Deborah has been working in health care for over 25 years. In this time she has held positions focusing on clinical practice, management, education, practice development, leadership and research. Her current role is Associate Professor of Midwifery Practice Development and Research with University of Technology, Sydney and South Eastern Sydney Illawarra Area Health Service. This chair was established to improve maternity care through the strengthening of midwifery practice, the development of contemporary maternity service models and engagement with research.
Deborah has worked across midwifery research, education and practice in both New Zealand and Australia. She was a Principal Lecturer, Researcher and Postgraduate Program Coordinator at Otago Polytechnic in New Zealand for 12 years where she facilitated learning in the Bachelor of Midwifery and Postgraduate Midwifery programs; working with a team to develop New Zealand’s first Master of Midwifery program. In 2008 Deborah was awarded the Excellence in Research Award, at this institution.
Associate Professor Davis completed her PhD in Midwifery at UTS, her thesis examining the discursive construction of case-loading midwifery in New Zealand. With a focus on the obstetric hospital setting her thesis described the way that space/place is implicated in constructing our understanding of women’s bodies and childbirth and thus, plays an active role in shaping midwifery practice. Space/place and its impact on the labouring woman, her supporters and caregivers, continue to be of particular interest to Deborah.
Associate Professor Davis is a member of the Australian College of Midwives, playing an active role in its activities, and the International Confederation of Midwives Research Advisory Network. She has contributed to National (NZ), State and Commonwealth government policies through membership on Technical Advisory Groups, Expert Advisory Groups, various Working Parties and consultations. Deborah regularly reviews scholarly work for journals such as "midwifery", "women and birth" and organisations including the New Zealand College of Midwives and the International Confederation of Midwives.
Can supervise: YES
Associate Professor Davis has several main research interests. These focus on; midwifery education, the impact of space/place on the experiences of women, their supporters and midwifery practice and practices/services that promote physiological birth and/or enhance the experiences of childbearing women.
She is the lead investigator on a large National New Zealand study that compares the outcomes of low risk women in the care of midwifery lead maternity carers, giving birth in a variety of settings including home, birthing units and hospitals. Working with the SLENZ (Second Life Education New Zealand) team, Deborah developed the first educational Birth Center in the virtual word of Second Life. This was designed using the Birth Unit Design principles developed by researchers at the University of Technology, Sydney. This Virtual Birth Center provides an opportunity for lay “residents” of Second Life and student midwives to learn about the importance of the design of birthing environments. Student midwives are also able to role play in this environment to develop their skills in midwifery practice and decision making.
Theoretical approaches: poststructural, Foucauldian, feminist, post-positivist
Methodologies/Methods: discourse analysis, interpretive, descriptive, cross sectional, cohort studies
Data collection methods: in-depth interview, focus groups, survey, database
Midwifery: undergraduate and postgraduate
Specific subject expertise; sociology of health, research methods, evidence informed practice, midwifery led care
Marsh, CA, Browne, J, Taylor, J & Davis, D 2019, 'Making the hidden seen: A narrative analysis of the experiences of Assumption of Care at birth.', Women and Birth.View/Download from: Publisher's site
Being involved in any child protection system is complex and multifaceted and none more so than in non-voluntary Assumption of Care which occurs in New South Wales when, for child protection concerns, the Department of Family and Community Services removes a newborn baby from her/his mother.This research studied childbearing women's and professionals' experiences of Assumption of Care at birth to increase understanding of individual participants' stories, how they made sense of meanings and how these experiences framed their lives.A narrative inquiry framework guided interviews with four groups: childbearing women, midwives, social workers and Family and Community Services case managers. Holistic form was used for reading, interpreting and analysing the narratives.This research found unwanted emotional (isolation, shame, guilt, loss, disenfranchised grief) and physical consequences (depression, substance abuse complications) for women experiencing an Assumption of Care at the time of birth. There were also conflicting ethical and moral positions for the professionals involved. The use/abuse of power, concealment of facts and disenfranchised grief were identified as intertwined plots that caused or increased tensions.Both the women and the professionals felt pressure from trying to achieve competing and overlapping roles. The unwanted effects of Assumption of Care are exacerbated by the current child protection and maternity care systems.To address the tensions raised in this study, we suggest a two-fold change to maternity care for women at risk of an Assumption of Care: a therapeutic justice model of maternity care and continuity of midwifery care with a dedicated midwife. Introducing these changes could increase women's and children's safety and wellbeing.
Kurz, E, Davis, D & Browne, J 2019, ''I felt like I could do anything!' Writing the phenomenon of 'transcendent birth' through autoethnography.', Midwifery, vol. 68, pp. 23-29.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:To discuss the concept of 'transcendent birth', an as yet poorly articulated and under recognised psychosocial wellness phenomenon of childbirth. DESIGN:an auto-ethnographical examination of the primary authors' journaled experiences as a student midwife and childbearing woman. SETTING:three maternity care units in South Eastern Australia as well as the home of the primary author. FINDINGS:The phenomenon of transcendent birth is linked with physiologic birth. Maternity care can hinder or facilitate physiologic birth, and therefore transcendent birth. KEY CONCLUSIONS:Transcendent birth is more likely in maternity care models which value the childbearing woman and physiologic birth. IMPLICATIONS FOR PRACTICE:Women's access to transcendent birth is demarcated by women's position in society, cultural knowledge of transcendent birth and the valuing of transcendent birth as a maternity care outcome.
Evans, J, Taylor, J, Browne, J, Ferguson, S, Atchan, M, Maher, P, Homer, CS & Davis, D 2019, 'The future in their hands: Graduating student midwives' plans, job satisfaction and the desire to work in midwifery continuity of care', Women and Birth.View/Download from: Publisher's site
© 2018 Australian College of Midwives Background: Midwife-led continuity of care models benefit women and the midwives who work in them. Australian graduate midwives are familiar with, and educated to provide, continuity of care to women although the opportunity to work exclusively in positions providing continuity of care on graduation is uncommon. Aim: To explore the immediate and aspirational employment plans and workforce choices, reasons for staying in midwifery and perceptions around factors likely to influence job satisfaction of midwives about to graduate from one Australian university during the years 2012–2016. Methods: This longitudinal study draws on survey responses from five cohorts of midwifery students in their final year of study. Findings: Ninety five out of 137 midwifery students responded to the survey. Almost nine out of ten respondents either aspired to work in a continuity of care model or recognised that they would gain job satisfaction by providing continuity of care to women. Factors leading to job satisfaction identified included making a difference to the women for whom they care, working in models of care which enabled them to provide women with 'the care I want to give', and having the ability to make autonomous midwifery decisions. Conclusion: Aligning early graduate work experiences with continuity of care models may have a positive impact on the confidence and professional development of graduate midwives, which in turn may lead to greater satisfaction and retention among a workforce already committed to supporting the maternity healthcare reform agenda.
Renfrew, MJ, Ateva, E, Dennis-Antwi, JA, Davis, D, Dixon, L, Johnson, P, Kennedy, HP, Knutsson, A, Lincetto, O, McConville, F, McFadden, A, Taniguchi, H, Bender, PTH & Zeck, W 2019, 'Midwifery is a vital solution-What is holding back global progress?', BIRTH-ISSUES IN PERINATAL CARE.View/Download from: Publisher's site
Atchan, M, Davis, D & Foureur, M 2018, 'An instrumental case study examining the introduction and dissemination of the Baby Friendly Health Initiative in Australia: key informants' perspectives', Women and Birth, vol. 31, no. 3, pp. 210-219.View/Download from: UTS OPUS or Publisher's site
Australia experiences high breastfeeding initiation but low duration rates. UNICEF introduced the global breastfeeding strategy, the Baby-Friendly Hospital Initiative, to Australia in 1992, transferring governance to the Australian College of Midwives (ACM) in 1995. In 2017 23% of facilities were registered as 'baby-friendly' accredited.
To examine the introduction and dissemination of the Baby-friendly Hospital Initiative into the Australian national setting.
An instrumental case study was conducted containing two components: analysis of historical documents pertaining to the Initiative and participant's interviews, reported here. A purposive sampling strategy identified 14 participants from UNICEF, ACM, maternity and community health services, the Australian government and volunteer organisations who took part in in-depth interviews. Thematic analysis explored participants' perceptions of factors influencing the uptake and future of the since renamed Baby Friendly Health Initiative (BFHI) and accreditation programme, BFHI Australia. Two broad categories, enablers and barriers, guided the interviews and analysis.
Participants revealed a positive perception of the BFHI whilst identifying that its interpretation and expansion in Australia had been negatively influenced by intangible government support and suboptimal capacity building. BFHI's advocacy agenda competed with BFHI Australia's need for financial viability. Widespread stakeholder collaboration and tangible political endorsement was seen as a way to move the strategy forward.
Dissemination of BFHI Australia is hampered by multi-level systems issues. Prioritisation, stakeholder collaboration and adequate resourcing of the BFHI is required to create a supportive and enabling environment for Australian women to determine and practice their preferred infant feeding method.
Braye, K, Ferguson, J, Davis, D, Catling, C, Monk, A & Foureur, M 2018, 'Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review.', Women and Birth, vol. 31, no. 4, pp. 244-253.View/Download from: UTS OPUS or Publisher's site
In some countries, up to 30% of women are exposed to intrapartum antibiotic prophylaxis for prevention of early-onset group B Streptococcal infection. Intrapartum antibiotic prophylaxis aims to reduce the risk of neonatal morbidity and mortality from this infection. The intervention may adversely affect non-pathogenic bacteria which are passed to the newborn during birth and are considered important in optimising health. Since many women are offered intrapartum antibiotic prophylaxis, effectiveness and implications of this intervention need to be established. This review considers clinical trials and observational studies analysing the effectiveness of intrapartum antibiotic prophylaxis.An integrative literature review was conducted. One systematic review, three clinical trials and five observational studies were identified for appraisal.Randomised controlled trials found intrapartum antibiotic prophylaxis effective but all retrieved randomised clinical trials had significant methodological flaws. High quality observational studies reported high rates of effectiveness but revealed less than optimal adherence to screening and administration of the prophylaxis. Scant consideration was given to short term risks, and long-term consequences were not addressed.Studies found intrapartum antibiotic prophylaxis to be effective. However, evidence was not robust and screening and prophylaxis have limitations. Emerging evidence links intrapartum antibiotic prophylaxis to adverse short and longer-term neonatal outcomes.Our review found high quality evidence of the effectiveness of intrapartum antibiotic prophylaxis was limited. Lack of consideration of potential risks of the intervention was evident. Women should be enabled to make informed decisions about GBS management. More research needs to be done in this area.
Payk, M, Robinson, T, Davis, D & Atchan, M 2018, 'An integrative review of the psychosocial facilitators and challenges of continuous subcutaneous insulin infusion therapy in type 1 diabetes', Journal of Advanced Nursing, vol. 74, no. 3, pp. 528-538.View/Download from: UTS OPUS or Publisher's site
© 2017 John Wiley & Sons Ltd Aim: To use systematic methods to explore the psychosocial facilitators and challenges of insulin pump therapy among people with type 1 diabetes. Background: Insulin pump therapy is now widely accepted in the management of type 1 diabetes. Given the increasing use of insulin pumps, it is timely to review the evidence relating to the psychosocial impacts of this therapy which have not been addressed in previous reviews. Design: An integrative review of the literature (January 2005–February 2017). Data sources: A systematic search of electronic databases: CINAHL, Cochrane, Medline, PsycINFO and Scopus. Review methods: Empirical literature reporting psychosocial facilitators and challenges of insulin pump therapy were eligible for inclusion. A constant comparative method was used to guide the review. Quality appraisal was performed using the Mixed Methods Appraisal Tool Version 2011. Results: Thirty-five potential articles identified from titles and abstracts were reviewed. Of these, 13 articles were included in the final review. Psychosocial facilitators of insulin pump therapy included the flexibility and freedom it provided for living with diabetes, enhancing social situations and daily management. In contrast, challenges included the demands of pump therapy, self-consciousness in wearing the pump and fear of hypoglycaemia and pump failure. Conclusion: Findings can be used by health professionals to inform people embarking on insulin pump therapy and prepare them with regard to expectations of the treatment. Further research is required to explore the role of diabetes health professional in providing psychosocial support to people with type 1 diabetes on insulin pump therapy.
Bowman, RL, Davis, DL, Ferguson, S & Taylor, J 2018, 'Women's motivation, perception and experience of complementary and alternative medicine in pregnancy: A meta-synthesis.', Midwifery, vol. 59, pp. 81-87.View/Download from: UTS OPUS or Publisher's site
BACKGROUNDcomplementary and Alternative Medicine use during pregnancy is popular in many countries, including Australia. There is currently little evidence to support this practice, which raises the question of women's motivation for use of these therapies and the experiences they encounter.OBJECTIVEthis study aims to explore the perceptions, motivations and experiences of pregnant women with regard to their use of Complementary and Alternative Medicine during pregnancy.METHODSa systemic review and meta-synthesis of the available research was conducted. Five databases were explored - CINAHL Plus, Medline, PubMed, AMED and Web of Science using the search terms complementary and alternative medicine; pregnancy; and pregnant. Articles included in this meta-synthesis were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool.FINDINGSten initial themes were drawn from the six studies. These ten themes were summarised by three cluster themes. The results suggest that women are using Complementary and Alternative Medicine in their pregnancy as a means of supporting their sense of self-determination, to pursue a natural and safe childbirth, and because they experience a close affiliation with the philosophical underpinnings of Complementary and Alternative Medicine as an alternative to the biomedical model.CONCLUSIONthese findings are important to practitioners, policy makers, governing bodies and researchers, providing insight into the motivations for Complementary and Alternative Medicine use by women in pregnancy.
Davis, D, Brown, WJ, Foureur, M, Nohr, EA & Xu, F 2018, 'Long-Term Weight Gain and Risk of Overweight in Parous and Nulliparous Women', OBESITY, vol. 26, no. 6, pp. 1072-1077.View/Download from: UTS OPUS or Publisher's site
Davis, D, Davey, R, Williams, LT, Foureur, M, Nohr, E, Knight-Agarwal, C, Lawlis, T, Oats, J, Skouteris, H & Fuller-Tyszkiewicz, M 2018, 'Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial.', JMIR research protocols, vol. 7, no. 5, p. e146.View/Download from: UTS OPUS or Publisher's site
Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy.The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention.This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women's weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care.Recruitment has commenced though the recruitment rate is slower tha...
Perriman, N, Davis, DL & Ferguson, S 2018, 'What women value in the midwifery continuity of care model: A systematic review with meta-synthesis', MIDWIFERY, vol. 62, pp. 220-229.View/Download from: UTS OPUS or Publisher's site
Atchan, M, Davis, D & Foureur, M 2017, 'An historical document analysis of the introduction of the Baby Friendly Hospital Initiative into the Australian setting.', Women and Birth, vol. 30, pp. 51-62.View/Download from: UTS OPUS or Publisher's site
Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century. The World Health Organization launched a global health promotion strategy to help create a 'breastfeeding culture'. Research on the programme has revealed multiple barriers since implementation.To analyse the sociopolitical challenges associated with implementing a global programme into a national setting via an examination of the influences on the early period of implementation of the Baby Friendly Hospital Initiative in Australia.A focused historical document analysis was attended as part of an instrumental case study. A purposeful sampling strategy obtained a comprehensive sample of public and private documents related to the introduction of the BFHI in Australia. Analysis was informed by a 'documents as commentary' approach to gain insight into individual and collective social practices not otherwise observable.Four major themes were identified: "a breastfeeding culture"; "resource implications"; "ambivalent support for breastfeeding and the BFHI" and "business versus advocacy". "A breastfeeding culture" included several subthemes. No tangible support for breastfeeding generally, or the Baby Friendly Hospital Initiative specifically, was identified. Australian policy did not follow international recommendations. There were no financial or policy incentives for BFHI implementation.Key stakeholders' decisions negatively impacted on the Baby Friendly Hospital Initiative at a crucial time in its implementation in Australia. The potential impact of the programme was not realised, representing a missed opportunity to establish and provide sustainable standardised breastfeeding support to Australian women and their families.
Marsh, CA, Browne, J, Taylor, J & Davis, D 2017, 'Characteristics and outcomes of newborns entered who entered into care (EIC) within 7 days of birth in NSW, Australia', Children and Youth Services Review, vol. 81, pp. 261-267.View/Download from: UTS OPUS or Publisher's site
© 2017 Introduction Out of home care (OOHC) is the last recourse when children are at risk of serious harm and the home environment is not considered safe. A large proportion of children in OOHC are under five years of age and an estimated 18% are under one year of age. This study is the first to identify, over a defined period of time, the number, and outcomes of newborn babies removed by an assumption of care (AoC) and placed into OOHC in New South Wales (NSW). This study additionally aims to investigate if there is any association between the amendments to the NSW Children and Young Persons (Care and Protection) Act 1998 in 2008 and any increase in the number of newborn babies entering into care (EIC). Method This study uses data on newborn babies aged seven days or less that entered into OOHC in NSW from January 1, 2006 to December 31, 2014. The data set (n = 1834) was analysed to determine the annual numbers, trends and characteristics of newborn babies who EIC in this vulnerable period. A pre and post 2008 analysis was undertaken to determine if legislative changes influenced the trend of prenatal reporting and the numbers of newborn babies EIC. Results The number of newborn babies EIC care steadily increased from 2006 to 2014 as did prenatal reporting. Aboriginal newborn babies were over represented in the data set which correlates with national data. Approximately one third of the sample was identified as Aboriginal (31.6%) and Aboriginal newborn babies are 9.5 times more likely to be in OOHC than non-Aboriginal. The odds of a prenatal report being submitted to FACS were 1.91 times higher for Aboriginal compared to non-Aboriginal. Our study shows that of the newborn babies that EIC care in the study period, only 6.6% were restored to their parent/s and only 5.1% were adopted. Comparison of the pre and post legislative amendment period indicated a higher proportion of newborn babies were EIC at a younger age in the second period compared to the first, a gr...
Marsh, CA, Browne, J, Taylor, J & Davis, D 2017, 'A researcher's journey: Exploring a sensitive topic with vulnerable women.', Women and Birth, vol. 30, no. 1, pp. 63-69.View/Download from: UTS OPUS or Publisher's site
The conduct of research regardless of the subject or methods employed brings responsibilities and challenges. These are greater when dealing with sensitive topics and vulnerable groups and therefore researchers must navigate a range of complex issues and make choices in relation to practical, ethical and philosophical concerns. While literature dealing with research methodologies and research design may assist to some degree, it cannot provide a clear pathway or template as each research project must respond to a unique set of circumstances. We can however, also learn from sharing our stories and critical reflections on our research processes.The purpose of this article is to highlight the practical and methodological issues arising from researching a sensitive topic with vulnerable women experiencing an Assumption of Care.Research involving topics that are deeply personal and private combined with a vulnerable population can be complex and challenging for the researcher. Although some issues were anticipated from the literature, others encountered in this study were unexpected. Special considerations and prerequisites were necessary to build mutual trust and share power with women who had experienced an Assumption of Care at birth. Narrative Inquiry was a good methodological fit for this study as it privileged the voices of women and insisted that their experiences be considered within the context of their lives.Although Narrative Inquiry is a suitable choice for researching sensitive topics with vulnerable women specific considerations are still required to ensure the benefits of this research for both participants and researchers. Family and Community Service (FACS) have now replaced the formerly known Department of Community Services (DoCS) and in consideration of the timing of this study this article uses the terminology as DoCS.
Foureur, M, Turkmani, S, Clack, DC, Davis, DL, Mollart, L, Leiser, B & Homer, CSE 2017, 'Caring for women wanting a vaginal birth after previous caesarean section: A qualitative study of the experiences of midwives and obstetricians.', Women and Birth, vol. 30, no. 1, pp. 3-8.View/Download from: UTS OPUS or Publisher's site
One of the greatest contributors to the overall caesarean section rate is elective repeat caesarean section.Decisions around mode of birth are often complex for women and influenced by the views of the doctors and midwives who care for and counsel women. Women may be more likely to choose a repeat elective caesarean section (CS) if their health care providers lack skills and confidence in supporting vaginal birth after caesarean section (VBAC).To explore the views and experiences of providers in caring for women considering VBAC, in particular the decision-making processes and the communication of risk and safety to women.A descriptive interpretive method was utilised. Four focus groups with doctors and midwives were conducted.The central themes were: 'developing trust', 'navigating the system' and 'optimising support'. The impact of past professional experiences; the critical importance of continuity of carer and positive relationships; the ability to weigh up risks versus benefits; and the language used were all important elements. The role of policy and guidelines on providing standardised care for women who had a previous CS was also highlighted.Midwives and doctors in this study were positively oriented towards assisting and supporting women to attempt a VBAC. Care providers considered that women who have experienced a prior CS need access to midwifery continuity of care with a focus on support, information-sharing and effective communication.
Knight-Agarwal, CR, Williams, LT, Davis, D, Davey, R, Cochrane, T, Zhang, H & Rickwood, P 2016, 'Association of BMI and interpregnancy BMI change with birth outcomes in an Australian obstetric population: a retrospective cohort study', BMJ OPEN, vol. 6, no. 5.View/Download from: UTS OPUS or Publisher's site
© 2015 Elsevier Ltd. Background: in Western countries, caesarean section rates are increasing at an alarming rate. This trend has implications for women's health and calls into question the use of pathogenesis to frame maternity services. The theory of salutogenesis offers an alternative as it focuses on health rather than illness. Sense of coherence (SOC), the cornerstone of salutogenesis, is a predictive indicator of health. This study aimed to explore associations between pregnant women's SOC, their birthing outcomes and factors associated with SOC changes. Methods: a longitudinal survey was conducted where women completed a questionnaire in the antenatal and postnatal period. Questionnaire one provided information on SOC scores, Edinburgh Postnatal Depression Scale (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. Questionnaire two provided information on SOC scores, EPDS scores and birthing outcomes. Findings: 1074 women completed questionnaire one and 753 women completed questionnaire two. Compared to women with low antenatal SOC, women with high antenatal SOC were less likely to experience caesarean section (OR 0.437 95% CI 0.209-0.915) and more likely to experience assisted vaginal birth (AVB) (OR 3.108 95% CI 1.557-6.203). Higher birth satisfaction, higher antenatal EPDS scores and lower antenatal SOC were associated with an increase in SOC. Epidural, AVB and decreased birth satisfaction were associated with a decrease in SOC. Conclusion: high sense of coherence in pregnant women is associated with half the likelihood of caesarean section compared to women with low sense of coherence. Women's sense of coherence is raised and lowered by degree of satisfaction with their births and lowered by some labour interventions.
Fonti, S, Davis, D & Ferguson, S 2016, 'The attitudes of healthcare professionals towards women using illicit substances in pregnancy: A cross-sectional study', Women and Birth, vol. 29, no. 4, pp. 330-335.View/Download from: Publisher's site
© 2016 Australian College of Midwives Aim To assess the attitudes of healthcare professionals towards women who use substances in the maternity setting. Background Illicit drug use in pregnancy leads to poor maternal and neonatal outcomes. Early access to antenatal care has been shown to improve outcomes however women who use substances in pregnancy have statistically low attendance rates to appointments. Fear of stigma from healthcare professionals is a commonly stated reason for not accessing maternity health services or not disclosing substance use to care givers, however little research has been conducted which assesses stigma from a healthcare perspective. Methods A cross-sectional quantitative research design was implemented using a previously validated attitudinal survey tool to assess the attitudes of healthcare practitioners and final year midwifery students. Ethics approval was sought and granted by the relevant institutions. A total of 147 completed questionnaires were returned. Data was analysed using the Statistical Package for the Social Sciences and parametric testing was undertaken. Results Participants had largely positive or neutral attitudes towards women who use substances in pregnancy. Most participants agreed or strongly agreed that the care they provide to can make a real difference to outcomes. Midwifery students had significantly lower mean attitude scores, showing more positive attitudes, than any other group tested. Conclusion This research provides useful insight into the attitudes of healthcare professionals. While larger scale research is needed, the positive findings of this study may work towards reducing fear of stigma as a barrier to care for women.
Knight-Agarwal, CR, Williams, LT, Davis, D, Davey, R, Shepherd, R, Downing, A & Lawson, K 2016, 'The perspectives of obese women receiving antenatal care: A qualitative study of women's experiences', Women and Birth, vol. 29, no. 2, pp. 189-195.View/Download from: Publisher's site
© 2015. Background: The prevalence of overweight and obesity is increasing amongst women of child bearing age. Maternal obesity has implications for both mother and baby including increased health risks from gestational hypertensive disorders, caesarean section and stillbirth. Despite the increasing prevalence of maternal obesity little is known of the experiences of these women within the health care system. The aim of this research was to investigate the perspectives of pregnant women with a body mass index (BMI) of ≥30 kg/m2 receiving antenatal care. Methods: A qualitative study using individual interviews was undertaken. Sixteen pregnant women with a BMI ≥30 kg/m2 participated. Interviews were audio recorded, transcribed, cross checked for consistency and then entered into a word processing document for analysis. Data was analysed using Interpretative Phenomenological Analysis. In any phenomenological study the researcher's objective is to elicit the participant's views on their lived experiences. Findings: Four major themes emerged: (1) obese during pregnancy as part of a long history of obesity; (2) lack of knowledge of the key complications of obesity for both mother and child; (3) communication about weight and gestational weight gain can be conflicting, confusing and judgmental; (4) most women are motivated to eat well during pregnancy and want help to do so. Conclusion: Specialist lifestyle interventions for obese women should be a priority in antenatal care. Extra support is required to assist obese women in pregnancy achieve recommended nutritional and weight goals. Health professionals should approach the issue of maternal obesity in an informative but non-judgmental way.
Perriman, N & Davis, D 2016, 'Measuring maternal satisfaction with maternity care: A systematic integrative review What is the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care?', WOMEN AND BIRTH, vol. 29, no. 3, pp. 293-299.View/Download from: Publisher's site
van Limbeek, S, Davis, D, Currie, M & Wong, N 2016, 'Non-surgical intrapartum practices for the prevention of severe perineal trauma: a systematic review protocol', JBI database of systematic reviews and implementation reports, vol. 14, no. 4, pp. 30-40.View/Download from: Publisher's site
REVIEW QUESTION/OBJECTIVE: The objective of this review is to determine the effectiveness of non-surgical intrapartum practices in reducing the incidence of severe perineal trauma (third and fourth degree tears) during childbirth.
Atchan, M, Davis, D & Foureur, M 2016, 'A methodological review of qualitative case study methodology in midwifery research', Journal of Advanced Nursing, vol. 72, no. 10, pp. 2259-2271.View/Download from: UTS OPUS or Publisher's site
Davis, DL & Homer, CSE 2016, 'Birthplace as the midwife's work place: How does place of birth impact on midwives?', Women and Birth, vol. 29, no. 5, pp. 407-415.View/Download from: UTS OPUS or Publisher's site
© 2016 Australian College of Midwives. Background: In, many high and middle-income countries, childbearing women have a variety of birthplaces available to them including home, birth centres and traditional labour wards. There is good evidence indicating that birthplace impacts on outcomes for women but less is known about the impact on midwives. Aim: To explore the way that birthplace impacts on midwives in Australia and the United Kingdom. Method: A qualitative descriptive study was undertaken. Data were gathered through focus groups conducted with midwives in Australia and in the United Kingdom who worked in publicly-funded maternity services and who provided labour and birth care in at least two different settings. Findings: Five themes surfaced relating to midwifery and place including: 1. practising with the same principles; 2. creating ambience: controlling the environment; 3. workplace culture: being watched 4. Workplace culture: "busy work" versus "being with"; and 5. midwives' response to place. Discussion: While midwives demonstrate a capacity to be versatile in relation to the physicality of birthplaces, workplace culture presents a challenge to their capacity to "be with" women. Conclusion: Given the excellent outcomes of midwifery led care, we should focus on how we can facilitate the work of midwives in all settings. This study suggests that the culture of the birthplace rather than the physicality is the highest priority.
Wong, N, Browne, J, Ferguson, S, Taylor, J & Davis, D 2015, 'Getting the first birth right: A retrospective study of outcomes for low-risk primiparous women receiving standard care versus midwifery model of care in the same tertiary hospital', Women and Birth, vol. 28, no. 4, pp. 279-284.View/Download from: Publisher's site
© 2015 Australian College of Midwives. Background: There is national and international concern for increasing obstetric intervention in childbirth and rising caesarean section rates. Repeat caesarean section is a major contributing factor, making primiparous women an important target for strategies to reduce unnecessary intervention and surgeries in childbirth. Aim: The aim was to compare outcomes for a cohort of low risk primiparous women who accessed a midwifery continuity model of care with those who received standard public care in the same tertiary hospital. Methods: A retrospective comparative cohort study design was implemented drawing on data from two databases held by a tertiary hospital for the period 1 January 2010 to 31 December 2011. Categorical data were analysed using the chi-squared statistic and Fisher's exact test. Continuous data were analysed using Student's t-test. Comparisons are presented using unadjusted and adjusted odds ratios, with 95% confidence intervals (CIs) and p-values with significance set at 0.05. Results: Data for 426 women experiencing continuity of midwifery care and 1220 experiencing standard public care were compared. The study found increased rates of normal vaginal birth (57.7% vs. 48.9% p= 0.002) and spontaneous vaginal birth (38% vs. 22.4% p= <0.001) and decreased rates of instrumental birth (23.5% vs. 28.5% p= 0.050) and caesarean sections (18.8% vs. 22.5% p= 0.115) in the midwifery continuity cohort. There were also fewer interventions in this group. No differences were found in neonatal outcomes. Conclusion: Strategies for reducing caesarean section rates and interventions in childbirth should focus on primiparous women as a priority. This study demonstrates the effectiveness of continuity midwifery models, suggesting that this is an important strategy for improving outcomes in this population.
Ferguson, S, Davis, D, Browne, J & Taylor, J 2015, 'Sense of coherence and childbearing choices: A cross sectional survey', Midwifery, vol. 31, no. 11, pp. 1081-1086.View/Download from: Publisher's site
© 2015 Elsevier Ltd. Background: as concern for increasing rates of caesarean section and interventions in childbirth in Western countries mounts, the utility of the risk approach (inherent in the biomedical model of maternity care) is called into question. The theory of salutogenesis offers an alternative as it focuses on the causes of health rather than the causes of illness. Sense of coherence (SOC), the cornerstone of salutogenic theory, is a predictive indicator of health. We hypothesised that there is a relationship between a woman's SOC and the childbirth choices she makes in pregnancy. Methods: the study aims to investigate the relationship between SOC and women's pregnancy and anticipated labour choices. A cross sectional survey was conducted where eligible women completed a questionnaire that provided information on SOC scores, Edinburgh Postnatal Depression (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. Findings: 1074 pregnant women completed the study. Compared to women with low SOC, women with high SOC were older, were less likely to identify pregnancy conditions, had lower EPDS scores and higher SBI scores. SOC was not associated with women's pregnancy choices. Conclusion: this study relates SOC to physical and emotional health in pregnancy as women with high SOC were less likely to identify pregnancy conditions, had less depressive symptoms and perceived higher levels of support compared to women with low SOC. Interestingly, SOC was not associated with pregnancy choices known to increase normal birth rates. More research is required to explore the relationship between SOC and women's birthing outcomes.
Ferguson, S, Davis, D, Browne, J & Taylor, J 2015, 'Examining the Validity and Reliability of Antonovsky's Sense of Coherence Scale in a Population of Pregnant Australian Women', Evaluation and the Health Professions, vol. 38, no. 2, pp. 280-289.View/Download from: Publisher's site
© The Author(s) 2015 Antonovsky's Orientation to Life questionnaires were developed to measure sense of coherence (SOC). Although the SOC 13 instrument is widely used to measure health in general populations, it has not been assessed in pregnant women. If the SOC 13 is to be used to assess women's childbearing health, it requires further examination. The purpose of the research is to assess the psychometric properties of Antonovsky's SOC 13 questionnaire in pregnant women. When administered to 718 pregnant Australian women, the construct validity of the SOC 13 was difficult to establish. The SOC 9 was created by removing 4 items and provided best data fit. The SOC 13 and SOC 9 were found to have sound criterion validity, internal reliability, and equivalence between versions. It is hoped that the present study will stimulate additional research on SOC scales to examine their ability to assess women's childbearing health.
Abdel-Latif, ME, Boswell, D, Broom, M, Smith, J & Davis, D 2015, 'Parental presence on neonatal intensive care unit clinical bedside rounds: Randomised trial and focus group discussion', Archives of Disease in Childhood: Fetal and Neonatal Edition, vol. 100, no. 3, pp. F203-F209.View/Download from: Publisher's site
Background There are limited data to inform the choice between parental presence at clinical bedside rounds (PPCBR) and non-PPCBR in neonatal intensive care units (NICUs). Methods We performed a single-centre, survey-based, crossed-over randomised trial involving parents of all infants who were admitted to NICU and anticipated to stay >11 days. Parents were randomly assigned using a computer-generated stratified block randomisation protocol to start with PPCBR or non-PPCBR and then crossed over to the other arm after a wash-out period. At the conclusion of each arm, parents completed the 'NICU Parental Stressor Scale ' (a validated tool) and a satisfaction survey. After completion of the trial, we surveyed all healthcare providers who participated at least in one PPCBR rounding episode. We also offered all participating parents and healthcare providers the opportunity to partake in a focus group discussion regarding PPCBR. Results A total of 72 parents were enrolled in this study, with 63 parents (87%) partially or fully completing the trial. Of the parents who completed the trial, 95% agreed that parents should be allowed to attend clinical bedside rounds. A total of 39 healthcare providers ' surveys were returned and 35 (90%) agreed that parents should be allowed to attend rounds. Nine healthcare providers and 8 parents participated in an interview or focus group, augmenting our understanding of the ways in which PPCBR was beneficial. Conclusions Parents and healthcare providers strongly support PPCBR. NICUs should develop policies allowing PPCBR while mitigating the downsides and concerns of parents and healthcare providers such as decreased education opportunity and confi dentiality concerns. Trial registration number Australia and New Zealand Clinical Trials Register number, ACTRN12612000506897.
Marsh, CA, Browne, J, Taylor, J & Davis, D 2015, 'Guilty until proven innocent? - The Assumption of Care of a baby at birth', Women and Birth, vol. 28, no. 1, pp. 65-70.View/Download from: Publisher's site
© 2014. Background: This paper provides an overview of the history of child protection, the associated law and the 2008 amendments to the Child and Young Persons (Care and Protection) Act 1998 in relation to the Assumption of Care at birth Practice. Objective: To explore the current practice of an Assumption of Care (AOC) where a newborn baby is removed from his/her mother at the time of birth, particularly focussing on the impact of the AOC on midwives. Discussion: Assumption of Care practices in NSW raise significant issues for midwives in relation to the midwifery codes of ethics and conduct and importantly, to their ability to work in ways that honour a "woman-centred care" philosophy. When midwives are exposed to conflict between workplace and personal or professional values such as the practice of AOC cognitive dissonance can occur. Conclusions: Further research is required to understand the impact of current Assumption of Care. Broader research to not only look at effect on the midwife but also on other health professionals involved and the women who personally experience the removal of their baby at the time of birth. Consideration must also be given to ways of working with vulnerable families to enhance the acceptability and efficacy of maternity services and with associated agencies will decrease the need for Assumption of Care at birth.
Knight-Agarwal, C, Davis, DL, Williams, L, Davey, R, Cox, R & Clarke, A 2015, 'Development and Pilot Testing of the Eating4two Mobile Phone App to Monitor Gestational Weight Gain', JMIR MHEALTH AND UHEALTH, vol. 3, no. 2.View/Download from: UTS OPUS or Publisher's site
Kurz, E & Davis, D 2015, 'Routine culture-based screening versus risk-based management for the prevention of early-onset group B streptococcus disease in the neonate: a systematic review', JBI database of systematic reviews and implementation reports, vol. 13, no. 3, pp. 206-246.View/Download from: Publisher's site
The Joanna Briggs Institute. BACKGROUND: Early-onset group B streptococcus disease, recognized as the most common cause of early onset neonatal sepsis in developed countries, is transmitted vertically from the group B streptococcus carrier mother to the neonate in the peripartum. Accordingly, early-onset group B streptococcus disease is prevented by halting the transmission of the microorganism from the mother to the infant. Two main methods, routine culture-based screening and risk-based management, may be used in the identification of mothers requiring intrapartum antibiotic prophylaxis in labor. While there are advantages and disadvantages to each, there is limited high level evidence available as to which method is superior.OBJECTIVES: To identify the effectiveness of risk-based management versus routine culture-based screening in the prevention of early-onset group B streptococcus disease in the neonate.TYPES OF PARTICIPANTS: This review considered studies which treated pregnant women with intrapartum antibiotic prophylaxis following risk- and culture-based protocols for the prevention of early-onset group B streptococcus disease in the neonate. Types of intervention: This review considered studies that evaluated risk-based management against routine culture-based screening for the prevention of early-onset group B streptococcus disease in the neonate. Types of studies: This review looked for highest evidence available which in this case consisted of one quasi experimental study and eight comparative cohort studies with historical or concurrent control groups. Types of outcomes: Incidence of early-onset group B streptococcus disease in neonates as measured by positive group B streptococcus culture from an otherwise sterile site. Secondary outcomes include neonatal death due to group B streptococcus sepsis and percentage of women who received intrapartum antibiotic prophylaxis.SEARCH STRATEGY: A multi-step search strategy was used to find studies which were l...
Davies, R, Davis, D, Pearce, M & Wong, N 2015, 'The effect of waterbirth on neonatal mortality and morbidity: a systematic review and meta-analysis', JBI database of systematic reviews and implementation reports, vol. 13, no. 10, pp. 180-231.View/Download from: Publisher's site
BACKGROUND: Women have been giving birth in water in many centers across the globe; however, the practice remains controversial. Qualitative studies highlight the benefits that waterbirth confers on the laboring woman, though due to the nature of the intervention, it is not surprising that there are few randomized controlled trials available to inform practice. Much of the criticism directed at waterbirth focuses on the potential impact on the neonate.OBJECTIVES: The objective of this review was to systematically synthesize the best available evidence regarding the effect of waterbirth, compared to landbirth, on the mortality and morbidity of neonates born to low risk women.INCLUSION CRITERIA: This review considered studies that included low risk, well, pregnant women who labor and birth spontaneously, at term (37-42 weeks), with a single baby in a cephalic presentation. Low risk pregnancies are defined as pregnancies with an absence of co-morbidity or obstetric complication, such as maternal diabetes, previous cesarean section, high blood pressure or other illness. Women may be experiencing their first or subsequent pregnancy. The fetus must also be well and without any co-morbidity or complication.The intervention of interest is waterbirth. The comparator is landbirth. Women and their babies must be cared for by qualified maternity healthcare providers throughout their labor and birth. The birth setting must be clearly described but can include home, hospital or birth center, either freestanding or attached to a hospital.This review considered randomized controlled trials, quasi-experimental studies and observational prospective and retrospective cohort studies.SEARCH STRATEGY: A multi-step search strategy was utilized to find published and unpublished studies, in English between January 1999 and June 2014.METHODOLOGICAL QUALITY: The first author assessed the quality of all eligible studies. The three secondary authors independently assessed six studies each, f...
Browne, J, Haora, PJ, Taylor, J & Davis, DL 2014, '"Continuity of care" experiences in midwifery education: Perspectives from diverse stakeholders', NURSE EDUCATION IN PRACTICE, vol. 14, no. 5, pp. 573-578.View/Download from: UTS OPUS or Publisher's site
Knight-Agarwal, CR, Kaur, M, Williams, LT, Davey, R & Davis, D 2014, 'The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study', WOMEN AND BIRTH, vol. 27, no. 2, pp. 138-144.View/Download from: UTS OPUS or Publisher's site
Browne, J, O'Brien, M, Taylor, J, Bowman, R & Davis, D 2014, ''You've got it within you': The political act of keeping a wellness focus in the antenatal time', MIDWIFERY, vol. 30, no. 4, pp. 420-426.View/Download from: UTS OPUS or Publisher's site
Raymond, JE, Foureur, MJ & Davis, DL 2014, 'Gestational Weight Change in Women Attending a Group Antenatal Program Aimed at Addressing Obesity in Pregnancy in New South Wales, Australia', Journal of Midwifery & Women's Health, vol. 59, no. 4, pp. 398-404.View/Download from: UTS OPUS or Publisher's site
Homer, CS, Scarf, VL, Catling, C & Davis, D 2014, 'Culture-based versus risk-based screening for the prevention of group B streptococcal disease in newborns: A review of national guidelines', Women and Birth, vol. 27, no. 1, pp. 46-51.View/Download from: Publisher's site
Background: Maternal colonisation with group B streptococcus (GBS) is recognised as the most frequent cause of severe early onset infection in newborns. National and international guidelines outline two approaches to the prevention of early onset disease in the neonate: risk based management and antenatal culture-based screening. We undertook an analysis of existing national and international guidelines in relation to GBS in pregnancy using a standardised and validated instrument to highlight the different recommended approaches to care.
Atchan, MA, Davis, D & Foureur, M 2014, 'Applying a Knowledge Translation Model to the uptake of the Baby Friendly Health Initiative in the Australian health care system', Women and Birth, vol. 27, no. 2, pp. 79-85.View/Download from: UTS OPUS or Publisher's site
Davis, D & Walker, K 2013, 'Towards an 'optics of power': technologies of surveillance and discipline and case-loading midwifery practice in New Zealand', GENDER PLACE AND CULTURE, vol. 20, no. 5, pp. 597-612.View/Download from: Publisher's site
Ferguson, S, Davis, D & Browne, J 2013, 'Does antenatal education affect labour and birth? A structured review of the literature', WOMEN AND BIRTH, vol. 26, no. 1, pp. E5-E8.View/Download from: UTS OPUS or Publisher's site
Hammond, AD, Foureur, M, Homer, CS & Davis, D 2013, 'Space, place and the midwife: Exploring the relationship between the birth environment, neurobiology and midwifery practice', Women and Birth, vol. 26, no. 4, pp. 277-281.View/Download from: UTS OPUS or Publisher's site
Background: Research indicates that midwives and their practice are influenced by space and place and that midwives practice differently in different places. It is possible that one mechanism through which space and place influence midwifery practice is via neurobiological responses such as the production and release of oxytocin, which can be triggered by experiences and perceptions of the physical environment.
Sheehy, AD, Davis, DL & Homer, CS 2013, 'Assisting women to make informed choices about screening for Group B Streptococcus in pregnancy: A critical review of the evidence', Women and Birth, vol. 26, no. 2, pp. 152-157.View/Download from: UTS OPUS or Publisher's site
The approach to the prevention of early onset GBS disease in the newborn varies considerably from country to country. The Centre for Disease Control in the United States advocates universal culture based screening with the administration of intra-partum antibiotics, usually benzylpenicillin or ampicillin, to women who are colonised with GBS. National groups in the UK and New Zealand advocate a risk-based approach where intra-partum antibiotics are given to women with identified risk factors. The Canadian Taskforce on preventive health care has identified a third approach; where intra-partum antibiotics are given to women with a positive GBS culture and an identified risk factor. There are no national guidelines or consensus in Australia.
Homer, CS, Besley, KJ, Bell, J, Davis, DL, Adams, J, Porteous, A & Foureur, M 2013, 'Does continuity of care impact decision making in the next birth after a caesarean section(VBAC)? A randomised controlled trial', BMC Pregnancy Childbirth, vol. 13, pp. 140-140.View/Download from: UTS OPUS or Publisher's site
Background: Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low.
Atchan, MA, Davis, D & Foureur, M 2013, 'The impact of the Baby Friendly Health Initiative in the Australian health care system a critical narrative review of the evidence', Breastfeeding Review, vol. 21, no. 2, pp. 15-22.View/Download from: UTS OPUS
Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation.
Stewart, S & Davis, D 2012, 'On the MUVE or in decline: Reflecting on the sustainability of the Virtual Birth Centre developed in Second Life', AUSTRALASIAN JOURNAL OF EDUCATIONAL TECHNOLOGY, vol. 28, no. 3, pp. 480-503.
Stewart, S, Sidebotham, M & Davis, D 2012, 'International networking: connecting midwives through social media', INTERNATIONAL NURSING REVIEW, vol. 59, no. 3, pp. 431-434.View/Download from: UTS OPUS or Publisher's site
Stewart, S, Sidebotham, M & Davis, D 2012, 'The virtual international day of the midwife: Social networking for continuing professional development', Nurse Education in Practice, vol. 12, no. 5, pp. 248-252.View/Download from: UTS OPUS or Publisher's site
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.
Davis, D, Foureur, M, Clements, V, Brodie, P & 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, no. 3, pp. E1-E10.View/Download from: Publisher's site
Wheeler, J, Davis, DL, Fry, M, Brodie, PM & Homer, CS 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.View/Download from: UTS OPUS or Publisher's site
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.
Clements, VJ, Fenwick, JH & Davis, DL 2012, 'Core Elements Of Transition Support Programs: The Experiences Of Newly Qualified Australian Midwives', Sexual and Reproductive HealthCare, vol. 3, no. 4, pp. 155-162.View/Download from: UTS OPUS or Publisher's site
Aim: This article reports on newly qualified midwives' experiences of the core elements of their transition support program: clinical rotations, supernumerary time, study days and midwife-to-midwife support. Background: There is limited knowledge and und
Davis, DL, Raymond, J, Clements, V, Adams, C, Mollart, L, Teate, A & Foureur, M 2012, 'Addressing obesity in pregnancy: The designand feasibility of an innovative intervention in NSW, Australia', Women and Birth, vol. 25, no. 4, pp. 174-180.View/Download from: UTS OPUS or Publisher's site
Objective: Obesity amongst women of child bearing age is increasing at an unprecedented, rate throughout the Western world. This paper describes the design of an innovative, collaborative, antenatal intervention that aims to assist women to manage their weight during pregnancy and, presents aspects of the programme evaluation.
Davis, D, Baddock, S, Pairman, S, Hunter, M, Benn, C, Anderson, J, Dixon, L & Herbison, P 2012, 'Risk of Severe Postpartum Hemorrhage in Low-Risk Childbearing Women in New Zealand: Exploring the Effect of Place of Birth and Comparing Third Stage Management of Labor', BIRTH-ISSUES IN PERINATAL CARE, vol. 39, no. 2, pp. 98-105.View/Download from: UTS OPUS or Publisher's site
Foureur, M, Leap, N, Davis, DL, Forbes, I & Homer, CS 2011, 'Testing the birth unit design spatial evaluation tool (BUDSET) in Australia: a Pilot Study', Health Environments Research & Design Journal, vol. 4, no. 2, pp. 36-60.View/Download from: UTS OPUS or Publisher's site
Objective: To pilot test the Birth Unit Design Spatial Evaluation Tool (BUDSET) in an Australian maternity care setting to determine whether such an instrument can measure the optimality of different birth settings. Background: Optimally designed spaces to give birth are likely to influence a woman's ability to experience physiologically normal labor and birth. This is important in the current industrialized environment, where increased caesarean section rates are causing concerns. The measurement of an optimal birth space is currently impossible, because there are limited tools available. Methods: A quantitative study was undertaken to pilot test the discriminant ability of the BUDSET in eight maternity units in New South Wales, Australia. Five auditors trained in the use of the BUDSET assessed the birth units using the BUDSET, which is based on 18 design principles and is divided into four domains (Fear Cascade, Facility, Aesthetics, and Support) with three to eight assessable items in each. Data were independently collected in eight birth units. Values for each of the domains were aggregated to provide an overall Optimality Score for each birth unit. Results: A range of Optimality Scores was derived for each of the birth units (from 51 to 77 out of a possible 100 points). The BUDSET identified units with low-scoring domains. Essentially these were older units and conventional labor ward settings. Conclusion: The BUDSET provides a way to assess the optimality of birth units and determine which domain areas may need improvement. There is potential for improvements to existing birth spaces, and considerable improvement can be made with simple low-cost modifications. Further research is needed to validate the tool.
Davis, D & Walker, K 2011, 'Case-Loading Midwifery In New Zealand: Bridging The Normal/Abnormal Divide 'With Woman'', Midwifery, vol. 27, no. 1, pp. 46-52.View/Download from: UTS OPUS or Publisher's site
Objectives: to explore the way that case-loading midwives in New Zealand construct midwifery (and in so doing, the concepts of woman and childbirth).
Davis, DL, Baddock, S, Pairman, S, Hunter, M, Benn, C, Wilson, D, Dixon, L & Herbison, P 2011, 'Planned Place Of Birth In New Zealand: Does It Affect Mode Of Birth And Intervention Rates Among Low-Risk Women?', Birth: issues in perinatal care, vol. 38, no. 2, pp. 111-119.View/Download from: UTS OPUS or Publisher's site
Background: Midwives providing care as lead maternity caregivers in New Zealand provide continuity of care to women who may give birth in a variety of settings, including home, primary units, and secondary and tertiary level hospitals. The purpose of thi
Foureur, M, Davis, D & Atchan, M 2011, 'The decision not to initiate breastfeeding-women's reasons, attitudes and influencing factors-a review of the literature', Breastfeeding Review, vol. 19, no. 2, pp. 9-17.View/Download from: UTS OPUS
Breastfeeding is the biological feeding norm for human babies. Encouraging breastfeeding is a primary health promotion strategy, with studies demonstrating the risks of artificial baby milks. each year approximately 10% of the women who give birth in New South Wales decide not to initiate breastfeeding, and the demographic characteristics of this group of women have previously been identified. This paper reviews the literature to explore the factors that influence women's decisions about breastfeeding, and their reasons for not initiating breastfeeding. The review revealed there are relatively few studies that explore the experiences of women who decide not to initiate breastfeeding, especially in the Australian context.
Foureur, M, Davis, DL, Fenwick, JH, Leap, N, Iedema, RA, Forbes, I & Homer, CS 2010, 'The Relationship Between Birth Unit Design And Safe, Satisfying Birth: Developing A Hypothetical Model', Midwifery, vol. 26, no. 5, pp. 520-525.View/Download from: UTS OPUS or Publisher's site
Recent advances in cross-disciplinary studies linking architecture and neuroscience have revealed that much of the built environment for health-care delivery may actually impair rather than improve health outcomes by disrupting effective communication an
Foureur, M, Leap, N, Davis, DL, Forbes, I & Homer, CS 2010, 'Developing The Birth Unit Design Spatial Evaluation Tool (Budset) In Australia: A Qualitative Study', Health Environments Research & Design Journal, vol. 3, no. 4, pp. 43-57.View/Download from: UTS OPUS
Objective: To develop a tool known as the Birth Unit Design Spatial Evaluation Tool (BUDSET), to assess the optimality of birth unit design. Background: The space provided for childbirth influences the physiology of women in labor. Optimal birth spaces a
Davis, DL & Walker, K 2010, 'The Corporeal, The Social And Space/Place: Exploring Intersections From A Midwifery Perspective In New Zealand', Gender Place And Culture, vol. 17, no. 3, pp. 377-391.View/Download from: UTS OPUS or Publisher's site
This article explores the interrelations between the corporeal, the social and the spatial as they operate to shape the discursive and material realities of childbirth in the obstetric hospital setting. It draws on interviews conducted with midwives thro
Davis, DL & Walker, K 2010, 'Re-discovering the material body through an exploration of theories of embodiment', Midwifery, vol. 26, no. 4, pp. 457-462.View/Download from: UTS OPUS or Publisher's site
The body is of central concern to midwifery yet, as a profession, we have largely failed to grapple with the corpus of feminist and other literature that deals with the body. This article provides an overview of the ways in which the body has been theorised, from the essential and biological through to postmodern theories of the body. We draw attention to the limitations of some of these approaches, suggesting that Elizabeth Groszs schema of the Mo¨ bius strip (representing the inter-relationships between the inside and outside, culture and nature) provides a useful framework for thinking about the body; one that avoids a biological materialism that disregards the effect of culture, and a cultural determinism that neglects the corporeal body. Recognising the multiplicity and fluidity of womens experiences of pregnancy, their body and childbearing emancipates us from the limitations imposed by the masculinist Western philosophical traditions that we have inherited.
To elicit factors influencing practising midwives with regard to tertiary study, a national survey was distributed attracting 386 responses from midwives working in a variety of settings. Many midwives engaged in tertiary study, cited personal interest and practice development as motivational factors, with midwifery practice topics providing the most interest. However midwives' time restrictions, the cost of papers and lack of financial or other incentives inhibited study. Midwives preferred face-to-face delivery with other midwives rather than mixed classes, followed by distance delivery with paper-based materials. Mixed modes of face-to-face and distance, or Internet based delivery, were not favoured by the midwives. These factors should be considered when designing tertiary programmes for practising midwives, incorporating adequate information, interaction and communication.
Davis, DL & McIntosh, C 2005, 'Partnership in education: the involvement of service users in one midwifery programme in New Zealand', Nurse Education in Practice, vol. 5, pp. 274-280.
Medical care throughout the 19th and 20th centuries was characterized by a paternalistic approach to care. From the mid-20th century we began to see a shift in the way health was conceptualized and approached. Individuals demanded more control over their experiences, encouraging individual choice and responsibility. The emergence of the discourses of individual choice and responsibility has had a significant impact on midwifery practice. This article focuses on some of the consequences of these discourses, suggesting that it has submerged some other important professional imperatives such as promoting normal birth. It is suggested that midwives will need to take a more active approach. This article explores this issue within the context of midwifery practice in New Zealand. While some points of history and details of the maternity system or practice may be specific to New Zealand, the discourses explored and implications for practice are relevant to many other Western countries and their midwives.
Scientific ways of knowing dominate our society today and this has major ramifications for midwifery. This article outlines the historical development and cultural understanding of ways of knowing in our society today. It is suggested that the patriarchal societies in which our ways of knowing have developed have emphasised scientific ways of knowing while other ways such as intuition and embodied knowledge received little acknowledgement. This article then goes on to explore these other ways of knowing, discusses their implications for midwifery care and suggests that to embrace many and varied ways of knowing is to more fully realise our abilities and potential as midwives. © 1989 ACMI.
This paper describes the personal journey of one independent practitioner as she moved from the environment of hospital practice and training to that of an independent practitioner. Many of the difficulties encountered on this journey can best be understood by reflection on the social, historical and political context in which nursing midwifery and women experience their world. Critical theory offers midwifery the opportunity to more fully understand our worlds and to move beyond the dominant social order and reconstruct our social wordls in more just and liberating ways. © 1989 ACMI.
Davis, D & Stewart, S 2015, 'Factors shaping assessment design in the virtual environment: A case study of midwifery' in Social Media and Networking: Concepts, Methodologies, Tools, and Applications, pp. 1027-1044.View/Download from: Publisher's site
© 2016, IGI Global. All rights reserved. The Virtual Birth Centre was created to provide student midwives with an opportunity to develop their midwifery knowledge and skills through a variety of teaching and learning strategies including role-play with peers in a safe, flexible, immersive learning environment. Role-play in the virtual environment has been shown to create a sense of presence or "really being there," which is associated with increased knowledge transfer from virtual to real world. Assessment in this project focused on formative "service user" (peer) feedback along with self-assessment against midwifery professional standards. The approach to assessment was shaped by a number of factors including the philosophical underpinnings and pedagogy of the programmes involved and the opportunities and limitations of the virtual world environment. Using the Virtual Birth Centre and midwifery as a case study, this chapter explores the factors influencing the development of assessments for the practice discipline of midwifery in a simulated, virtual environment.
Davis, D & Stewart, S 2014, 'Factors shaping assessment design in the virtual environment: A case study of midwifery' in Cases on the Assessment of Scenario and Game-Based Virtual Worlds in Higher Education, pp. 1-24.View/Download from: Publisher's site
© 2014 by IGI Global. All rights reserved. The Virtual Birth Centre was created to provide student midwives with an opportunity to develop their midwifery knowledge and skills through a variety of teaching and learning strategies including role-play with peers in a safe, flexible, immersive learning environment. Role-play in the virtual environment has been shown to create a sense of presence or "really being there," which is associated with increased knowledge transfer from virtual to real world. Assessment in this project focused on formative "service user" (peer) feedback along with self-assessment against midwifery professional standards. The approach to assessment was shaped by a number of factors including the philosophical underpinnings and pedagogy of the programmes involved and the opportunities and limitations of the virtual world environment. Using the Virtual Birth Centre and midwifery as a case study, this chapter explores the factors influencing the development of assessments for the practice discipline of midwifery in a simulated, virtual environment.
Davis, DL 2010, 'Second life: The development of a virtual birth centre', Celebrating excellence in Midwifery, Royal Hospital for Women, Randwick.
Davis, DL 2010, 'The impact of place on childbirth outcomes in New Zealand', 14th Annual Congress of the Perinatal Society of Australia and New Zealand, Wellington, New Zealand.
Background: In NZ the majority of childbearing women are cared for by midwives who access a variety of birth settings. Over 84% of all births in NZ occur in tertiary or secondary hospitals where midwives report that they struggle to promote normal birth. Method: All low risk women giving birth in 2006-2007 were identified in the Midwifery Maternity Provider Organisation database (n=16,200). Outcomes were compared for those women planning to birth (at onset of labour); at home, in primary, secondary and tertiary level facilities. Results: Outcomes varied significantly between birth settings. The risk of emergency CS was higher for women planning to birth in tertiary (RR 6.12, 95% CI 4.88-7.68) or secondary settings (RR 2.99, 95% CI 2.39-3.75) compared to those planning to birth in a primary facility. Babies born to women planning to birth secondary and tertiary hospitals also had a higher risk of admission to NICU (RR 1.44, 95% CI 1.08-1.91 and RR 1.88, 95% CI 1.39-2.53). Conclusions: For low risk women in the care of midwives, planned place of birth has a significant influence on childbirth outcomes.
Davis, DL, Herbison, P, Baddock, S, Pairman, S, Hunter, M, Benn, C, Wilson, D, Anderson, J & Dixon, L 2010, 'The impact of place on childbirth outcomes in New Zealand', 3rd Biennial Conference: Breathing New Life into Maternity Care, Alice Springs, Australia.
Stewart, S & Davis, DL 2009, 'Using second life to teach students about normal birth', Australian College of Midwives 16th National Conference, Adelaide, Australia.
Davis, DL & Stewart, S 2009, 'Promoting normal birth in the virtual space of Second Life', Normal Labour and Birth: 4th Research Conference, Grange-over-Sands, United Kingdom.
Davis, DL, Pairman, S, McIntosh, C, Hickey, R & Patterson, J 2008, 'Preparing direct entry midwifery students for autonomous, woman centred practice (Symposia)', International Confederation of Midwives 28th Triennial Congress. Midwifery: A worldwide commitment to women and the newborn, Glasgow, Scotland.
Davis, DL 2008, 'Midwives making space for childbirth', International Confederation of Midwives 28th Triennial Congress. Midwifery: A worldwide commitment to women and the newborn., Glasgow, Scotland.
Davis, DL 2008, 'With your feet on the ground and your eyes on the horizon', NSW Midwives Association State Conference: Midwives Business: Peeling Back the Layers, Coffs Harbour, Australia.