Resources Events > NZCOM Journal > Issue 53 > The core of the core: What is at the heart of hospital core midwifery practice in New Zealand?

The core of the core: What is at the heart of hospital core midwifery practice in New Zealand?


Background: New Zealand midwives who are employed by District Health Boards and are based in hospitals and maternity units are known as core midwives. Half of New Zealand midwives are employed as core midwives, performing a variety of key roles and, as such, are central to the functioning of maternity services. The sustainability of core midwifery is therefore highly significant for the future of maternity services in New Zealand. Research on sustainable midwifery practice operates as a constructive counterpoint to the growing literature on burnout and stress amongst midwives.

Aim: The question this study asked is: What sustains midwives who have been in hospital practice in New Zealand for more than eight years? The findings will inform workforce planners, managers and the midwifery profession about what may well contribute to the retention of midwives who are essential to the maternity services provided in hospital settings.

Methods: A qualitative descriptive study was conducted in New Zealand, recruiting and interviewing 22 core midwives with between 8 and 40-plus years’ experience. Interviews were transcribed and thematic analysis was undertaken by the research team. Analysis was done as a group in a reciprocal fashion between the individual interviews and the data as a whole. Themes were clustered into groups and excerpts from the data used to illustrate the agreed themes. Ethical approval was obtained from Auckland University of Technology Ethics Committee.

Findings: This study found that core midwives sustain themselves in practice through developing significant core midwifery skills. Core midwives quickly build a partnership with women; and they are prepared to deal with everything, including unexpected and critical incidents. Core midwives often take on a managerial role in a unit and, as such, create the culture of the unit while supporting students and new graduates, as well as Lead Maternity Carers.

Conclusion: Core midwives highlight the importance of effective relationships with women, whānau, colleagues and managers. Our sample displayed unique and specific skills: connecting quickly with women, anticipating ahead to keep women safe, managing complexity, being prepared for everything, managing a unit and displaying flexibility and adaptability in their work. However, these core midwives feel invisible and undervalued at times, a finding that may well shine much needed light on what threatens sustainability of the core midwifery service nationwide.

Keywords: core midwifery skills, hospital core midwives, sustainable midwifery

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