Fox, D., Sheehan, A. & Homer, C. 2018, 'Birthplace in Australia: Processes and interactions during the intrapartum transfer of women from planned homebirth to hospital.', Midwifery, vol. 57, pp. 18-25.View/Download from: UTS OPUS or Publisher's site
the aim of the study was to explore the views and experiences of women, midwives and obstetricians on the intrapartum transfer of women from planned homebirth to hospital in Australia.a Constructivist Grounded Theory approach was taken, to conceptualise the social interactions and processes grounded in the data.urban and regional areas in four states of south-eastern Australia.semi-structured qualitative interviews were conducted with 36 women, midwives and obstetricians who had experienced an intrapartum homebirth transfer within three years prior to the interview. Interviews were audio recorded and transcribed verbatim.women who were transferred to hospital from a planned homebirth made physical and psychological journeys out of their comfort zone, as they faced the uncertainty of changing expectations for their birth. The trusting relationship between a woman and her homebirth midwife was crucial to women's sense of safety and well-being in hospital. Midwives and obstetricians, when congregating in the hospital birthing rooms of transferred women, also felt out of their comfort zones. This was due to the challenges of converging with others who possessed conflicting paradigms of safety and risk in birth that were at odds with their own, and adapting to different routines, roles and responsibilities. These differences were derived from diverse professional, social and personal influences and often manifested in stereotyping behaviours and 'us and them' dynamics. When midwife-woman partnerships were respected as an inclusive part of women's care, collaboration ensued, conflict was ameliorated, and smooth transfers could be celebrated as successes of the maternity care system.supporting woman centred care in homebirth transfers means acknowledging the social challenges of collaborating in the unique context of a transferred woman's hospital birthing room. Understanding the power of the midwife-woman partnership, and its value to the health and well-being of each ...
Hogan, R., Fox, D. & Barratt-See, G. 2017, 'Peer to peer mentoring: Outcomes of third-year midwifery students mentoring first-year students.', Women and birth : journal of the Australian College of Midwives, vol. 30, no. 3, pp. 206-213.View/Download from: Publisher's site
Undergraduate midwifery students commonly experience anxiety in relation to their first clinical placement.A peer mentoring program for midwifery students was implemented in an urban Australian university. The participants were first-year mentee and third-year mentor students studying a three-year Bachelor degree in midwifery. The program offered peer support to first-year midwifery students who had little or no previous exposure to hospital clinical settings. Mentors received the opportunity to develop mentoring and leadership skills.The aim was to explore the benefits, if any, of a peer mentoring program for midwifery students.The peer mentoring program was implemented in 2012. Sixty-three peer mentors and 170 mentees participated over three academic years. Surveys were distributed at the end of each academic year. Quantitative survey data were analysed descriptively and qualitative survey data were analysed thematically using NVivo 10 software.Over 80% of mentors and mentees felt that the program helped mentees adjust to their midwifery clinical placement. At least 75% of mentors benefited, in developing their communication, mentoring and leadership skills. Three themes emerged from the qualitative data, including 'Receiving start-up advice'; 'Knowing she was there' and 'Wanting more face to face time'.There is a paucity of literature on midwifery student peer mentoring. The findings of this program demonstrate the value of peer support for mentees and adds knowledge about the mentor experience for undergraduate midwifery students.The peer mentor program was of benefit to the majority of midwifery students.
Hogan, R., Orr, F., Fox, D., Cummins, A. & Foureur, M. 2017, 'Developing nursing and midwifery students' capacity for coping with bullying and aggression in clinical settings: Students' evaluation of a learning resource.', Nurse education in practice, vol. 29, pp. 89-94.View/Download from: UTS OPUS or Publisher's site
An innovative blended learning resource for undergraduate nursing and midwifery students was developed in a large urban Australian university, following a number of concerning reports by students on their experiences of bullying and aggression in clinical settings. The blended learning resource included interactive online learning modules, comprising film clips of realistic clinical scenarios, related readings, and reflective questions, followed by in-class role-play practice of effective responses to bullying and aggression. On completion of the blended learning resource 210 participants completed an anonymous survey (65.2% response rate). Qualitative data was collected and a thematic analysis of the participants' responses revealed the following themes: 'Engaging with the blended learning resource'; 'Responding to bullying' and 'Responding to aggression'. We assert that developing nursing and midwifery students' capacity to effectively respond to aggression and bullying, using a self-paced blended learning resource, provides a solution to managing some of the demands of the clinical setting. The blended learning resource, whereby nursing and midwifery students were introduced to realistic portrayals of bullying and aggression in clinical settings, developed their repertoire of effective responding and coping skills for use in their professional practice.
Catling, C., Hogan, R., Fox, D., Cummins, A., Kelly, M. & Sheehan, A. 2016, 'Simulation workshops with first year midwifery students.', Nurse Education in Practice, vol. 17, pp. 109-115.View/Download from: UTS OPUS or Publisher's site
Simulated teaching methods enable a safe learning environment that are structured, constructive and reflective. We prepared a 2-day simulation project to help prepare students for their first clinical practice. A quasi-experimental pre-test - post-test design was conducted. Qualitative data from the open-ended survey questions were analysed using content analysis. Confidence intervals and p-values were calculated to demonstrate the changes in participants' levels of understanding/ability or confidence in clinical midwifery skills included in the simulation. 71 midwifery students participated. Students rated their understanding, confidence, and abilities as higher after the simulation workshop, and higher still after their clinical experience. There were five main themes arising from the qualitative data: having a learning experience, building confidence, identifying learning needs, developing communication skills and putting skills into practise. First year midwifery students felt well prepared for the clinical workplace following the simulation workshops. Self-rated understanding, confidence and abilities in clinical midwifery skills were significantly higher following consolidation during clinical placement. Longitudinal studies on the relationship between simulation activities and student's overall clinical experience, their intentions to remain in midwifery, and facility feedback, would be desirable.
Fox, D., Sheehan, A. & Homer, C.S. 2014, 'Experiences of Women Planning a Home Birth Who Require Intrapartum Transfer to Hospital: A Metasynthesis of the Qualitative Literature', International Journal of Childbirth, vol. 4, no. 2, pp. 103-119.View/Download from: UTS OPUS or Publisher's site
Recent evidence supports the safety of planned home birth for low-risk women when professional midwifery care and adequate collaborative arrangements for referral and transfer are in place. The purpose of this article is to synthesize the qualitative literature on the experiences of women planning a home birth, who are subsequently transferred from home to hospital.
Fox, D. 2013, 'Diffusion of Innovation theory made easy—An introductory workshop', Women and Birth, vol. 26, pp. S42-S43.
Fox, D., Lina, C., Kelly, E.R.T., Raes, A., Rooslee, S.I., Keing, P.S. & Seng, C.Y. 2013, 'One to one midwifery in Singapore: The first 100 births', British Journal of Midwifery, vol. 21, no. 10, pp. 701-707.View/Download from: UTS OPUS or Publisher's site
The Enhanced Midwifery Maternity Care (EMMa Care) programme at the National University Hospital in Singapore was implemented in 2011 to provide women with primary obstetric care in collaboration with one-to-one midwifery support. The continuity of care women are able to access from both an obstetrician and a midwife provides a unique opportunity for women and babies to benefit from both obstetric expertise and holistic midwifery care. This article describes the development of the programme, and the outcomes of the births of the first 100 women who booked. Sixty women were primiparous and 40 were multiparous. Birth outcome data demonstrated a caesarean rate of 20% and seven out of nine vaginal birth after caesarean (VBAC) attempts were successful (77.77% success rate). Of the women birthing vaginally, 81.33% did so without any pharmacological pain management; 58 women used water immersion in labour and 36 birthed their babies in water. There were no third or fourth degree perineal tears, no postpartum haemorrhages and the episiotomy rate was 4%. Apgar scores were above 7 at 5 minutes in all but one baby; five babies required phototherapy for hyperbilirubinemia and eight babies (including one set of twins) were admitted to the neonatal intensive care unit (NICU) for hypoglycaemia and/or prematurity. EMMa Care is associated with good maternal and neonatal outcomes. Caesarean section rates were lower than overall rates in the same hospital setting and use of pharmacological pain management was minimal.
Fox, D., Lina, C., Ting Kelly, E.L., Raes, A., Ihdinaa Rooslee, S., Siew Keing, P. & Yap Seng, C. 2013, 'One-to-one midwifery care in Singapore – the first 100 births', British Journal of Midwifery, vol. 21, no. 10, pp. 701-707.View/Download from: Publisher's site
Fox, D., Sheehan, A. & Homer, C. 2013, 'Views and experiences of women planning a home birth who subsequently require transfer to hospital: A meta-synthesis of the qualitative literature', WOMEN AND BIRTH, vol. 26, no. 1, pp. S29-S29.View/Download from: Publisher's site
Fox, D., Sheehan, A. & Homer, C. 2017, 'Birthplace in Australia: Processes of referral and transfer from planned homebirth to hospital', 15th World Congress on Public Health, Melbourne.View/Download from: UTS OPUS
Fox, D., Sheehan, A. & Homer, C. 2017, 'Birthplace in Australia: Supporting woman centred care in homebirth transfer.', International Confederation of Midwives Congress, Toronto Canada.View/Download from: UTS OPUS
Fox, D., Sheehan, A. & Homer, C. 2016, 'Birthplace in Australia: Qualitative perspectives on intrapartum transfer from planned homebirth to hospital', Canadian Association of Midwives 16th Annual Conference, Victoria, British Columbia, Canada.View/Download from: UTS OPUS
Fox, D., Denney-Wilson, E. & Laws, R. 2016, Breastfeeding content for pregnancy section of 'My Baby Now' app, using breastfeeding promotion as a strategy to reduce childhood overweight and obesity. Collaboration between Deakin University and UTS., Online.
Fox, D. 2017, 'Transfer from planned homebirth to hospital: views and experiences of women, midwives and obstetricians'.
Recent evidence supports the safety of planned homebirth for low risk women when professional midwifery care and adequate collaborative arrangements for referral and transfer are in place. Much is known about rates of transfer, but little is known about the experiences of the women and caregivers involved.
The aim was to explore the views and experiences of women, midwives and obstetricians involved in the intrapartum transfer of women from planned homebirth to hospital in the Australian context.
Thirty-six semi-structured interviews were conducted with women, midwives and obstetricians. A constructivist grounded theory approach was taken to enable exploration of the social interactions and processes that occurred.
Four categories emerged from the analysis, 'Fostering relationships and reducing uncertainty', 'Transferring out of the comfort zone', 'Us and them' and 'Celebrating a successful transfer'. The grounded theory, 'Supporting woman centred care in homebirth transfer', was synthesised by integrating findings grounded in the data with theoretical codes gained from intergroup conflict theory.
Effective strategies of collaboration included mutual respect, supporting the midwife-woman partnership and regarding the transfer as a success of the system rather than a 'failed homebirth'. The goal of a 'healthy mother and a healthy baby' was ostensibly shared by women and caregivers, however, arriving at a common definition of a 'healthy mother and a healthy baby' was less straightforward, due to the different paradigms of childbearing that converged on the birthing room of a transferred woman.
From the perspectives of Australian law, healthcare policy and human rights, the woman is the only person with the authority to make informed decisions for the health and well-being of herself and her baby. Women's personal definitions of 'healthy' are made in the context of their individual parameters of risk and safety, encom...