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Student midwives’ views on maternity care just before their graduation

Authors

  • Liesbeth Van kelst,

    1. Liesbeth Van kelst MSc RN RM
      Midwifery Lecturer
      Center for Health Services and Nursing Research, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium
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  • Bernard Spitz,

    1. Bernard Spitz MD PhD
      Professor of Obstetrics and Gynaecology
      Department of Obstetrics and Gynaecology, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium
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  • Walter Sermeus,

    1. Walter Sermeus PhD RN
      Professor, Programme Director Master in Nursing and Midwifery
      Center for Health Services and Nursing Research, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium
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  • Ann M. Thomson

    1. Ann M. Thomson MSc RM MTD
      Professor (Emerita) of Midwifery
      School of Nursing, Midwifery & Social Work, University of Manchester, UK
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L. Van kelst: e-mail: liesbeth.vankelst@med.kuleuven.be

Abstract

van kelst l., spitz b., sermeus w. & thomson a.m. (2013) Student midwives’ views on maternity care just before their graduation. Journal of Advanced Nursing69(3), 600–609. doi: 10.1111/j.1365-2648.2012.06042.x

Abstract

Aim.  To report a hermeneutic study of student midwives’ views on maternity care just before their graduation.

Background.  Woman-centred care, which is the hallmark of midwifery, is taught to midwifery students around the globe. Woman-centred care is advantageous for women at low obstetric risk. However, adopting this ideology might be a problem for student midwives whose clinical placements are mainly in a medicalized obstetric-led hospital setting.

Design.  A hermeneutic phenomenological study was conducted.

Methods.  In 2010, three focus groups were held where 19 student midwives participated. Data were transcribed verbatim and analysed using van Manen’s approach.

Findings.  The choice for midwifery was a ‘positive’ choice and not the result of an elimination process. Students’ description of a midwife as a coach was in line with the international definition of a midwife. With regard to maternity care, midwifery students identified two types of care, factory-style care and tailored care, both of which were ascribed to caregivers and hospital culture. Furthermore, student midwives made the distinction between hierarchy and teamwork, referring to the professional relations in maternity care. Hierarchy was driven by tradition, it implied that decisions were made top-down, and it resulted in impersonal relations. Midwifery students felt it was unjust that midwives were not allowed to perform deliveries while having the legal autonomy to do so.

Conclusion.  In spite of the medicalized context, midwifery education succeeded in educating midwives who hold a woman-centred ideology. Midwifery students linked style of care to a person rather than to a profession.

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