The experiences of midwives involved with the development and implementation of CenteringPregnancy at two hospitals in Australia
- Publication Type:
- Thesis
- Issue Date:
- 2010
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Aims :
The aims of the study were to describe the experiences of the midwives who were part
of the first Australian CenteringPregnancy Pilot Study and to inform the future
development of CenteringPregnancy.
Background
CenteringPregnancy is a model of group antenatal care that has evolved over the past
two decades in North America. A pilot study that explored the feasibility of
implementing CenteringPregnancy in Australia was undertaken in 2006-2008. I was the
research midwife employed to coordinate this study and I explored the experiences of
the midwives who were participants as the focus of my Master of Midwifery (Honours)
research.
Method :
An Action Research approach was undertaken to study the implementation of
CenteringPregnancy in Australia. This included a qualitative descriptive study to
describe and explore the experiences of the midwives who were participants. The study
was set in two hospital antenatal clinics and two outreach community health-care
centres in southern Sydney. Eight midwives and three research team members formed
the Action Research group. Data collected were primarily from focus groups and
surveys and were analysed using simple descriptive statistics and thematic content
analysis.
Findings :
CenteringPregnancy enabled midwives to develop relationships with the women in their
groups and with their peers in the Action Research group. The group antenatal care
model enhanced the development of relationships between midwives and women that
were necessary for professional fulfilment and the appreciation of relationship-based
care. The use of supportive organisational change, enabled by Action Research
methods, facilitated midwives to develop new skills that were appropriate for the group
care setting and in line with a strengths-based approach. Issues of low staffing rates,
lack of available facilities for groups, time constraints, recruitment difficulties and
resistance to change impacted on widespread implementation of CenteringPregnancy.
Conclusions :
The experience of the midwives who provided CenteringPregnancy care suggests that it
is an appropriate model of care for the Australian midwifery context, particularly if
organisational support and recruitment strategies and access to appropriate facilities are
addressed. The midwives who undertook CenteringPregnancy engaged in a new way of
working that enhanced their appreciation of relationship-based care and was positive to
their job satisfaction.
Implications for practice
Effective ways to implement CenteringPregnancy models of care in Australia were
identified in this study. These included a system of support for the midwives engaging
in facilitating groups for the first time. It is important that organisations also develop
other supportive strategies, including the provision of adequate group spaces, effective
recruitment plans and positive support systems for change management. In the light of
current evidence the development of continuity of care models which enhance the
relationship between an individual women and her midwife, it is important to explore
the effects of group care on this unique relationship.
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