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Supporting midwife-led care through action research: A tale of mess, muddle and birth balls

Deery, Ruth and Hughes, Deborah (2004) Supporting midwife-led care through action research: A tale of mess, muddle and birth balls. Evidence based midwifery, 2 (2). pp. 52-58. ISSN 1479-4489

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Aim. To explore the processes and outcomes of an action research project undertaken to support midwife-led care in a
maternity unit in the north of England.
Objectives. To identify changes in care given by midwives, to offer developmental opportunities to midwives to support the
continuation of a midwife-led ethos and to examine the process of cultural shift created by relocation to shared facilities.
Method. Action research, with its emphasis on collaboration and participation, was considered an appropriate approach,
because it facilitates understanding of, and is able to adapt to, changing situations within clinical practice. A variety of
data-gathering methods, including telephone interviews, personal construct analysis and observation, were used to explore
and consolidate midwife-led care in one setting during a time of transition.
Findings/results. Key weaknesses were identified within a midwife-led unit (MLU) and actions agreed and taken to address
these, with a resulting strengthening of midwife-led care. The reflective process, an integral part of action research, fostered
a shared concept of midwife-led care and an expanded skill-base for the facilitation of physiological childbirth.
Implications. Action research can stimulate change and development within a midwifery context providing common values
are identified and participation is realised. Although the methodology can be complex, it has the potential to clarify and
solve problems within a specific clinical context.

Item Type: Article
Additional Information: Reproduced by permission of Evidence Based Midwifery, published by Ten Alps Publishing on behalf of the Royal College of Midwives. © 2004 The royal college of midwives,
Uncontrolled Keywords: Action research, midwifery, participation, collaboration, values, change, practice-development, midwife-led care
Subjects: R Medicine > R Medicine (General)
R Medicine > RG Gynecology and obstetrics
Schools: School of Human and Health Sciences
School of Human and Health Sciences > Centre for Applied Childhood Studies

Atkinson S. (1994) Rethinking the principles and practice of action
research: the tensions for the teacher-researcher. Educational Action
Research 2(3): 383-401.
Burnard P. (1991) A method of analysing interview transcripts in qualitative
research. Nurse Education Today 11: 464-6.
Cook T. (1998) The importance of mess in action research. Educational
Action Research 6(1): 93-108.
Deery R. (2003) Engaging with clinical supervision in a community
midwifery setting: an action research study. Unpublished PhD thesis.
University of Sheffield, UK.
Deery R, Hughes D, Lovatt A, Topping A. (1999) Hearing midwives’
views: focus groups on maternity care in Calderdale NHS Trust.
Unpublished report. Primary care research group, University of
Deery R, Kirkham M. (2000) Moving from hierarchy to collaboration:
the birth of an action research project. Practising Midwife
Department of Health. (1993) Changing childbirth: report of the expert
maternity group (Cumberlege report). HMSO: London.
Department of Health. (1996a) In the patient’s interest. Multi-professional
working across organisational boundaries: a report by the
standing medical and nursing and midwifery advisory committee.
HMSO: London.
Department of Health. (1996b) Patient partnership: building a collaborative
strategy. NHS Executive: London.
Department of Health. (2001) Research governance for health and
social care. HMSO: London.
Downe S. (2001) Is there a future for normal birth? Practising Midwife
4(6): 10-2.
Edwards R, Ribbens J. (1998) Living on the edges: public knowledge,
private lives, personal experience: In: Feminist dilemmas in qualitative
research: public knowledge and private lives. Sage: London:
Elliot J. (1991) Action research for educational change: developing
teachers and teaching. Open University Press: Buckingham.
Fraser D. (2000) Action research to improve the pre-registration
midwifery curriculum – part one: an appropriate methodology.
Midwifery 16: 213-23.
Grbich C. (1999) Qualitative research in health: an introduction.
Sage: London.
Hart E, Bond M. (1995) Action research for health and social care: a
guide to practice. Open University Press: Buckingham.
Henderson C. (1997) ‘Changing childbirth’ and the West Midlands
region 1995 to 1996. RCM: London.
Holloway W, Jefferson T. (2002) Doing qualitative research differently:
free association, narrative and the interview method. Sage: London.
Hughes D, Deery R, Lovatt A. (2002) A critical ethnographic approach
to facilitating cultural shift in midwifery. Midwifery 18: 43-52.
Hughes D, Deery R. (2002) Where’s the midwifery in midwife-led care?
Practising Midwife 5(7): 18-9.
International Confederation of Midwives. (2002) Proceedings of the
26th triennial congress. International Confederation of Midwives:
Jones O, Walker J. (2003) From concept to reality: developing a
working model of a stand-alone birth centre: In: Kirkham M. (Ed.).
Birth centres: a social model for maternity care. Elsevier Science:
Kirkham M, Stapleton H. (2000) Midwives’ support needs as childbirth
changes. Journal of Advanced Nursing 32(2): 465-72.
Kirkham M. (2003) Birth centres as an enabling culture: In: Kirkham
M. (Ed.). Birth centres: a social model for maternity care. Elsevier
Science: Oxford.
Kitzinger S. (1998) Letter from Europe: the caesarean epidemic in Great
Britain. Birth 25(1): 56-8.
Lipsky M. (1980) Street-level bureaucracy: dilemmas of the individual in
public services. Russell Sage Foundation: New York.
Lomax P. (1995) Action research for professional practice. British
Journal of In-Service Education 21(1): 1-9.
McNiff J. (1988) Action research: principles and practice (first edition).
Routledge: London.
McNiff J, Lomax P, Whitehead J. (1996) You and your action research
project. Routledge: London.
McNiff J. (2002) Action research: principles and practice (second
edition). Routledge/Falmer, Taylor Francis Group: London.
Mellor N. (1998) Notes from a method. Educational Action Research
6(3): 453-70.
Munro J, Ford H, Scott A, Furnival E, Andrews S, Grayson A. (2002)
Action research project responding to midwives’ views of different
methods of fetal monitoring in labour. MIDIRS Midwifery Digest
12(4): 495-8.
Murphy-Lawless J. (1998) On reading birth and death. Cork University
Press: Ireland.
Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. (2001) Early
maternal and neonatal morbidity associated with operative delivery
in second stage of labour: a cohort study. The Lancet 358: 1203-7.
Nolan M. (2001) Midwife-led units: a natural home for childbirth?
Practising Midwife 4(9): 22-3.
Oakley A. (1993) Essays on women, medicine and health. Edinburgh
University Press: Edinburgh.
Oakley A. (2000) Experiments in knowing: gender and method in the
social sciences. Polity Press: London.
Odent M. (1992) The nature of birth and breastfeeding. Bergin and
Garvey: London.
Page LA. (2000) The new midwifery, science and sensitivity in practice.
Churchill Livingstone: London.
Paranjothy S, Thomas J. (2001) National sentinel caesarean section
audit report: RCOG clinical effectiveness support unit. RCOG
Press: London.
RCM. (2000) Vision 2000. RCM: London.
Reed J, Procter S. (1995) Practitioner research in health care: the inside
story. Chapman and Hall: London.
Robson C. (2001) Real world research: a resource for social scientists
and practitioner-researchers. Blackwell Publishers: London.
Rowe-Murray HJ, Fisher JRW. (2001) Operative intervention in delivery
is associated with compromised early mother-infant interaction.
British Journal of Obstetrics and Gynaecology 108: 1068-75.
Sandall J. (1998) Occupational burnout in midwives: new ways of
working and the relationship between organisational factors and
psychological health and wellbeing. Risk Decision and Policy 3(3):
Schön DA. (1983) The reflective practitioner. Aldershot: Avebury.
Stringer E. (1996) Action research – a handbook for practitioners. Sage:
Sutton J, Scott P. (1996) Understanding and teaching optimal fetal positioning.
Birth Concepts: Tauranga.
Sutton J. (2002) Reclaiming and rediscovering our heritage. Butterworth
Heinemann: London.
Tew M. (1998) Safer childbirth? A critical history of maternity care.
Free Association Books: London.
Walker J. (1996) Interim evaluation of a midwifery development unit.
Midwives 109(1305): 266-70.
Waterman H, Tillen D, Dickson R, de Koning K. (2001) Action
research: a systematic review and guidance for assessment. Health
Technology Assessment 5(23): iii-157.
Winter R, Munn-Giddings C. (2001) A handbook for action research in
health and social care. Routledge: London.

Depositing User: Sara Taylor
Date Deposited: 02 Mar 2007
Last Modified: 19 Dec 2016 08:34


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