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Professor Patricia Brodie

Biography

Pat is Adjunct Professor of Midwifery at UTS having been involved in a wide range of midwifery practice, teaching, research and management roles that span almost 30 years in Australia. She has a strong track record in leading and evaluating midwifery continuity of care and practice development. Until recently, Pat was Professor of Midwifery Practice Development and Research in Sydney South West Area Health Service where she was influential in leading the strategic reform of maternity service policy and practice to increase focus on woman centred care and greater utilization of midwives’ skills. This included the successful development, implementation and evaluation of two midwifery group practices, at Camden and Campbelltown, and the early development of similar models at Fairfield, Royal Prince Alfred and Canterbury Hospitals. This work built on her pioneering achievements in the 1990s to reform models of maternity care at Westmead and St George Hospitals in Sydney.

From 1999– 2002 Pat was employed as one of two full time research midwives for the national Australian Research Council funded 'Australian Midwifery Action Project'. Pats particular area of inquiry was a review of contemporary Australian midwifery regulation and practice issues. Her professional doctorate work at this time examined the effect of interprofessional collaboration in midwifery and maternity care and the rationale for making midwifery visible and increasing the recognition and contribution of midwives within mainstream maternity service provision in Australia.

For more than a decade Pat has been influential in providing high-level strategic advice and policy direction for the organisation and development of public hospital maternity services and models of care across New South Wales in a variety of roles. This has included her appointment as Senior Clinical Adviser - Maternity Services in the NSW Department of Health as well as a number of advisory roles including as a member of the NSW Health, Maternal & Perinatal Ministerial Advisory Committee and the NSW Health's Maternal & Perinatal Health Priority Taskforce. In 2007, Pat joined the Perinatal and Infant Sub Committee of the NSW Mental Health Program Council as an invited midwifery leader, to progress the SAFE START initiative and related perinatal and infant mental health initiatives throughout NSW. ??

As a researcher and policy adviser Pat has been involved in identifying and challenging the national and state based 'systems' of maternity care, and identifying the professional and practice issues affecting midwifery including standards of midwifery education, workforce, regulation and interprofessional practice. In 2007, Pat was an invited member of the Reference Group for the project: 'Developing interprofessional learning and practice capabilities within the Australian health workforce - building capacity within the higher education sector'; co-managed by the University of Sydney and UTS. Her recent research activities include as co-investigator on the National Health Workforce Taskforce funded project to develop National Core Competencies and Educational Framework for Maternity Services 2008-2009 and collaborative research with colleagues from University of Western Sydney and Sydney South West Area Health Services: Exploring professional collaborations: A key to sustainable universal health services for vulnerable families.

In May 2009, she was invited by the NSW Minister for Health to be one of five members of the Independent Panel to monitor the implementation of The Garling Report – reforming health care and systems across NSW.

Pat is the immediate past president of the Australian College of Midwives (ACM) and in 2007 was awarded life membership of the College for her sustained service and contributions to the midwifery profession and maternity services locally and nationally over three decades.

Pat’s current role is as a Midwifery Advisor with the World Health Organization in Papua New Guinea where she is working with the National Department of Health to provide leadership and support to midwives involved in strengthening standards of midwifery education, practice and regulation.

In October 2010 Pat received the UTS Social Inclusion Award for her work to improve midwifery education and outcomes for women in Papua New Guinea through her work as a Midwifery Advisor there.

In 2012, Pat was appointed a Member of the Order of Australia for her services to midwifery. The honour recognised her pioneering efforts in developing midwifery policy and models of care in NSW and her ongoing work in education and research.

Professional

National President of the Australian College of Midwives and also the previous past President of the NSW Midwives Association

Image of Patricia Brodie
WHO CC Midwifery Coordinator/Advisor, Faculty of Health
Member, WHO Collaborating Centre for Nursing, Midwifery and Health Development (WHO or WHOCC)
Bachelor of Health Sciences, Masters of Nursing, Doctorate in Midwifery
 

Research Interests

continuity of midwifery care
midwifery workforce
midwifery regulation
health services leadership
The capacity for increasing professional capital in midwifery and the linkages to improving women's outocmes and experiences of maternity care

Midwifery - undergraduate and postgraduate
Primary Health Care - postgraduate
Health Services Management - postgraduate

Book Chapters

Leap, N., Dahlen, H.G., Brodie, P.M., Tracy, S.K. & Thorpe, J. 2011, 'Relationships - the glue that holds it all together' Midwifery continuity of care and sustainability' in Davies, L., Dallenbach, R. and Kensington, M. (eds), Sustainability, Midwifery and Birth, Routledge, London, UK, pp. 61-74.
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In late December 2009, four midwifery leaders sat around a kitchen table in Sydney and audio-recorded a conversation about experiences of developing midwifery models of care. With this chapter in mind, we focussed on what we saw as features of sustainable models that enable women to develop a trusting relationship with their midwives through pregnancy, labour and the early weeks of new motherhood. Mostly we reflected on our experiences of setting up midwifery group practices in the Australian public health system where midwives are employed, but some of us also drew on our experiences in the United Kingdom (UK) and New Zealand (NZ); this included our involvement in models where midwives are self-employed and working either privately or as part of the public health system.
Brodie, P.M., Homer, C.S. 2009, 'Transforming the Culture of a Maternity Service: St George Hospital, Sydney, Australia' in Robbie Davis-FLoyd, Lesley Barclay, Betty-Anne Daviss, Jan Tritten (eds), Birth Models That Work, University of California Press, London, UK, pp. 187-212.
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Homer, C.S., Brodie, P.M. & Leap, N. 2008, 'Getting started: What is midwifery continuity of care? (Chapter 1)' in Homer, C; Brodie, P; Leap, N (eds), Midwifery continuity of care: A practical guide, Churchill Livingstone Elsevier, Sydney, Australia, pp. 1-24.
Leap, N., Homer, C.S. & Brodie, P.M. 2008, 'Introducing continuity of care in mainstream maternity services: Building blocks for success (Chapter 4)' in Homer, C; Brodie, P; Leap, N (eds), Midwifery continuity of care: A practical guide, Churchill Livingstone Elsevier, Sydney, pp. 67-88.
Homer, C.S., Brodie, P.M. & Leap, N. 2008, 'Midwifery continuity of care for specific communities (Chapter 10)' in Homer, C; Brodie, P; Leap, N (eds), Midwifery continuity of care: A practical guide, Churchill Livingstone Elsevier, Sydney, Australia, pp. 181-194.
Homer, C.S., Brodie, P.M. & Leap, N. 2008, 'Midwifery continuity of care: The future (Chapter 12)' in Homer, C; Brodie, P; Leap, N (eds), Midwifery continuity of care: A practical guide, Churchill Livingstone Elsevier, Sydney, Australia, pp. 215-219.
Brodie, P.M. & Leap, N. 2008, 'From ideal to real: the interface between birth territory and the maternity service organization' in Fahy, K., Foureur, M., Hastie, C (eds), Birth Territory and Midwifery Guardianship, Elsevier, Oxford, UK, pp. 149-167.
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Books

Homer, C.S., Brodie, P.M. & Leap, N. 2008, Midwifery continuity of care, Churchill Livingstone Elsevier, Sydney.
The many pressures on maternity services such as escalating intervention rates, rising costs, and midwife and doctor shortages has resulted in a growing interest in how midwifery continuity of care can be provided. Midwifery Continuity of Care provides a robust and well structured 'how to' guide to this topic by discussing the development, implementation and evaluation of differing ways of providing continuity. This new book includes practical advice on engagement with stakeholder as well as outlining ways of receiving and acting on feedback in relation to development, implementation and ongoing evaluation. Midwifery Continuity of Care includes summaries and vignettes which bring midwifery continuity of care to life and make them relevant to practising midwives, managers and others working within maternity services. Written by an international team of contributors, this book highlights the lessons learned by others to help develop new ways of thinking and practising. It will be an invaluable practical guide to all midwives, midwifery managers, student midwives and educators, and will also be of interest to policy makers and health service executives.

Conference Papers

Homer, C.S., Rumsey, M., Brodie, P.M., Dawson, A., Copeland, F.H. & Daly, J. 2013, 'Helping build foundations for improved maternal health in PNG', Melbourne, May 2013 in International Council of Nurses 25th Quadrennial Congress.
Brodie, P.M. 2013, 'Midwives: Empowerment, Respect, and Quality', May 2013 in Women Deliver - The 3rd Global Conference, Kuala Lumpur.

Journal Articles

Dawson, A., Brodie, P.M., Copeland, F.H., Rumsey, M., Homer, C.S. 2014, 'Collaborative approaches towards building midwifery capacity in low income countries: A reviewof experiences', Midwifery, vol. 30, pp. 391-402.
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Research paper
Brodie, P.M. 2013, ''Midwifing the midwives': Addressing the empowerment, safety of, and respect for, the world's midwives', Midwifery, vol. 29, no. 10, pp. 1075-1076.
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Globally, the impact that regulated, competent midwives make to positive maternal and infant health outcomes is seen as central in efforts to accelerate progress towards the achievement of Millennium Development Goals 4 and 5. Skilled, empowered midwives earn respect from women and communities by providing competent, culturally sensitive care, but they do more than just contribute to safer childbirth. Midwives, especially those working in developing countries, are essential to ensuring access to contraception, reducing malaria and mother-to-child transmission of HIV, eradicating obstetric fistula and preventing deaths from unsafe abortions. In addition, midwives are central to addressing gender-based violence and the upholding of human rights in their communities. It is clear that `the world needs midwives, now more than ever+ (ICM, 2013) and yet in most countries around the world, the recruitment of sufficient number of midwives remains grossly short of identified need. Increasing the number of midwifery student places, midwifery tutors and well-equipped classrooms alone will not, however, be enough to address current critical shortages. Significantly, retention and motivational strategies also have to be high on the list of strategies within global midwifery workforce priorities.
Wheeler, J., Davis, D.L., Fry, M., Brodie, P.M., Homer, C.S. 2012, 'Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature', Women and Birth, vol. 25, no. 3, pp. 107-113.
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Objective: To undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth. Method: Ovid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) making sense of evidence tools. Findings: Asian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries. Conclusion: Current research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.
Davis, D.L., Foureur, M., Clements, V.J., Brodie, P.M. & Herbison, P. 2012, 'The self reported confidence of newly graduated midwives before and after their first year of practice in Sydney, Australia', Women and Birth, vol. 25, pp. e1-e10.
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Graduates from a new, 3-year Bachelor of Midwifery program joined those educated through the 1 year, postgraduate route (for those already qualified as nurses) for the first time in New South Wales (NSW) Australia in 2007. Many hospitals offer transition support programs for new graduates during their first year of practice though there is little evidence available to inform these programs. To establish the new midwife's confidence in working to the 14 National Competency Standards for the Midwife 1 and the International Confederation of Midwives (ICM) Definition of a Midwife and to explore whether the new midwife's confidence changed over the new graduate year. In particular the study set out to determine whether there were any differences in the confidence of new graduates from undergraduate or postgraduate programs. Pre and post survey with comparisons longitudinally and within undergraduate and postgraduate cohorts. Three Area Health Services in Sydney and surrounding areas, Australia. A convenience sample of all new graduate midwives employed in the three Area Health Services in the early months of 2008. New graduate midwives rated their level of confidence (1-10) in working to the 14 National Competency Standards for the Midwife and the ICM Definition of a Midwife during their first weeks of employment and after the completion of their first year of practice. Midwives prepared through the undergraduate and postgraduate routes commenced their first year of practice with similar levels of confidence. The confidence of these midwives increased modestly over the first year of practice. Those from postgraduate programs were significantly more confident than those from undergraduate programs on four competencies after the first year of practice. Participant's self reported confidence in working to the ICM Definition of a Midwife was low.
Homer, C.S., Griffiths, M., Brodie, P.M., Kildea, S., Curtin, A.M. & Ellwood, D. 2012, 'Developing a Core Competency Model and Educational Framework for Primary Maternity Services: A national consensus approach', Women and Birth, vol. 25, no. 3, pp. 122-127.
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An appropriately educated and competent workforce is crucial to an effective health care system. The National Health Workforce Taskforce (now Health Workforce Australia) and the Maternity Services Inter-Jurisdictional Committee funded a project to develop Core Competencies and Educational Framework for Primary Maternity Services in Australia. These competencies recognise the interdisciplinary nature of maternity care in Australia where care is provided by general practitioners, obstetricians and midwives as well as other professionals. Participants: Key stakeholders from professional organisations and providers of services related to maternity care and consumers of services.
Smith, R.M., Brodie, P.M., Homer, C.S. 2012, 'Reviewing and reflecting on practice: The midwives experiences of credentialling', Women and Birth, vol. 25, no. 4, pp. 159-165.
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Background: In 2005, the NSW Health Department issued a directive requiring midwives who worked in midwifery-led models of care to undergo a process known as credentialling. Credentialling involved a four-step process: self-assessment, face-to-face panel review of midwifery practice, assessment of emergency management skills and discussion of a case study from practice.
Homer, C.S., Passant, L., Brodie, P.M., Kildea, S.V., Leap, N., Pincombe, J. & Thorogood, C. 2009, 'The role of the midwife in Australia: Views of women and midwives', Midwifery, vol. 25, no. 6, pp. 673-681.
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Objective to research the role of midwives in Australia from the perspectives of women and midwives. This study was part of a commissioned national research project to articulate the scope of practice of Australian midwives and to develop national competency standards to assist midwives to deliver safe and competent midwifery care. Design a multi-method approach with qualitative data collected from surveys with women and interviews with midwives. Setting participants represented each state and territory in Australia. Participants midwives who were randomly selected by the regulatory authorities across the country and women who were consumers of midwifery care and involved in maternity activism. Key conclusions midwives and women identified a series of key elements that were required of a midwife. These included: being woman centred; providing safe and supportive care; and working in collaboration with others when necessary. These findings were consistent with much of the international literature. Implications for practice a number of barriers to achieving the full role of the midwife were identified. These included a lack of opportunity to practice across the full spectrum of maternity care, the invisibility of midwifery in regulation and practice, the domination of medicine, workforce shortages, the institutional system of maternity care, and the lack of a clear image of what midwifery is within the wider community. These barriers must be addressed if midwives in Australia are to be able to function according to the full potential of their role.
Foureur, M., Brodie, P.M., Homer, C.S. 2009, 'Midwife-centred versus Woman-centered Care: A developmental phase?', Women and Birth, vol. 22, no. 2, pp. 47-49.
As three of the early leaders and researchers in the field of midwifery continuity of care in Australia, we have been instrumental in addressing reforms to the fragmented model of maternity service delivery. These services have seen each childbearing woman in our public health system enduring up to 20 different care providers in one pregnancy experience.1 The last 20 years of research has included randomised controlled trials, case control studies and large population based epidemiological investigations. These studies have convincingly shown that midwifery continuity of care, provided in any location, is highly satisfying for women, leads to reduced interventions and is no less safe in terms of maternal and perinatal mortality when compared to the fragmented models that emerged last century.2 Many health services have now changed their models of care-delivery to incorporate new systems that are focused on improving the experience for each woman by enabling continuity of care from a known midwife. The key characteristic of these new models is that they have a specific focus on woman-centered or relationship-based care.
Dunston, R., Lee, A., Boud, D.J., Brodie, P.M. & Chiarella, E.M. 2009, 'Co-Production and Health System Reform - From Re-Imagining To Re-Making', Australian Journal of Public Administration, vol. 68, no. 1, pp. 39-52.
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There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.
Homer, C.S., Passant, L., Kildea, S.V., Pincombe, J., Thorogood, C., Leap, N. & Brodie, P.M. 2007, 'The development of national competency standards for the midwife in Australia', Midwifery, vol. 23, no. 4, pp. 350-360.
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OBJECTIVE: to develop and validate national competency standards for midwives in Australia. This study was part of a commissioned national research project to articulate the scope of practice of Australian midwives and to develop national competency standards to assist midwives to deliver safe and competent midwifery care. DESIGN: a multi-method, staged approach was used to collect data through a literature review, workshop consultations, interviews, surveys and written submissions in order to develop national competency standards for Australian midwives. Subsequently, direct observation of practice in a range of settings ensured validation of the competencies. SETTING: maternity-care settings in each state and territory in Australia. PARTICIPANTS: midwives, other health professionals and consumers of midwifery care. FINDINGS: The national competency standards for the midwife were developed through research and consultation before being validated in practice. KEY CONCLUSIONS: the national competency standards are currently being implemented into education, regulation and practice in Australia. These will be minimum competency standards required of all midwives who seek authority to practise as a midwife in Australia. It is expected that all midwives will demonstrate that they are able to meet the competency standards relevant to the position they hold. IMPLICATIONS FOR PRACTICE: the competency standards establish a national standard for midwives and reinforce responsibility and accountability in the provision of quality midwifery care through safe and effective practice. In addition, individual midwives may use the competency standards as the basis of their ongoing professional development plans.
Kildea, S.V., Barclay, L. & Brodie, P.M. 2006, 'Maternity care in the bush: Using the internet to provide educational resources to isolated practitioners', Rural and Remote Health, vol. 6, no. 3, pp. 1-12.
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Telecommunication infrastructure is being rolled out across Australia with little knowledge about the uptake by health professionals in remote areas. Computer mediated communication has the potential to offer educational support to remote practitioners; however, the viability of this is uncertain. The aim of this research was to establish and evaluate an internet-based resource library targeting the needs of remote area maternity service providers. METHODS: A participatory action research (PAR) approach was used to involve remote area maternity service providers in the Northern Territory of Australia. The evaluation of the resource library included its performance on reach, agency affiliation and richness, factors identified to affect the sustainability and utility of such a resource. An additional component of the evaluation framework documented the facilitators of and barriers to using an information technology strategy to reduce the isolation of remote area maternity service providers. RESULTS: Overall, the evaluation of the resource library was very positive. Feedback from the PAR team described the resource as contemporary, useful and relevant. Practitioners in leadership and education positions identified the resource library as a valuable tool that enabled them to access professional knowledge, which could then be distributed to any remote-based practitioners, who experienced difficulties with access themselves.
Brodie, P.M. 2002, 'Addressing the Barriers to Midwifery: Australian midwives speaking out', Australian Journal of Midwifery, vol. 15, no. 3, pp. 4-13.
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Homer, C.S., Davis, G.K., Brodie, P.M., Sheehan, A., Barclay, L., Wills, J. & Chapman, M. 2001, 'Collaboration in Maternity Care: A randomised controlled trial comparing community-based continuity of care with standard hospital care', British Journal of Obsterics and Gynaecology, vol. 108, no. 1, pp. 16-22.
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Brodie, P.M. & Barclay, L. 2001, 'Contemporary Issues in Australian Midwifery Regulation', Australian Health Review, vol. 24, no. 4, pp. 103-118.
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Homer, C.S. & Brodie, P.M. 2000, 'What do Women feel about Community-based antenatal care?', Australian & New Zealand Journal of Public Health, vol. 24, no. 6, pp. 590-595.
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Tracy, S.K., Barclay, L. & Brodie, P.M. 2000, 'Contemporary Issues in the Workforce and Education of Australian Midwives', Australian Health Review, vol. 23, no. 4, pp. 78-88.
This paper, which is based on the preliminary findings of the Australian Midwifery Action Project (AMAP), outlines the issues around the midwifery labour force and education in Australia. One of the most alarming features is the lack of comprehensive data on midwives. Where data is available it demonstrates the shortage of midwives and the lack of consistency in educational programs for midwives within states and nationally. It is difficult to form a national picture with published sources of data because there are differences in definition and a lack of relevant information. Strategies for educational reform are discussed in relation to improving the supply and preparation of midwives.

Reports

Brodie, P.M., Barclay, L., Lane, K., Leap, N., Reiger, K. & Tracy, S.K. 2003, 'Results of the Australian Midwifery Action Project Education Survey', Australian Journal of Midwifery, Australian College of Midwives, Canberra, Australia, pp. 1-33.