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Background developing a student׳s sense of capability, purpose, resourcefulness, identity and connectedness ( five-senses of success ) are key factors that may be important in predicting student satisfaction and progression within their university program. Aim the study aimed to examine the expectations and experiences of second and third year midwifery students enroled in a Bachelor of Midwifery program and identify barriers and enablers to success. Method a descriptive exploratory qualitative design was used. Fifty-six students enroled in either year 2 or 3 of the Bachelor of Midwifery program in SE Queensland participated in an anonymous survey using open-ended questions. In addition, 16 students participated in two year-level focus groups. Template analysis, using the Five Senses Framework, was used to analyse the data set. Findings early exposure to ‘hands on' clinical midwifery practice as well as continuity of care experiences provided students with an opportunity to link theory to practice and increased their perception of capability as they transitioned through the program. Student׳s sense of identity, purpose, resourcefulness, and capability was strongly influenced by the programs embedded meta-values, including a ‘woman centred' approach. In addition, a student׳s ability to form strong positive relationships with women, peers, lecturers and supportive clinicians was central to developing connections and ultimately a sense of success. A sense of connection not only fostered an ongoing belief that challenges could be overcome but that students׳ themselves could initiate or influence change. Conclusions the five senses framework provided a useful lens through which to analyse the student experience. Key factors to student satisfaction and retention within a Bachelor of Midwifery program include: a clearly articulated midwifery philosophy, strategies to promote student connectedness including the use of social media, and further development of clinician׳s skills in preceptorship, clinical teaching and facilitation. Program delivery methods and student support systems should be designed to enable maximum flexibility to promote capability and resourcefulness and embed sense of purpose and identity early in the program.

BACKGROUND: A shift has occurred in the last decade toward preregistration undergraduate Bachelor of Midwifery programs in Australia. This has led to an increase in the numbers of student midwives from diverse backgrounds with limited experience of university and socialization into hospital systems.AIM: This study aimed to explore commencing midwifery students’ beliefs about birth and expectations of the role of the midwife.METHOD: A qualitative descriptive approach was used. All 115 commencing first-year midwifery students enrolled in the first week of an undergraduate Bachelor of Midwifery program were invited and completed a self-administered survey. The survey used open-ended questions to elicit student beliefs about birth and the role of the midwife. Latent content analysis was used to analyze the data set.FINDINGS: Midwifery students’ beliefs were captured within the four themes: birth as “a miracle,” “a woman’s journey,” “a transformative event,” and “a natural process.” Students articulated the role of the midwife as one of support, education, advocacy, and partnership. Student beliefs and expectations were aligned with the emergent philosophy of the normality of birth and woman-centered care within the Australian maternity care context.CONCLUSION: Greater understanding is essential to designing quality midwifery education programs that are responsive to the needs of commencing student midwives. Supporting midwifery students’ successful transition into, and early engagement with the midwifery profession, may have long-term benefits in terms of retention and successful completion of their program. In addition, ensuring professional socialization occurs early is likely to develop graduates who are well prepared to work across their full scope and are willing to participate in the reform of maternity services in Australia.

Relatively little is known about the extent of trauma and birth-related fear in midwives and how this might affect practice.(1) Determine prevalence of birth related trauma and fear in midwives and associations with midwives' confidence to advise women during pregnancy of their birth options and to provide care in labour. (2) Describe midwives' experiences of birth related trauma and/or fear.A mixed methods design. A convenience sample of midwives (n=249) completed an anonymous online survey. Descriptive and inferential statistics were used to analyse the quantitative data. Latent content analysis was used to extrapolate meaning from the 170 midwives who wrote about their experiences of personal and/or professional trauma.The majority of midwives (93.6%) reported professional (n=199, 85.4%) and/or personal (n=97, 41.6%) traumatic birth experiences. Eight percent (n=20) reported being highly fearful of birth. Trauma was not associated with practice concerns but fear was. Midwives categorised as having 'high fear' reported more practice concerns (Med 23.5, n=20) than midwives with 'low fear' (Med 8, n=212) (U=1396, z=-3.79, p0.001, r=0.24). Reasons for personal trauma included experiencing assault, intervention and stillbirth. Professional trauma related to both witnessing and experiencing disrespectful care and subsequently feeling complicit in the provision of poor care. Feeling unsupported in the workplace and fearing litigation intensified trauma.High fear was associated with lower confidence to support childbearing women. Fear and trauma in midwives warrants further investigation to better understand the impact on professional practice.

develop and test a tool designed for use by academics to evaluate pre-registration midwifery students' critical thinking skills in reflective writing.a descriptive cohort design was used.a random sample (n = 100) of archived student reflective writings based on a clinical event or experience during 2014 and 2015.a staged model for tool development was used to develop a fifteen item scale involving item generation; mapping of draft items to critical thinking concepts and expert review to test content validity; inter-rater reliability testing; pilot testing of the tool on 100 reflective writings; and psychometric testing. Item scores were analysed for mean, range and standard deviation. Internal reliability, content and construct validity were assessed.expert review of the tool revealed a high content validity index score of 0.98. Using two independent raters to establish inter-rater reliability, good absolute agreement of 72% was achieved with a Kappa coefficient K = 0.43 (p0.0001). Construct validity via exploratory factor analysis revealed three factors: analyses context, reasoned inquiry, and self-evaluation. The mean total score for the tool was 50.48 (SD = 12.86). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of .93.this study establishedthe reliability and validity of the CACTiM (reflection) for use by academics to evaluate midwifery students' critical thinking in reflective writing. Validation with large diverse samples is warranted.reflective practice is a key learning and teaching strategy in undergraduate Bachelor of Midwifery programmes and essential for safe, competent practice. There is the potential to enhance critical thinking development by assessingreflective writing with the CACTiM (reflection) tool to provide formative and summative feedback to students and inform teaching strategies.

Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n=862) was divided into two groups; midwives working in continuity (n=214) and those not working in continuity (n=648). Mann Whitney U tests were used to compare the groups.The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p=.002; CBI Work p.001; CBI Client p.001) and Anxiety (p=.007) and Depression (p=.004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p.001) and the Skills and Resources subscale (p=.002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward.

Background The health and wellbeing of midwives are important considerations for workforce retention and quality care. The occurrence and relationships among mental health conditions such as burnout and depression have received little attention. We investigated the prevalence of burnout, depression, anxiety and stress in Australian midwives. Methods An online survey was conducted in September 2014. Participants were recruited through the Australian College of Midwives and professional networks. The survey sought personal and professional details. Standard measures included the Copenhagen Burnout Inventory (CBI) (Personal, Work and Client subscales), and Depression, Anxiety, and Stress Scale (DASS). The sample was collapsed into two groups according to DASS clinical cut-offs (normal/mild versus moderate/severe/extreme). Effect size statistics were calculated and judged according to Cohen’s guidelines. Results One thousand thirty-seven surveys were received. Respondents were predominantly female (98%), with an average age of 46.43 years, and 16.51 years of practice. Using a CBI subscale cut-off score of 50 and above (moderate and higher), 64.9% (n = 643) reported personal burnout; 43.8% (n = 428) reported work-related burnout; and 10.4% (n = 102) reported client-related burnout. All burnout subscales were significantly correlated with depression, anxiety and stress, particularly personal and work-related burnout with Spearman’s rho correlations ranging from .51 to .63 (p

Summary Background Midwives require well developed critical thinking to practice autonomously. However, multiple factors impinge on students' deep learning in the clinical context. Analysis of actual case scenarios using root cause analysis may foster students' critical thinking and application of ‘best practice' principles in complex clinical situations. Objective To examine the effectiveness of an innovative teaching strategy involving root cause analysis to develop students' perceptions of their critical thinking abilities. Methods A descriptive, mixed methods design was used. Final 3rd year undergraduate midwifery students ( n =22) worked in teams to complete and present an assessment item based on root cause analysis. The cases were adapted from coroners' reports. After graduation, 17 (77%) students evaluated the course using a standard university assessment tool. In addition 12 (54%) students provided specific feedback on the teaching strategy using a 16-item survey tool based on the domain concepts of Educational Acceptability, Educational Impact, and Preparation for Practice. Survey responses were on a 5-point Likert scale and analysed using descriptive statistics. Open-ended responses were analysed using content analysis. Results The majority of students perceived the course and this teaching strategy positively. The domain mean scores were high for Educational Acceptability (mean=4.3, SD=.49) and Educational Impact (mean=4.19, SD=.75) but slightly lower for Preparation for Practice (mean=3.7, SD=.77). Overall student responses to each item were positive with no item mean less than 3.42. Students found the root cause analysis challenging and time consuming but reported development of critical thinking skills about the complexity of practice, clinical governance and risk management principles. Conclusions Analysing complex real life clinical cases to determine a root cause enhanced midwifery students' perceptions of their critical thinking. Teaching and assessment strategies to promote critical thinking need to be made explicit to students in order to foster ongoing development.

Suitably qualified Australian midwives may prescribe drugs. By June 2016, 250 midwives were endorsed to prescribe. The range of drugs that midwives may prescribe is determined by state and territory legislation. There are therefore significant variations across the country in what can be prescribed. Midwives must undertake additional training to become competent to prescribe. Clear guidelines for consultation and referral also underpin safe prescribing.

Background: The Trans-Tasman Midwifery Education Consortium was established in 2017 to provide leadership and strategic direction to drive progressive, high quality, evidence-informed midwifery education. In 2018, the Consortium conducted a Delphi study to investigate the priorities facing midwifery education in Australia and New Zealand.

the predicted midwifery workforce shortages in several countries have serious implications for the care of women during pregnancy, birth and post partum. There are a number of factors known to contribute to midwifery shortages and work attrition. However, midwives assessment of their own professional identity and role (sense of empowerment) are perhaps among the most important. There are few international workforce comparisons.to compare midwives' sense of empowerment across Australia, New Zealand and Sweden using the Perceptions of Empowerment in Midwifery Scale-R (PEMS-Revised).a self-administered survey package was distributed to midwives through professional colleges and networks in each country. The surveys asked about personal, professional and employment details and included the Perceptions of Empowerment in Midwifery Scale-R (PEMS-Revised). Descriptive statistics for the sample and PEMS were generated separately for the three countries. A series of analysis of variance with posthoc tests (Tukey's HSD) were conducted to compare scale scores across countries. Effect size statistics (partial eta squared) were also calculated.completed surveys were received from 2585 midwives (Australia 1037; New Zealand 1073 and Sweden 475). Respondents were predominantly female (98%), aged 50-59 years and had significant work experience as a midwife (+20 years). Statistically significant differences were recorded comparing scores on all four PEMS subscales across countries. Moderate effects were found on Professional Recognition, Skills and Resources and Autonomy/Empowerment comparisons. All pairwise comparisons between countries reached statistical significance (p.001) except between Australia and New Zealand on the Manager Support subscale. Sweden recorded the highest score on three subscales except Skills and Resources which was the lowest score of the three countries. New Zealand midwives scored significantly better than both their Swedish and Australian counterparts in terms of these essential criteria.midwives in New Zealand and Sweden had a strong professional identity or sense of empowerment compared to their Australian counterparts. This is likely the result of working in more autonomous ways within a health system that is primary health care focused and a culture that constructs childbirth as a normal but significant life event. If midwifery is to reach its full potential globally then developing midwives sense of autonomy and subsequently their empowerment must be seen as a critical element to recruitment and retention that requires attention and strengthening.

STEWART S., SIDEBOTHAM M. & DAVIS D. (2012) International networking: connecting midwives through social media. International Nursing Review59, 431–434 Purpose: This article reports on the ‘Virtual International Day of the Midwife E-vent’, an innovative initiative that uses social media to provide opportunities for learning and networking internationally. Background: This e-vent was conceived of and initiated in 2009 by a small group of midwives with an interest in social media. The e-vent uses web conferencing software and schedules a presentation every hour for a 24-h period so as to reach midwives or other interested parties in all time zones of the globe. Methods: The authors draw on their experiences to describe the e-vent including the e-vent aims and organizing processes, and to report on participation trends over the 3-year period. Findings: The e-vent has seen significant growth over a 3-year period with participation increasing from an average of five participants per session to 50. The organizing committee has expanded to include an international team and they have extended the reach of the project by establishing a Facebook page. Conclusions: While the use of social media has its limitations, projects such as the International Day of the Midwife E-vent have real potential to increase access to educational materials and provide opportunities for international networking.

Retention of students is critical to education programs and future workforce. A mixed methods study evaluated student engagement within a Bachelor of Midwifery program and connection with career choice through participation in student support circles. Centred on the Five Senses of Success Framework (sense of capability, purpose, identity, resourcefulness and connectedness) and including four stages of engagement (creating space, preparing self, sharing stories, focused conversations), the circles support and develop student and professional identity. Of 80 students 43 (54%) provided responses to a two item survey assessed against a five point Likert scale to determine utility. Using a nominal group technique, student's voices gave rich insight into the personal and professional growth that participation in the student support circles provided. Evaluated as helpful to first year students in orientating to university study and early socialisation into the profession, the circles appear to influence the development of a strong sense of professional identity and personal midwifery philosophy based on the relational nature of the midwife being with woman rather than doing midwifery. This suggests that student support circles positively influence perceptions and expectations, contributing to a shared sense of purpose and discipline connection, for enhancing student retention and future workforce participation.

Background Midwifery prescribing was introduced in Australia in 2010 and is available to those notated as Medicare Eligible. Only 59% of Medicare Eligible midwives are endorsed prescribers. Aim To explore and describe Australian midwives views of prescribing including the barriers and enablers to prescribing. Methods Online survey. Eligible participants were Australian midwives who had completed an educational programme required for endorsement as a midwifery prescriber (n = 131). Descriptive statistics and content analysis were used to analyse the data set. Results Sixty-six midwives entered data (50% response rate). Twelve midwives (18%) had commenced prescribing. Prescribers agreed that being able to prescribe enhanced women's access to medicines and role satisfaction. The most common barriers to initiating prescribing were regulatory issues and processes, and no pathway to support midwifery prescribing in the public sector. The enabling factors most commonly reported were supportive relationships, education and personal factors such as motivation, knowledge and confidence. Conclusion Prescribing was viewed positively by midwives, but only a small proportion of suitably educated midwives were able to translate this into prescribing. Prolonged and complicated registration processes, restrictive drug formularies, and a lack of prescribing roles for public sector midwives were clear barriers. Supportive professional relationships, quality education and personal motivation and confidence assisted midwives in overcoming these barriers. Offering mentoring may help midwives to move into prescribing practice and use it in a manner that best meets the health needs of women and infants in midwifery care.

Education programs leading to professional licencing need to ensure assessments throughout the program are constructively aligned and mapped to the specific professional expectations. Within the final year of an undergraduate degree, a student is required to transform and prepare for professional practice. Establishing assessment items that are authentic and able to reflect this transformation is a challenge for universities. This paper both describes the considerations around the design of a capstone assessment and evaluates, from an academics perspective, the quality and applicability of an e-portfolio as a capstone assessment item for undergraduate courses leading to a professional qualification. The e-portfolio was seen to meet nine quality indicators for assessment. Academics evaluated the e-portfolio as an authentic assessment item that would engage the students and provide them with a platform for ongoing professional development and lifelong learning. The processes of reflection on strengths, weaknesses, opportunities and threats, comparison of clinical experiences with national statistics, preparation of professional philosophy and development of a curriculum vitae, whilst recognised as comprehensive and challenging were seen as highly valuable to the student transforming into the profession.

Background: Within the current literature on the globalization of the healthcare workforce, it is difficult to separate the migration experience of nurses from that of midwives. As more countries are moving to offer direct entry educational programmes and provide separate registration for midwives, information specific to that professional group will be required to guide workforce planners and inform employment practice. This qualitative study tracks the migration experience of midwives moving between the UK and Australia. Methods: A purposeful sample of 18 midwives who had migrated from the UK to one state in Australia was interviewed within a descriptive phenomenological framework. Data were analysed using thematic coding within Nvivo (QSR International, Melbourne, Australia). Results: The strongest motivator for migration was to improve the family's lifestyle. Push factors included disillusionment with working conditions, standard of living in the UK and national politics. The majority of midwives had organized their own entry visa and employment. Most midwives had occupied senior positions in the UK but accepted employment initially within entry-level positions in Australia. Discussion: Despite both countries offering similar standards of living, the majority of midwives expected to achieve an improvement in family lifestyle in Australia. Midwives indicated they were prepared to lose professional status and seniority of position to gain a better overall lifestyle for their family. To examine the long-term sustainability of international recruitment processes, further research is indicated to examine the ongoing experience and integration of migrant midwives into the workforce in Australia. © 2011 The Authors. International Nursing Review

Background the number of midwives and nurses migrating from the United Kingdom (UK) and seeking registration in Australia is growing annually. Studies examining nurse migration have yet to identify features of the experience that apply specifically to the midwifery workforce. This information is vital to inform future international recruitment practice and to promote midwifery retention. This paper reports on a study examining the experiences of a group of midwives from the United Kingdom settling into the workforce within one state in Australia. Design this descriptive phenomenological study examined the lived experience of UK migrant midwives practising in Queensland using open ended interviews and reflective journaling. Data analysis was conducted following the guidance of Moustakas, adapted from the van Kaam method of analysis of phenomenological data. Setting all data gathered from midwives living and working in Queensland. Participants midwives ( n =18) working in Queensland who had left the UK after 1 January 2000. Findings a central theme emerging from participants' experiences is described as ‘finding a way'. Their experience was encompassed in a model of acculturation used by the midwives to find their way through the health-care systems in Queensland to be the kind of midwife that suited them and their life style. The three ways of being were influential association, capitulation and detachment. The most common feature of the experience was that of influential association. Key conclusions midwives need to be well informed to provide realistic expectations prior to migration. Recruitment and management personnel should seek to match midwifery capacity with roles where their skills will be maximised.

Background undergraduate midwifery programmes offer opportunities for school leavers and young people (aged less than 21 years) to enter the profession. There is limited research exploring this age groups experience of their Bachelor of Midwifery programme. In order to retain these students we need to ensure that their experiences of undertaking a Bachelor of Midwifery program are positive and barriers and challenges are minimised. Aim this study explored young midwifery students' experience of their Bachelor of Midwifery program. Method a descriptive exploratory qualitative approach was used to explore the experiences of eleven students aged 20 years or less on enrolment. Data was collected using face-to-face or telephone-recorded interviews. Thematic analysis was used to analysis the data set. Findings three major themes described the young students' experiences. The first labelled ‘The challenges of being young' presented a number of age related challenges including transport issues with on-call commitments as some students had not gained a driver's license. Students experienced some degree of prejudice relating to their age from their older student peers and some clinical staff during placements. ‘Finding your way' was the second theme and described the strategies students used to build confidence and competence both in the university and clinical environment. The young students reported a strong commitment to the profession. They demonstrated high levels of connection with women and found the continuity of care experiences invaluable to their learning. The final theme ‘Making the transition from teenager to midwife' demonstrated some unique insights into how studying to become a midwife impacted upon their personal and professional growth. Conclusion the young students in this study encountered some unique issues related to their age. However as they progressed through the program they developed confidence in themselves and visualised themselves as having a long midwifery career. They were strongly motivated towards providing woman-centred maternity care and considered their continuity of care experiences fundamental to them developing a strong sense of themselves as midwives. Attracting and retaining young students is essential if the profession is to realise its goal of ensuring all women have access to a known midwife.

The Australian national midwifery education standards require students to complete a number of continuity of care (COC) experiences. There is increasing evidence outlining the value of this experience to the student, but there is limited research examining women's experiences of having a COC midwifery student. This study aimed to investigates the woman's experiences.A retrospective descriptive cohort design was used. A paper-based survey was posted to all women cared for by a midwifery student in 2013 (n=698). Descriptive statistics were used to explore the proportion, mean score, standard deviation and range of the variables. Construct validity of the Satisfaction and Respect Scales was tested using exploratory factor analysis. Free text responses were analysed using latent content analysis.One-third of women returned a completed survey (n=237/698, 34%). There was a significant positive correlation (p0.05) between the number of AN/PN visits a midwifery student attended and women's levels of satisfaction. Women were very satisfied with having a student midwife provide continuity. The qualitative data provided additional insight demonstrating that most women had a positive relationship with the midwifery student that enhanced their childbearing experience.The women in this study valued continuity of midwifery care and were able to form meaningful relationships with their midwifery student. Programs leading to registration as a midwife should privilege continuity of care experiences. Not only does this benefit women but provides the future midwifery workforce with a clear understanding of models that best meet women's individual and the benefits of working in these models.

The aim of this study was to look at neonatal death following termination of pregnancy in 31 cases over a six-year period in our region and to determine why this was occurring. We have highlighted two main areas of concern: failure to perform feticide in keeping with RCOG advice, and classification and registration below the clinical limit of viability. In these circumstances, appropriate counselling of the family and an antenatal plan for the postnatal care of the dying infant made prior to delivery are essential. We question the rationale of the existing classification and registration requirements below the clinical limit of viability.

In this article the author looks at how midwives can plan the care they give women in the antenatal period to be consistent with the principles outlined within the recently published NICE antenatal care guideline. Midwives are encouraged to think about services with vision and focus on the enabling aspects of the guidance in their interpretation and approach to implementation.

The major stumbling block for egg donation lies in the recruitment of sufficient suitable donors. This study ascertained the views of egg donors in the UK by analysing 113 completed questionnaires that asked questions about demographics, stimulus to donate, support network available, ethics, the 'process' of donation and payment. Ideas for future recruitment were also sought. The mean age of donors was 31.7 years, and most donors were donating for the first time. Ninety-one per cent of donors were Caucasian and 93% had children of their own. Ninety-six (85%) donors felt fully supported in their decision to become an egg donor and 60 (53%) discussed their donation with their GP. Information regarding egg donation came from many sources. The main motivation to donate was a desire to help childless couples. Many respondents had themselves suffered, or knew of couples with, infertility. Eighty-three (73.5%) respondents felt that expenses alone should be paid to egg donors, and many expressed concerns that large financial incentives may attract the 'wrong women' to donate. Forty-nine (43%) respondents found the procedure painful or stressful in some way, although 95% had no regrets concerning their donation, and 72% would donate again. A common reason for donors not wishing to donate again was age restriction. Respondents were asked their opinion with regard to recruitment and the enthusiasm they expressed needs to be harnessed if the current shortcomings in available donors are to be overcome. Specific recommendations to achieve this are made.

midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models.this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices.a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha.sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 p.001) and assessment (r=.87 p.001). Scores on the clinical learning environment scale were significantly correlated with perceptions of the caseload model (rho=.86 p.001), learning culture (rho=.94 p.001) and assessment (rho=.65 p.01) scales.embedding students within midwifery continuity of care models was perceived to be highly beneficial to learning, developed partnerships with women, and provided appropriate clinical skills development required for registration, while promoting students׳ confidence and competence. The flexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance.

Collaborative partnerships between health care providers and academics are essential in the provision of quality undergraduate midwifery programs. While health care providers often contribute to clinical assessment and teaching in midwifery programs, they are rarely involved in assessment design and evaluation. This paper describes the evaluation of an assessment task designed to develop critical thinking skills in final year undergraduate midwifery students. Health care providers' involvement sought to confirm the authenticity and validity of the assessment task and facilitate further engagement. A mixed method descriptive study design was used. After reviewing a sample of student work, health care providers completed a 20 item survey and participated in a focus group. Survey items were based on the domains of Educational Acceptability, Educational Impact and Preparation for Practice. Participants gave high scores for each domain and commented positively on the innovative nature of the assessment, students' ability to undertake in-depth analysis of complex cases, and development of student's critical thinking skills. Participants also reported greater confidence in students' competence and the program. Involving health care providers in evaluation of an assessment task validated the assessment, contributed to clinicians' perceptions of student credibility, and fostered strong links between the program and industry.

Background Marked differences exist between the maternal and neonatal outcomes of Australian Aboriginal and Torres Strait Islander women and their babies compared with the outcomes for other Australian women and their babies. Australian government policies underline the need to increase the number of practising Aboriginal and Torres Strait Islander midwives and nurses as a strategy for delivering culturally appropriate healthcare to improve health outcomes for Aboriginal and Torres Strait Islander families. Additional challenges are experienced by Aboriginal and/or Torres Strait Islander midwifery students providing Continuity of Care (COC) to Australian Aboriginal and/or Torres Strait Islander childbearing women. One such example is the challenge presented due to the close connections and relationships that exist within some Aboriginal and/or Torres Strait Islander cultures in terms of the maintenance of a professional relationship, in particular, the maintenance of professional boundaries. Whilst there is a growing body of evidence on the benefits to women of continuity of midwifery care models, little is known about the experiences of Aboriginal and Torres Strait Islander women who receive COC from Aboriginal and Torres Strait Islander midwifery students. Aim To explore the experiences of Australian Aboriginal and Torres Strait Islander childbearing women who participated in a Continuity of Care journey with an Aboriginal and/or Torres Strait Islander Bachelor of Midwifery student. Methods Exploratory, descriptive study using semi-structured interviews informed by an Indigenous Research Methodology. Findings Thematic analysis identified four major themes: (i) communicating our way, (ii) the role of relationships, (iii) support and assistance and (iv) challenges of the system. The findings illustrated the benefits Aboriginal women experience as a result of having Aboriginal and/or Torres Strait Islander midwifery students provide Continuity of Care. Conclusion Increasing the number of Australian Aboriginal and/or Torres Strait Islander midwives is essential to improving health outcomes for Australian Aboriginal and Torres Strait Islander childbearing women and their families. Caseload midwifery models with Aboriginal and Torres Strait Islander midwives across Australia are needed. Health services, in partnership with Universities and Aboriginal and Torres Strait Islander communities, have a vital role to play in the development and expansion of these models.

The obstetric emergency shoulder dystocia is a relatively rare event which is generally unpredictable but is associated with a high level of fetal mortality and morbidity and has the potential to lead to litigation. To minimize these problems, it is essential that health professionals are adequately trained in the management of shoulder dystocia. This article presents the results of a survey of training activities and an analysis of practice guidelines in relation to shoulder dystocia. The findings suggest a need for a more formalized, structured and monitored approach to training.

The maternity reform agenda within Australia has seen a considerable shift in the last decade towards recognition of the role of the midwife and promotion of midwifery care. The current legislative changes and focus on providing woman centred models of care have created unprecedented opportunities for midwives to rise to the challenge and work to the full scope of practice of a midwife. Changes to maternity service delivery and the educational preparation of midwives have been accompanied by growing recognition of the distinction between nursing and midwifery. As a result midwifery in Australia is in transition, moving from a position of submersion within nursing to one of a strong well educated autonomous profession with a defined scope of practice. This paper examines the changing landscape of midwifery in Australia within three areas: regulation, education and practice.

There has been much professional and media interest in the subject of infertility treatment within the last 12 months with the introduction of the recent NICE guidelines, and a promise of a Government review of the Human Fertilization and Embryology Act.

There is a growing concern internationally about the continued rise in birth intervention. Caesarean section rates continue to rise within the international arena. Women are losing confidence in the birth process being natural and safe and often exhibit moderate to high levels of fear during pregnancy. Simultaneously midwives are in danger of losing their role as the guardians of normal birth. This paper presents an easy to follow, evidence based framework that midwives can use at a personal or organisational level to promote normal birth and support women to move back to feeling excited anticipation about birth.

It has been a very long and difficult pregnancy but finally after 3 years of doubt, mistrust, apprehension and angst we can welcome the birth of the newly created Confidential Enquiry Into Maternal And Child Health (CEMACH). CEMACH was officially launched under the parentage of NICE on 1 April 2003, and after the years of consultation and waiting, we will now be watching carefully as expectations of this new organization are high.

The aim of the study was to describe the level of burnout in midwives working at a maternity unit in South East Queensland, Australia. Method A self-administered questionnaire was distributed to all registered midwives ( N = 110) working at the study site during November 2011. The questionnaire included a demographic survey and the Copenhagen Burnout Inventory. Fifty-eight (52.7%) staff completed the package. Data was entered into SPSS database version 19 and descriptive statistics were used to determine means, ranges and frequencies. Results Almost 30% of the sample experienced moderate to high levels of burnout some 50% of participants scored moderate to high for personal burnout with a similar number scoring high for work-related burnout. In comparison, burnout related to working with clients was very low. Differences between participants were associated with years of experience, area of work and employment position (FT/PT, level of position and work area). Participants aged 35 years or younger and with less than 10 years midwifery experience scored highest on the personal and work-related domains whereas participants over 35 years scored highest within the client-related domain. Midwives at level 1 (lowest pay group) scored highest for work-related burnout and client-related burnout. Midwives in more senior positions (level 2 and above) scored highest for personal burnout. Conclusion Personal and work-related burnout was high in this group of midwives while burnout related to caring for women was low. These results provide insight into the emotional health of midwives in one maternity unit. While more work is needed, strategies to decrease and/or prevent burnout may include clinical mentorship and reorganising models of maternity care to increase work satisfaction and autonomy and strengthen relationships between midwives and women.

In order to maintain competence to practice, midwives must become lifelong learners and engage in education and CPD activities. The Virtual International Day of the Midwife event (VIDM) is a free online annual synchronous conference that uses social networking tools to bring midwives together to network, share research and practice information. This paper presents the evaluation based on the 2010 and 2011 events. Participants appreciated the opportunity to be able to network with colleagues in an international context, believed the event provided access to quality material and presenters, and valued the accessibility and availability of the event and resources. Participants suggested that the event could be improved by making the program more accessible, with sessions spread over several days, as opposed to 24 hours; providing information about appropriate netiquette and extensive advertising. Further research is required to investigate how social networking and initiatives such as the VIDM impact on practice in the long term. © 2012 Elsevier Ltd.

The eighth annual Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) report should be compulsory reading for all midwives because there within the tables, the facts and figures and the analysis and commentary is a clear message. Midwives can make a difference. CESDI was established to reduce the numbers of fetal and infant losses. Within this report there is clear evidence that improvements have been made in intrapartum related deaths which account for 0.62 deaths per 1000 lives births compared to 0.95 in 1994.

The Seventh Annual CESDI Report (2000), should be essential reading for all those professionals directly and indirectly involved in the care of pregnant women and babies. While there is encouraging evidence within the changing local practice chapter that recommendations are being put firmly into practice in some regions, there are still areas of concern highlighted in this report where major improvements could be made.

The Sixth Annual CESDI Report published in June contains important messages for all of those professionals concerned with the care of mothers and babies. The findings represent the work of a large number of individuals from different professional groups who have contributed to data collection, or confidential enquiry panels. For this report to remain on the shelf unread devalues the basic principle of the work of CESDI as an organization ‘to improve the understanding of how the risks of death in late fetal life and infancy fom 20 weeks of pregnancy to one year’. This report, therefore, should bre essential reading and should form the basis of discussion within a multidisciplinary forum to look at ways of disseminating the findings and moving practice forward in ways to improve care.

When a previously infertile couple realise their dream and a pregnancy is achieved, there is very little information available to them, or to the professionals caring for them, on how to cope with the mixed and varying emotions they may experience during the pregnancy. How will they adapt to parenthood? Will the transition from being infertile individuals to parents be difficult or smooth? How may they shed the identity of failure and learn to live with success?

International reports highlight that improvements to health outcomes for Indigenous populations is linked to greater participation by Indigenous people in the provision of health service delivery. Australian government policies underline the need to increase the number of practising Indigenous midwives as a strategy for delivering culturally appropriate healthcare that will help improve health outcomes for Aboriginal and Torres Strait Islander families. One of the key components of the 'Close the Gap' initiative includes enabling Aboriginal and Torres Strait Islander people to enter the healthcare workforce. Indigenous midwives and nurses' lived experiences, along with their knowledge of health service delivery, provides them with unique insight of the health system. It is recognised that it is essential to increase the numbers of Aboriginal and Torres Strait Islander people with tertiary level qualifications in order to provide culturally appropriate healthcare that will ultimately lead to increased uptake and subsequent health improvements. In this presentation, we share the stories told to us as part of a small, qualitative study that explored the experiences of a sample of Indigenous Australian women and Indigenous student midwives who participated in a 'follow through' journey as part of a Bachelor of Midwifery program in northern Australia. The findings of our study highlight the urgent need for improved strategies and policies that recruit and retain Indigenous midwifery students as their contribution is key to improving health outcomes for Indigenous childbearing women and their families.

Midwives should all know what CESDI is, and what it sets out to achieve. The overall aim to ‘To improve understanding of how the risks of death in late fetal life and infancy from 20 weeks of pregnancy to 1 year might be reduced’ remains as valid today as when it was first stated in 1992. There should be systems in place to ensure that the recommendations made, are taken up nationwide to fulfil that aim.