Women and Birth
Volume 22, Issue 4 , Pages 112-118, December 2009

Encountering the culture of midwifery practice on the postnatal ward during Action Research: An impediment to change

  • Lois McKellar

      Affiliations

    • School of Population Health and Clinical Practice, The University of Adelaide, Australia
    • School of Nursing and Midwifery, University of South Australia, Australia
    • Corresponding Author InformationCorresponding author at: Discipline of Nursing, School of Population Health and Clinical Practice, Level 3, Eleanor Harrald Building, The University of Adelaide, SA 5000, Australia. Tel.: +61 8 8303 3866; fax: +61 8 8303 3594.
    • ,
  • Jan Pincombe

      Affiliations

    • School of Nursing and Midwifery, University of South Australia, Australia
    • ,
  • Ann Henderson

      Affiliations

    • Centre for Continuing Education, Children, Youth & Women's Health Service, Australia

Received 22 December 2008; received in revised form 12 February 2009; accepted 12 February 2009.

Summary 

Background

The reduction of time available to midwives during the hospital postnatal stay suggests that there is a need to review postnatal care. Innovative strategies are required which give attention to specific family needs and assist in the transition to parenthood. Nevertheless, new ideas and changes are not always readily accepted in midwifery practice.

Aim

To enhance the provision of postnatal care to parents in the early postnatal period given time constraints for parents’ hospital stay.

Methods

Action research was employed to explore the educational experiences of parents in the postnatal period. An action research group (ARG) was established, comprising predominantly of midwives. Based on data collected from parents through questionnaires, focus groups and interviews, three actions were developed and implemented on a postnatal ward.

Results

The actions were evaluated by 122 parents through self-report questionnaires. Midwives working on the postnatal ward and midwives involved in the ARG provided feedback regarding the actions through separate focus group discussions. The parents who participated in the study and, the midwives involved in the ARG, were positive about the actions and perceived them to be beneficial in preparing parents for parenthood. Many of the ward midwives, however, were negative about the actions and questioned their benefit for midwifery practice.

Discussion

The negativity of the ward midwives regarding the innovations implemented in the study contrasted strikingly with the positive responses from both parents and the action research midwives. Two themes emerged which may explain the response of midwives to the actions, notably, a lack of ownership of the actions and the problematic nature of the current culture of the postnatal-care environment.

Conclusion

It appears that the provision of hospital postnatal care has been influenced by an underlying culture in midwifery practice, which in turn, has impeded the change required to enhance postnatal care.

Keywords: Midwifery, Postnatal care, Action research, Institutional change, Midwifery culture

 

PII: S1871-5192(09)00028-6

doi:10.1016/j.wombi.2009.02.003

Women and Birth
Volume 22, Issue 4 , Pages 112-118, December 2009

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