through social support which was found to be pivotal in relation to developing and sustaining a waterbirth culture [ 6 ].

Access to immersion in water for labour and birth is reliant on both the care provider and the policies and procedures that guide clinical practice. Policies and guidelines in relation to water immersion for birth in Australia usually reflect the organisation’s interpretation of the current literature [ 7 ]. Additionally, more evidence is required around the effect of immersion in water on neonatal morbidity [ 1 , 8 , 9 ] and management of the third stage of labour [ 7 ]. A literature review exploring midwives concerns around waterbirth [ 10 ] identified three clinical issues (neonatal water aspiration and neonatal and maternal infection and thermo-regulation) and two practice issues (midwives skills and education and emergency procedures around maternal collapse). The clinical issues were not evidence based and the practice issues could ‘be addressed by appropriate policy, guidelines and practice’ [ 10 ]. Other work exploring how a convenience sample of 249 Australian midwives utilised normal birth guidelines, found that although the majority (90%) were aware that specific guidelines existed, only 71% reported routinely using them to guide their clinical practice [ 11 ].

It has been suggested that the waterbirth environment nurtures woman-centred care by facilitating shared decision making and perceptions of control around their care [ 8 ]. However, recent Australian research found some midwives perceive waterbirth policies and guidelines can limit their scope to facilitate water immersion and did not always support women’s informed choice [ 12 ].

There is limited research examining midwives' education, knowledge and practice around immersion in water for labour or birth. To address this gap in evidence and build our knowledge around this topic, our intention was to obtain a contemporary overview of midwives' experience of their education, knowledge and practice around immersion in water for labour or birth in Western Australia (WA).

The specific aim of this WA study was to assess Midwifery Group Practice (MGP) and Community Midwifery Program (CMP) midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth. This mixed method study was performed in two sequential phases. Phase one incorporated a cross sectional design and examined midwives' perceptions of education, knowledge and practice around immersion in water for labour or birth through a questionnaire; 34 midwives were invited to participate. Phase two employed a qualitative descriptive design to explore what midwives enjoyed about caring for women who labour or birth in water and the challenges midwives experienced with waterbirth; two focus groups were held.

Mixed methods were utilised to provide in-depth knowledge [ 13 , 14 ] relating to the education, knowledge and practice around immersion in water for labour or birth. This methodology offers researchers using quantitative methods the opportunity to utilise qualitative research to gain deeper understanding of the investigated phenomenon [ 15 ]. Utilising this two phase mixed methodology provided a more informative, constructive and thorough integration of the research results, building on the links between methods rather than within methods [ 15 ]. We envisaged being able to utilise both numbers and words would give greater insight into the bigger picture around midwives' experience of their education, knowledge and practice around immersion in water for labour or birth.

Participants and setting

The study was performed at the sole tertiary public maternity hospital in WA, which has approximately 5200 births annually. Women can labour and birth in the tertiary maternity hospital’s Labour Ward and Birth Suite or the Family Birth Centre (an adjacent building within the hospital grounds).

Perinatal data collected in 2016, by King Edward Memorial Hospital (KEMH) in WA confirmed that 5% (228 of 4402) of infants ≥37 weeks gestation were born immersed in water. Currently WA and South Australia are the only Australian states with state-wide policies and guidance supporting immersion in water for labour and birth, although waterbirth is available in every state and territory [ 16 , 17 ]. In WA midwives are guided by state-wide clinical waterbirth guidelines [ 16 ]. Between August and November 2016 we invited the 34 midwives who provided care for women who opted to use water for labour and/or birth to participate. Throughout the study, women choosing to labour and/or birth in water were cared for by midwives working within two publically funded services: the MGP and CMP. These low risk continuity of care models [ 18 ] are ideally suited to provide care for women who labour and/or birth in water, as this model facilitates a shift from high risk obstetric-led care to low risk midwifery-led care [ 18 , 19 ]. Both the MGP and CMP operate their services (antenatal, intrapartum and postnatal care) from the Family Birth Centre (FBC) with the CMP also providing antenatal, intrapartum and postnatal care to women in their homes and local community clinics. In these midwifery care models, a primary midwife is supported by a small team of midwives who provide continuity of care 24 h a day throughout pregnancy, birth and up to two weeks post birth. Perinatal data collected in 2016 at KEMH confirmed MGP and CMP midwives birthed 16% (813 of 5189) of all women at KEMH. Although, no women received immersion in water for labour and birth in the tertiary maternity hospital’s Labour Ward and Birth Suite throughout the duration of the study, in the last two weeks of the study the tertiary maternity hospital agreed that immersion in water for labour and birth could be facilitated in their main Labour and Birth Suite.

Recruitment and data collection

Midwives were invited to participate in the study through an information letter and in-house designed questionnaire (Additional file 1 ), both of which were sent to their workplace mobile phone. Midwives who did not want to complete the online questionnaire were given the option to complete a hard copy and return it to the research team by placing it in a locked box situated in the FBC. Returning a completed questionnaire was deemed implied consent. Ethics approval was gained from the Women and Newborn Health Service Ethics Committee (Approval Number 2016103QK) at the study centre.

The questionnaire was validated through a review process with an expert panel involving a midwifery educator and three midwives who had experience caring for women who had birthed in water. Feedback from the panel resulted in changes to questions around being competent to facilitate water immersion for labour or birth and actively promoting this birth choice for labour and birth. This question was divided into two questions, one focused upon labour and another concerning birth.

The aim of the questionnaire was to examine midwives' perceptions of education, knowledge and practice around immersion in water for labour. Midwives were asked about: their employment status (if they worked in the MGP or CMP and how long they had been working as a midwife and facilitating water immersion for labour or birth); their education (training undertaken to facilitate immersion in water for labour or birth and number of births required to develop waterbirth confidence); their practice (two factors they would discuss with women in relation to water immersion for labour or birth); their confidence caring for women immersed in water for labour and birth (in the first, second and third stages of labour); their enjoyment facilitating immersion in water for labour and birth; whether they actively promote water immersion for labour and birth; and their interpretation of four scenarios around antenatal, early labour, birth and third stage clinical care. The scenarios required a written response, were scored and were based on information relating to the state-wide clinical waterbirth guidelines [ 16 ]. It was decided to give midwives completing the questionnaire a website link to the state-wide guidelines [ 16 ], in the information letter accompanying the questionnaire. By providing a website link to this guidance, we were examining how midwives interpreted and applied the guidance in their clinical practice. In relation to confidence and enjoyment, midwives were asked to place a cross on a 10 cm line (where zero was ‘not confident’ or ‘does not enjoy’ and 10 was ‘very confident’ or ‘enjoys’), to quantify their perceptions on the continuum from zero to ten.

An item was included at the end of the questionnaire (phase one) inviting midwives to participate in a focus group to discuss their experiences around immersion in water for labour or birth. The first author conducted the two focus groups. Observations were documented by the fourth author in the form of field notes. Each focus group lasted approximately 45 min. The focus groups were held at the study centre in an interview room that was convenient to all interested midwives. Prior to commencing the focus group, midwives were reminded that their privacy would be maintained by issuing each of them a unique identifier; the discussions linked to an individual’s identity should ‘remain in the room’; and that the focus group would be audio recorded. All midwives verbally consented to these conditions.

The final questions for the focus groups (Additional file 2 ) were based around the results from phase one, with two questions being developed: question one asked ‘What contributes to your enjoyment of waterbirth?’ Two prompts were utilised for this question. The first one addressed the promotion of natural birth and the second was around supporting women’s choice. Question two asked ‘Are there any issues with waterbirth?’ One prompt was utilised around the issue of exploring which stage of labour midwives found most challenging.

Data analysis

Phase one: quantitative data.

Each of the four clinical scenarios was allocated a maximum score according to whether a midwife correctly identified key aspects of clinical practice based on the state-wide clinical waterbirth guidelines [ 16 ]. Four members of the research team independently scored each scenario. The team then met to compare scores. Any disagreement in relation to the scores was discussed and a consensus reached by referring back to the data.

Means, and interquartile ranges were used to summarise continuous data (such as the scores for each scenario). Frequency distributions were used to summarise categorical data (such as feeling equipped to facilitate waterbirth following training). Statistical software (SPSS version 22) was used for analysis.

Phase two: Qualitative data

Transcribed focus groups were subjected to thematic analysis [ 20 ] by five members of the research team, who analysed a cross-section of transcripts and field notes ensuring each data source was reviewed by at least two members [ 21 ]. Analysis required the research team to become submerged in the data. Transcripts and field notes were deconstructed enabling the research team to identify patterns, similarities and themes from the midwives’ words or sentences [ 13 , 20 , 21 ]. The team met weekly over three months to negotiate, clarify and refine the themes. Any disagreements on interpretation were negotiated by referring back to the data. All the researchers were clinical or academic midwives, with varying experiences of facilitating immersion in water for labour or birth. As a process of member checking, preliminary themes were presented to five midwife participants who confirmed agreement with the themes.

Table 1 summarises the midwives’ perception of their education, knowledge and practice around immersion in water for labour and birth. A total of 29 (85%) out of a potential 34 midwives returned a questionnaire. The mean time midwives were qualified was 162 months (13 years and 5 months), with the mean time midwives had been facilitating waterbirth being 83 months (eight years and 9 months). Most (59%; n  = 17) midwives worked in the MGP. The majority (93%; n  = 27) of midwives used the WA state-wide clinical guidelines for waterbirth [ 16 ] for their education and training, with 90% ( n  = 26) accessing the E-learning package developed by the study hospital’s education department. Following waterbirth training, 93% ( n  = 27) felt equipped to facilitate waterbirth with the mean number of waterbirths required to facilitate confidence being seven.

On a scale of 0 to 10 (where zero was ‘not confident’ and 10 was ‘very confident’), midwives were very confident caring for women in water during the first stage of labour (mean score of 10). They were also confident caring for women in the second stage (mean score of 9) and third stage of labour (mean score of 8). The mean score in relation to confidence using the emergency evacuation to get the woman out of the bath was eight. On a scale of 0 to 10 (where zero was ‘does not enjoy’ and 10 was ‘enjoys’), midwives enjoyed facilitating immersion in water and birth, obtaining a mean score of 10. Finally, mean scores for the antenatal, early labour, birth and third stage of labour scenarios indicated midwives were practicing according to the WA state-wide clinical guidelines for waterbirth [ 16 ].

Two focus groups comprising of seven and five midwives were performed. Findings are presented with supportive quotes in italics from the midwives. For confidentiality a pseudo-name was allocated to each midwife.

Caring for women who labour or birth in water

Exploration of what midwives enjoyed about caring for women who labour or birth in water revealed three distinctive themes: instinctive birthing; woman-centred atmosphere; and undisturbed space (Table 2 ).

Instinctive birthing

The theme ‘instinctive birthing’ described how midwives perceived labouring or birthing in water nurtured an instinctive birthing behaviour led by the woman. Anna reflected ‘ You absolutely see the hormones that promote labour take over. You know labour progresses better and the woman relaxes into labour ’. Noreen agreed; they ‘ Really feel what the body is able to do and how birth feels ’, whilst Kate described how she perceived water enabled her to trust a woman’s ability to instinctively birth:

I think they progress really well. I don’t do many vaginal exams, but they are getting in [the water] and they are well established, they are fully before you know it and they don’t push early. Like sometimes with their first grunt the heads on view…They’re not asking for epidurals, they’re not asking for gas.

Jasmine agreed with Kate’s sentiments: ‘ Because you can’t see as the vagina is submerged, the first sign she needs to push is she’s pushing ’ whilst Anna summarised her experience was that ‘ They’re more likely to reach down and lift the baby up themselves ’.

Woman-centred atmosphere

The theme ‘woman-centred atmosphere’ described a labour and birth environment which was woman centred, calm, peaceful and relaxed. Initially midwives discussed how labouring and birthing in water empowered women. Jacquie noted ‘ I feel women have more control ’. Anna agreed suggesting she thought it was to do with power stating ‘ The woman holds more of the power in labour ’. Noreen continued the discussion ‘ the thing is society brings up pictures of women with somebody doing it [the birth] for them, there is a cultural thing of having somebody delivering the baby whilst [with water] there is themselves and their body ’. Bonnie reflected on Noreen’s comments suggesting water promoted a change in the woman’s demeanour ‘ You can see the change in the woman’s face and in her body when she gets in the water, it’s nice and relaxed ’. Beth agreed water ‘ Promotes the environment to be quiet and peaceful ’. Jacquie thought this may be because ‘ The space between contractions is very different from a land birth, they are very much more focused on their breathing and calmer ’. Whilst Noreen shared how a woman’s relaxed state affected the care she gave ‘ You know it’s all relaxed and you can concentrate more on the signs, the natural signs of a woman giving birth ’ . Sophie agreed ‘ It’s so calming for the women. I think it relaxes them which then relaxes us ’.

Undisturbed space

The theme ‘undisturbed space’, described how water creates an undisturbed space where access to the woman is mediated by the water. Jasmine noted that ‘ If you’re in the bath people knock and they stay out, they leave you alone. As far as society is concerned, it’s not acceptable to walk into the room when someone’s in the bath. If someone’s in lithotomy, fine ’. Kerry reflected it also had an impact on how safe the woman felt. ‘ Especially for the women who have a sexual abuse history, they feel safer in the water, they feel like you can’t get at them ’. The topic of safety led to a discussion around privacy with Olivia commenting that ‘ It’s [‘water] their ‘own space and you have to really reach into their space, rather than them being poked and prodded [with a land birth]’. Dorothy agreed stating ‘ It’s more undisturbed ’. Kerry continued ‘ Even though you can see beneath the water and everything, I think for them it just feels, more private under the water ’. Kate reflected on her experiences by recounting a scenario ‘ A woman that came back to the waterbirth study day and spoke about when she got in [the pool] there was a real sense of privacy, even though she had nothing on, the water was like a veil ’. Baily also remarked on how the ‘dynamics’ of a labour in water effects the partner ‘ I get a sense they quite like it too, because they are able to just sit and observe and hold that silent still place…my experience is that even men feel quite comfortable in that space ’.

The challenges midwives experienced with waterbirth

Analysis of the focus group transcripts exploring the question ‘are there any issues with waterbirth’ revealed that issues highlighted by the midwives were perceived as challenges. Two themes were identified: learning through reflection and facilities required to support waterbirth.

Learning through reflection

The theme ‘learning through reflection’ illustrates how midwives learnt by documenting and then reflecting on the clinical challenges encountered during their day to day clinical practice around water immersion for labour and birth. Kerry shared ‘ I didn’t used to but since we’ve been doing group practice… when you look at your records you can see most of them are waterbirths ’. Olivia continued ‘ I don’t remember all of the waterbirths…I’ve got a little book that I just pop them in ’. Kate reflected on her colleagues comments sharing she did not keep records of each waterbirth and that her confidence caring for women in water ‘ took a long time. I’ve probably done, I don’t know over 150 now ’. Kate went on to explain why ‘ You had to flex the head and then move the hand and then sweep the perineum, it was really hands on. But that’s how we were taught. So to move to totally hands off [waterbirth] where you’re not even poised is challenging ’. Olivia agreed with Kate’s sentiments describing a waterbirth scenario where ‘ I remember taking over from somebody else and it was a hypno-birth and so there was no talking…it was a good learning experience ’.

To illustrate, the topic of learning through clinical experience led to a discussion around placental cord snapping. Bonnie shared ‘ I’ve had a few cord snaps now. Like quite a few issues, but it hasn’t changed my feeling of how to perform waterbirth because I know it’s going to be fine and we just deal with it as it comes ’. Kerry empathised, supporting Bonnie by acknowledging ‘ I think a lot of midwives get anxious even though they may pretend they don’t get anxious about waterbirths. They want to get the baby out as fast as possible. But I think if you make them [the women] aware you don’t just yank it [the baby up]… you need to check how long it [the cord] is before you can go yanking’ .

Facilities required to support waterbirth

The theme ‘facilities required to support waterbirth’ related to ensuring waterbirth facilities were suitable, available and accessible for women and identified challenges relating to the provision of infrastructure around waterbirth. Jasmine stated:

If we want this option [waterbirth] open for all women then we need to provide the facilities for that to happen. I have an issue with it being inequitable at the moment. The Birth Centre has the birth pool and blow up pools that are free of charge whilst clients [women] in the main hospital and CMP have to pay and hire their own…how come one group of clients under the same public system get it for nothing and the other group have to pay?

Sophie was also concerned by the rollout of waterbirths to the main hospital but her frustration was around the referral process. ‘ When waterbith was approved in the main hospital…I had a patient come over and say ‘I want a waterbirth but they [the main hospital] won’t facilitate one for me over there and they’ve told me to come to the Birth Centre and I was quite surprised ’. Whilst Kate’s sentiments concerned the content of the waterbirth guidelines. ‘ When it [the waterbirth guideline] was first developed we didn’t have telemetry and now we do. So I think waterbirth telemetry needs to be incorporated into the guideline’ . Other midwives did not appear sure of how often in-service needed to be provided in relation to emergency management, pool evacuation and assessment of blood loss. There was debate between midwives in relation to how often these drills should be performed. Dorothy confirmed ‘ In the CMP we have to do like a quiz, you know we put the blood in the water every six months and estimate it ’. Whilst Jacquie confirmed ‘ We do up a calendar [of available professional development sessions]’ and it was up to individuals to ensure their development was up to date.

This mixed methods study enabled us to explore midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth in WA. Quantitative analysis found the majority of midwives felt equipped following waterbirth training to facilitate labour and birth in water, with scenario responses indicating midwives were practicing according to the WA state-wide guidance. Additionally, midwives were confident and enjoyed caring for women who used water immersion. Qualitative exploration of what midwives enjoyed about caring for women who used water immersion for labour and/or birth revealed three distinctive themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Whilst exploration of the challenges experienced with waterbirth revealed two themes: learning through reflection and facilities required to support waterbirth. Our discussion will focus on what waterbirth offers midwives.

Labouring and birthing in water is centred around the philosophy that pregnancy and birth are normal life events [ 19 ]. The importance of sustaining a waterbirth culture highlighted by these WA midwives aligns with the belief that maintaining low risk birth cultures is essential to meet the needs of healthy, low risk women through recognition and respect of midwives’ contribution [ 22 ]. Midwives in this study were experts in their field, who had been qualified for a mean of 13 years and five months and facilitating waterbirth for a mean of eight years and nine months; similar to other research [ 6 ]. During the study it was agreed that immersion in water for labour and birth could be facilitated in the tertiary Labour and Birth Suite. We suggest this expertise will be integral in relation to supporting midwives in the tertiary Labour and Birth Suite to become skilled waterbirth practitioners. Indeed, an action research study introducing a problem solving waterbirth workshop with UK midwives and their co-ordinators positively affected change in waterbirth practice and was recognised for its potential shift toward normalising low risk midwifery care [ 6 ].

Midwives are guided by the International Confederation of Midwives (ICM) Position Statement on ‘keeping birth normal’ [ 23 ] which asserts that midwives are advocates and experts in low risk childbirth. The ICM acknowledges that ‘women should have access to midwifery-led care, one-to-one support, including the choice of a home birth and immersion in water’ [ 23 ] which aligns with the international recommended pathway towards evidence based respectful maternity care [ 24 ]. Utilising immersion for labour and/or birth provides midwives with an opportunity to facilitate this experience for women.

The theme of ‘learning through reflection’ articulated by the midwives supports the ICM Philosophy of Midwifery Care [ 25 ] ensuring competent midwifery care is informed and guided by continuous education. The association between workplace learning and competence was confirmed in a Japanese study with nurse/midwives who related learning through reflection to their self-reported competence [ 26 ]. Differences were noted based upon level of experience whereby learning from feedback and training were associated with competence for more experienced clinicians compared to learning through practice and from others for self-reported competence for those with less experience [ 26 ]. Fittingly, the Australian national competency standards for the midwife [ 27 ] present domains around the provision of woman-centred care, with one domain suitably entitled ‘reflective and ethical practice’. Midwives in this study reinforce the relevance of this domain in their practice as both the clinical scenarios and focus group findings illustrated they valued having the ability and skills to analyse and reflect in, on and about practice to ultimately maintain clinical competence and confidence. In short, when care is provided by midwives who are educated [ 28 , 29 ], regulated [ 21 , 30 ] and provide respectful evidence based care [ 24 ], the outcomes are improved for women and their infants [ 1 , 24 , 28 , 29 ]. The midwives in this study adhered to these principles empowering women to realise their potential to birth, though the medium of water.

Strengths and limitations

Although the quantitative methods employed provided limited scope to explore the wide range of experiences midwives in our study encountered caring for women who laboured and/or birthed in water, they did provide the research team with an objective starting point for further exploration of specific aspects of the questionnaire [ 21 , 30 ]. For example, utilising a question for the focus groups gleaned from a phase one question asking midwives to score their enjoyment facilitating immersion in water for labour and birth, gave us the opportunity to contextualise what they enjoyed; providing a connection between the quantitative and qualitative components that could not be answered by mono-methods alone. By utilising both numbers and words to explore this topic [ 14 , 15 ], the qualitative and quantitative components became cohesively integrated, producing research findings around midwives enjoyment which were greater than the sum of individual parts of the research [ 31 ]. This approach exposed the importance of instinctive birthing; woman-centred atmosphere; and undisturbed space.

Midwives in this study were self-selected from the MGP and CMP midwives based within the sole tertiary public maternity hospital in WA. Providing midwives with a website link to the WA state-wide waterbirth guidelines may have influenced their responses. This was a self-assessment of competence which is a subjective aptitude. The research would have been strengthened by comparing the midwives responses to their actions. Participating midwives may have been motivated and confident in their waterbirth practice. The sample of midwives included in phase one was small and may not be representative of all midwives who provide care for women who labour and/or birth in water. We acknowledge these factors could have had an impact in relation to the findings and should be considered when interpreting transferability of the findings to other settings.

This research contributes to the growing knowledge base examining midwives' education, knowledge and practice around immersion in water for labour or birth. It also highlights the importance of exploring what immersion in water for labour and birth offers midwives, as this research suggests they are an integral component in relation to supporting and sustaining a waterbirth culture. Midwives in this WA study were both competent and confident and enjoyed caring for women who used water immersion. Perhaps this was because the medium of water not only empowered women to realise their potential, but also themselves.

Abbreviations

Community Midwifery Program

Family Birth Centre

International Confederation of Midwives

King Edward Memorial Hospital

Midwifery Group Practice

United Kindgom

Western Australia

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Acknowledgements

We would like to thank King Edward Memorial Hospital for providing funding for the research staff and the midwives for graciously sharing their experiences.

The research was not supported by a research grant. King Edward Memorial Hospital provided funding for the research staff to undertake and complete the project with no role in study design, data collection, analysis, interpretation and writing the manuscript.

Availability of data and materials

We had assured the midwives participating in the study we would maintain their confidentiality and privacy. As there 29 midwives in this study, we were not able to make their supporting data available as we felt their identity may be compromised.

Author information

Authors and affiliations.

School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia, 6102, Australia

Lucy Lewis, Yvonne L. Hauck & Brooke Thomson

Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, 6008, Australia

Lucy Lewis, Yvonne L. Hauck, Janice Butt, Chloe Western, Helen Overing, Corrinne Poletti & Jessica Priest

Family Birth Centre, Midwifery Group Practice and Community Midwifery Program, King Edward Memorial Hospital, Subiaco, 6008, Western Australia, Australia

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Contributions

All authors read and approved the final version of the manuscript. LL was responsible for the proposal, ethics approval development of the data collection tool/questions and coordination of the study. For the quantitative data she assisted data entry into SPSS. She also performed the quantitative data analysis. For the qualitative data she ran the focus groups and participated in thematic analysis. She drafted the article and was responsible for the final editing which incorporated the team member’s comments. YH assisted LL with the proposal and ethics approval and development of the data collection tool. For the qualitative data she participated in the thematic analysis. She assisted LL with the drafting of the article. JB assisted with development of the data collection tool/questions and made comments on the final article. CW assisted with the coordination of the study. For the qualitative data she assisted with the focus groups. She made comment on the final article. HO participated in thematic analysis. She made comment on the final article. CP participated in thematic analysis. She made comment on the final article. JP participated in thematic analysis. She made comment on the final article. DH assisted with coordination of the study. She made comment on the final article. BT contributed and approved the final article.

Corresponding author

Correspondence to Lucy Lewis .

Ethics declarations

Ethics approval and consent to participate.

Ethics approval was gained from the Women and Newborn Ethics Committee (Approval Number 2016103QK) at the study centre. Returning a completed questionnaire was deemed implied consent. An item was also included at the end of the questionnaire inviting midwives to participate in a focus group to discuss their experiences around immersion in water for labour or birth. Prior to commencing the focus group midwives were reminded that their privacy would be maintained by issuing each of them a unique identifier; the discussions linked to an individual’s identity should ‘remain in the room’; and that the focus group would be audio recorded. All midwives verbally consented to these conditions.

Competing interests

The authors declare that they have no competing interests.

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Additional files

Additional file 1:.

Midwives satisfaction with waterbirth questionnaire. (PDF 184 kb)

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Focus group questions. (DOCX 12 kb)

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Lewis, L., Hauck, Y.L., Butt, J. et al. Midwives’ experience of their education, knowledge and practice around immersion in water for labour or birth. BMC Pregnancy Childbirth 18 , 249 (2018). https://doi.org/10.1186/s12884-018-1823-0

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Received : 01 December 2017

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Published : 19 June 2018

DOI : https://doi.org/10.1186/s12884-018-1823-0

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A journal article should be written in a different style from that of an academic essay.  Aim for a clear, readable and accessible style. If this is the first time you have submitted an article to a journal it may help to ask a colleague or tutor to read it.

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We welcome contributions about clinical practice, such as reflection on practice, personal experiences, service evaluation and clinical governance/safety.  We are particularly interested in current issues, new developments, controversial topics, and would like articles that share experiences to help others advance their practice and/or challenge clinical practice.

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We welcome submissions on primary and secondary research. We are keen to encourage submissions from any research undertaken as part of a higher education course, such as a dissertation or essay. Occasionally, the larger pieces of work may need to be split into two related papers.

Research articles are a maximum 3500 words  including in-text references, tables/figures and the reference list.

Guideline - Primary Research (audits / RCTs / Cohort studies)

• Abstract - 350 word maximum o Objective o Methods o Results o Conclusion • Main paper o Introduction State the objectives of the work and provide an adequate background, avoiding a detailed literature survey or a summary of the results. o Methods A brief but clear outline of the methodology, making clear the study setting, the sample, the hypothesis (where relevant) and the reason for the chosen method. Please provide information of ethical approvals granted and particular ethical considerations in your study. Please provide details of funding, if appropriate. o Results Results should be clear and concise. Results/findings consistent with your chosen methodology. Tables and graphs may be used – maximum of three in total . o Discussion Relate your findings to focus their relevance to midwifery practice. Also include a brief statement of limitations of the research, and implications for practice and future research. o Conclusion A concise conclusion to include implications for future practice/research. • Statement of permissions obtained if appropriate. • Reference list - maximum of 25 references.

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To encourage advancement, understanding and adoption of research into daily midwifery practice, MIDIRS welcome pieces that discuss and critique a particular published piece of research.  These will help the reader gain a greater understanding of how to critique research, while also gaining knowledge about the specific research study being discussed. 

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We encourage reviews of local, national and international guidelines/reports that have implications directly or indirectly for midwives.  Such commentaries will help our readers to understand what reports mean for midwifery practice and to place report recommendations into context.

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Article Submission

Midwifery Dissertations: Choosing a Good Topic

The right topic for a dissertation is always a hard choice to make. Your midwifery dissertation is not an exception. Since you are not writing a midwifery essay that can be prepared in a couple of hours, you have to take the choice of a topic seriously.

In this article, you will find a short list of possible topics to cover in midwifery dissertations. Before that, we want you to read and consider some basic rules of selecting a topic for a midwifery dissertation.

Make sure you are going to research something really important. Midwifery is about dealing with people and being near in the most significant periods of their lives. Thus, your midwifery dissertation should be devoted to some acute problems that midwives and their patients might face.

Be specific and do not pick broad issues to discuss in your midwifery dissertation. Even if the issue you have chosen seems to be too narrow, it will transform and expand in the process of writing and researching.

Now, let us give you a couple of specific topic ideas for your midwifery dissertation.

Midwifery in the United States and other Western countries

In your midwifery dissertation, you may compare American midwife practices to those in other developed countries.

Home birthing and the role of midwives

Giving birth to a child is very different from that in a hospital. Tell in your midwifery dissertation about the peculiarities of home birthing, the role of a midwife, possible risks, etc.

Male midwives

This is a really interesting issue to investigate in the midwifery dissertation, since men are not that frequently involved in this field.

You are a novice dissertation writer, which means you need additional dissertation help. Our next article is devoted to some peculiarities of a dissertation research process.

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Writing your journal article in 12 weeks: a guide to academic publishing success.

Patricia Jarrett

Research Fellow in Midwifery, School of Health and Education, Middlesex University

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Consider the scene: You have finished your research report/MSc dissertation/PhD and your manager/supervisor/employer asks ‘have you published?’ What do you do? Where do you start? How do you condense many months and possibly years of work into one 3 000 word article fit for publication? Many will recognise this scenario as the ever increasing pressure (in academia and clinical practice) to publish in high impact quality journals grows. The problem is, however, that the publishing world is often shrouded in mystery and uncertainty. Additionally, little guidance for new researchers or clinicians on how they might write an article fit for publication, exists. Another problem is time, or lack of it. Lack of time is one of the most common reasons why those working in academia fail to publish. Although others have attempted to address writing and publication issues, Writing Your Journal Article in 12 weeks: A Guide to Academic Publishing Success offers a fresh approach. In her book, Belcher both demystifies the publication world and offers guidance on managing time.

Wendy Laura Belcher is an academic, editor and professor. She has several years' experience as an academic author and has won several awards for writing. Writing Your Journal Article in 12 weeks is a well written workbook, presented in an easy and accessible style. It is the result of a ‘publication focused course’ previously run by Belcher and although written for graduate students and new faculty members, it would be of help to anyone wishing to publish in academic journals.

The aims of the book, in the author's words, are to help ‘those in the trenches’ to ‘understand the rules of academic publishing’. It is a workbook, where wannabe authors are invited to revise a piece of academic writing to a standard where it can be submitted for publication. The book is divided into 12 chapters—each chapter corresponds to a week of writing—and contains a comprehensive index, contents page, recommended reading and works cited. There are also chapters on how to use the book and guidance on responding to journal decisions. Each week the reader is asked to complete five specific daily tasks in order to complete their article for publication. There are four types of tasks: workbook tasks, social tasks, writing tasks and planning. The tasks encourage daily writing to bring the reader closer to the goal of completing and submitting a journal article. It is not really for those who want to ‘dip in and out’ for tips on writing, as Belcher states, ‘the learning is in the doing’.

There are a number of central beliefs running through the book, one is that to be successful in writing you must write regularly. Belcher discourages leaving writing to a block of time—to be a writer you must write. She also advocates making writing a social rather than lone activity—sharing ideas, joining a writing group, finding a writing partner—all increase productivity. Belcher, unlike other writers in this area, takes a more macro approach to her advice on writing, concentrating on developing argument and structure, rather than advising on the micro elements of writing, for example syntax and style. Belcher believes that revision of argument, structure and summarising make the biggest difference to an articles quality and therefore success in being published.

In summary, chapters relating to weeks one to four focus on development of the argument and selection of journal, two of the most important considerations in academic writing, according to Belcher. Chapters relating to weeks five to eight, focus on identifying suitable literature and deciding appropriate entry points for the article, that is, where does what you want to say fit within the existing literature. For those who tend to end up ‘drowning in the literature’ Belcher offers some good advice on strategies for reading and selecting only that literature applicable to your article. Strengthening the structure, presenting the evidence, opening and closing your research article are discussed within chapters relating to weeks six to eight. Weeks nine through to twelve deal with the importance of perseverance and responding to journal decisions: ‘How you respond to journal decisions about your submitted articles will determine your academic career’.

One of the advantages of the book is that it is a workbook. That is, it does provide ‘clear guidance’ on how to publish. If you proceed through the workbook, chapter by chapter, you will have an article that can be sent for publication by the end of 12 weeks. The prescriptive style may not appeal to all.

Mass., what took you so long on midwifery?

Re “Sweeping maternal health bill is passed: Lawmakers vote to expand access to midwives” (Metro, Aug. 16): Gee, way to go, Massachusetts. When I lived in Seattle, insurance was required to cover midwifery care, including postpartum and well-baby evaluations, breast-feeding support, and prenatal classes.

My children are in their 40s.

Wendie Howland

The writer is a retired registered nurse.

Because of an editing error, an earlier version of this letter omitted the fact that the writer is retired.

Globe Opinion

Click here to place an order for topic brief service to get instant approval from your professor.

Best Midwifery Dissertation Topics Ideas & Examples

Table of Contents

List of Midwifery dissertations Topics and Some Tips for Selecting Better Dissertation Topics in Midwifery

Many students feel difficulty in pursuing their studies in midwifery, let alone making a selection of topics for the dissertation. If you are searching for examples of midwifery literature review topics, midwifery research topics, midwifery dissertation titles , midwifery dissertation topics, or midwifery research questions this post is for you.

Do you belong to the above group of students who are not only shy but are also confused about how to make a selection of dissertation topics in midwifery for the midwifery dissertation?

Let’s first define what midwifery means and what its importance is in our social and medical structure.

What is Midwifery?

Midwifery is a healthcare profession that provides care to childbearing women during pregnancy, labor, and birth and during the postpartum period. They take care of the newborn and the mother. They also provide primary care to women which includes primary care to women, gynecological examination of women, family planning, and menopausal care.

In the nursing profession, students may be asked to write a dissertation on any topic of midwifery.

Tips for Selecting Midwifery Dissertation Topics

Like any dissertation in which it is difficult to choose a topic and write it, midwifery dissertations also students face the same problem. So, it is not an exception. However, one must know the important areas for the selection of the topic for the dissertation. Therefore, prior to the final selection of the topic, there are some important tips that would help students in selecting   midwifery dissertation topics. These tips are as follows.

• The students must be sure that they are going to discuss one of the most important topics in the subject.
• The dissertation on midwifery must touch on some of the serious problems which are faced by mothers and newborns.
• The students must take care that their topic is specific, and it is not broad in its nature.
• If someone has chosen a narrow topic, he/she must expand it through research and writing.
• Clear attention should be given to traditional midwifery dissertation topics in order to know their content and scope.
• The topic chosen must be aimed at explaining the profession in greater detail. The students choose the research topic which can help to improve the healthcare of mothers and their children.
• The students must enhance their basic knowledge for a better understanding of the subject.

Prenatal Care:

• The role of midwives in promoting healthy prenatal behaviors
• Assessing the effectiveness of prenatal education programs
• Addressing cultural barriers in accessing prenatal care

Postpartum Care:

• Strategies for improving postpartum support for new mothers.
• The impact of postpartum depression on maternal health outcomes
• Exploring alternative postpartum care models, such as home visits

Labor and Delivery:

• Examining the use of pain management techniques during labor
• Investigating the influence of birth environment on labor outcomes
• Evaluating the role of midwives in reducing cesarean section rates

Maternal Health:

• Addressing disparities in maternal healthcare access
• Exploring the impact of maternal nutrition on birth outcomes
• Investigating interventions to reduce maternal mortality rates globally.

Neonatal Care:

• Assessing the effectiveness of breastfeeding support in neonatal care units
• Exploring the role of midwives in neonatal resuscitation
• Investigating best practices for kangaroo care in low-resource settings

Women’s Health:

• Examining midwifery-led models of women’s health care
• Investigating the role of midwives in promoting sexual and reproductive health
• Addressing cultural taboos surrounding women’s health issues

Family Planning:

• Evaluating the impact of contraceptive counseling provided by midwives
• Exploring the role of midwives in providing abortion care
• Assessing barriers to accessing family planning services in rural areas

Midwifery Education and Training:

• Assessing the effectiveness of simulation training in midwifery education
• Exploring innovative teaching methods in midwifery programs
• Investigating strategies for mentorship and professional development in midwifery

Midwifery Ethics and Legal Issues:

• Examining ethical dilemmas faced by midwives in clinical practice.
• Exploring legal frameworks for midwifery practice across different countries
• Assessing the impact of litigation on midwifery practice

Mental Health in Pregnancy and Childbirth:

• Investigating the prevalence of anxiety disorders in pregnant women
• Exploring interventions for addressing trauma in childbirth
• Assessing the role of midwives in identifying and supporting women with perinatal mental health issues

Integrative Medicine in Midwifery Practice:

• Exploring the integration of complementary therapies in midwifery care
• Assessing the safety and efficacy of herbal remedies during pregnancy and childbirth
• Investigating cultural practices and rituals surrounding pregnancy and birth

Technology in Midwifery:

• Examining the use of telemedicine in midwifery practice
• Exploring the impact of mobile health applications on maternal and neonatal health outcomes
• Assessing the role of artificial intelligence in improving prenatal diagnosis and monitoring

LGBTQ+ Inclusive Care:

• Investigating the experiences of LGBTQ+ individuals in maternity care settings
• Assessing cultural competency training in midwifery education programs
• Exploring strategies for creating inclusive and affirming birth environments

Global Health and Midwifery:

• Examining the role of midwives in addressing maternal and neonatal health disparities in low-income countries
• Investigating the impact of international partnerships on improving midwifery services
• Assessing the cultural appropriateness of western midwifery models in diverse global contexts

Midwifery and Public Health:

• Exploring the role of midwives in promoting breastfeeding initiation and duration
• Assessing the impact of midwifery-led prenatal care on birth outcomes
• Investigating strategies for reducing maternal and neonatal morbidity and mortality through public health interventions

More Midwifery Dissertation Topics

In light of the above guidance, students can choose any topic from the following given midwifery dissertation topics.

• The impact of maternal obesity on birth outcomes
• The use of midwife-led continuity of care models in maternity care
• The role of midwives in promoting breastfeeding
• The use of technology in midwifery practice
• The impact of cultural diversity on midwifery care
• The use of midwifery-led care in low-risk pregnancies
• The role of midwives in reducing maternal mortality rates
• The use of telehealth in midwifery practice
• The impact of poverty on maternal and newborn health
• The use of water birth in midwifery practice
• The role of midwives in promoting maternal mental health
• The use of midwifery-led care in premature births
• The impact of the COVID-19 pandemic on midwifery practice
• The use of aromatherapy in midwifery practice
• The role of midwives in promoting gender equity in maternal health
• The use of midwifery-led care in home births
• The impact of policy changes on midwifery practice
• The use of midwifery-led care in rural and remote areas
• The role of midwives in promoting maternal and newborn nutrition
• The use of hypnobirthing in midwifery practice
• The impact of midwifery-led care on maternal satisfaction
• The use of midwifery-led care in women with complications in pregnancy
• The role of midwives in promoting maternal and child health
• The use of midwifery-led care in family planning
• The impact of the integration of midwifery practice and primary care
• The use of midwifery-led care in women with a history of trauma
• The role of midwives in promoting gender-sensitive care
• The use of midwifery-led care in low-income communities
• The impact of midwifery education on quality of care
• The use of midwifery-led care in women with chronic conditions.
• Role of a midwife: The role of the midwife in the present healthcare environments.
• Midwifery profession: Nursing and Midwifery-two identical yet different professions. Are they likely to go together? Or one will replace the other? What are the Prospects of males working in the midwifery profession?
• Improvements are needed in the midwifery profession in light of scientific developments in the health and childcare fields.
• The state of midwifery in developed and underdeveloped countries.
• Midwifery field: Discuss the latest practices in nursing and midwifery fields.
• The evolution of midwifery from ancient times to modern times.
• The relation between nursing and midwifery.
• The role of prenatal counseling in the growth of a child.
• Critical analysis of midwifery as the profession dominated by women.
• Midwifery service: How to improve midwifery services to less privileged women?
• What is the future growth of the midwifery profession?
• Pregnant women: Do the midwives influence decision-making and facilitate informed choices among pregnant women?
• Midwives’ descriptions and perceptions of pregnant women with problems of substance abuse .
• Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomized trial (the MidU study)

Midwifery is a noble profession with a lot of growth potential. There could be more thought-provoking nursing dissertation topics for research in this field. Interested in further details, call us for more Midwifery Dissertation topics.

Related posts:

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I'm stuck. Choose me a midwify dissertation topic.

EccentricaGallumbits · 30/09/2009 12:02

Things I like Normal birth Water Art Placentas Knitting. TIA.

The role of the knitted placenta in art.

also there has to have been at least 10 research papers already done on said subject.

Homebirth - is it an unacknowledged feminist stance against the male-dominated hegemony of the obstetric unit? !!

Interested in this thread?

Then you might like threads about this subject:

Aha...that's where my idea comes unstuck I suspect

...and knitting

Antenatal preparation and mode of birth? I thankfully escaped a dissertation, but sometimes wonder, if I had to...then shudder, and have a cup of tea.

Can't you do your own research? If I wasn't so lazy and could motivate myself to do my dissertation I'd want to do some research. I was thinking about doing research on partnerss feelings about the birth. But then I realised I wouldn't have enough time for Mn'ing and decided to stick at a diploma.

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Breech presentation in pregnancy and the demise of knowledgeable clinicians available to assist with vaginal birth.

who the bloody hell thought it would be a good idea to do this to myself? am sorely tempted to jack it in and go back to nursing.

not enough time / energy for primary research. Has to be literature review. Breech is tempting. Perhaps something about whether nurses make better midwives or not. spirituality ad birthing? but what focus?

Do women need spiritual care from midwives? Spirituality, midwifery and childbirth in the UK?

Spirituality of midwives and its impact on maternal care Does midwives' experience of water-assisted birth affect their attitudes towards it? (could you manage a questionnaire as well as a literature review?) Like the 'Does previous nursing training affect midwives' practice?' idea.

Im a mental health nurse (with interest in perinatal mental health). I did my dissertation on Post Traumatic Stress Disorder following childbirth. Quite a few 'recent' (from 1994) papers out there.

Or what about ante natal care in prisons?

Still haven't decded. I really don't want to do something tat will traumatise me for the next 10 months so things like PTSD, emergencies and cappitity while interesting are out. I'm wondering about language used by midwives / medical peeps, whether women mind us talking bollocks a different language? whether women have jargo or medical / professional terms explained? and if it makes a difference to their experience? what do you think?

how about hypnosis & birth? there's some research going on in Adelaide at the moment Think the language issue a good one... interesting how rhetoric is used to manipulate choices ie get women so afraid they will agree to whatever medics want.

EccentricaGallumbits I'm being a bit cheeky (hijack) but can I just ask you, your a nurse, yes? Did you train as a nurse with midwifery in mind to do after initial nurse training, and do you think that it has benefited you by doing the nurse training first? Sorry lots of questions it's just I have started an access course to do nursing/midwifery....slightly undecided which pathway and am applying now to uni's. Any advice would be amazing......

pnd incidence related to birth experience Or, is it helpful to tell women they are not in labour until 2cm dilated?

cultural issues, esp as affecting women who are displaced, like asylum seekers? tho' might be a bit traumatic. I'd like a quick hijack, too- having a midlife crisis and considering long term dream of mw training? good idea or not?

well can you knit your own stretchy cervix and birth canal?

Hokay. Hijackers! I did always have an incling to do midwifery. I did nursing first because a. there was a nursing campus near me and the DDs were littler so less travelling. b. direct entry midwifery is hellishly competetive to get into so thought nursing might give me a leg up on the way (it did) c. I wasn't completely sure about the midwifery so thought having nursing as a base would be a good start because you an do lots of stuff, specialisms, etc from it. I am very glad I did nursing first because I actually love nursing, just don't like the crappy beurocracy that goes with it. not that midwifery is any different in that way but there are other options and a different supervision system. The nursing bit does help hugely when actually working in maternity. You have a more rounded view of medicine, surgery, physiology, pain, communication, psychology, sociology etc etc. However that's not to say that all that stuff isn't covered in the 3 year course. I think it just helps being more practiced in it before you start. If you do consider the nursey bit first then it may be useful checking with local universities if they do the 18 month conversion because lots don't and you may have to commute miles. And finally perfect for a midlife crisis career change. I have to say that. Thanks for suggestions. keep them coming. Am liking the decision making angle to the language thingy.

and yes. i have been known to knit uteri

hellishly competitive have to say I made a rather fine placenta out of felt with dressing gown cord covered with tights as umbilical cord (when I was nct teacher) I had this idea that 'visual' aids should be homely, would be more empowering...so...if you have knitted a uterus, what about something on women's understanding of physiology, how that relates to their exp of labour? prob no primary research on this tho. love your name btw.

(yes, hijacking again) Just wondering how you managed studying nursing with little children. i am considering a nursing degree but don't know how on earth i would make time for my 4 kids!?

post-traumatic stress incidence following instrumental delivery and impact on postnatal depression and/or bonding with baby

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