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Flashcards in Week Three Deck (15):
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Midwife

A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered qualifications to be registered and/or legally licensed to practise midwifery. The international confederation of midwives believes that a midwife offers care based on a philosophy, which influences the model of care.

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Statement of Belief

1. Childbearing is a profound experience, which carries significant meaning to the woman, her family and community.
2. Birth is a normal physiological process.
3. Midwives are the most appropriate care providers to attend women during pregnancy, labour, birth and postnatal period.
4. Midwifery care empowers women to assume responsibility for their health and for the health of their families.
5. Midwifery care takes place in partnership with women and is personalised, continuous and non-authoritarian.
6. Midwifery care combines art and science. Midwifery care is holistic in nature, grounded in an understanding of the social, emotional, cultural, spiritual, psychological and physical experiences of women and based upon the best available evidence.
7. Midwives have confidence and trust in, and respect for women and their capabilities in childbirth.
8. The women is the primary decision-maker in her care and she has the right to information that enhances her decision-making abilities.

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Statement of Belief - Results

1. Midwifery care promotes, protects and supports women's reproductive rights and respects ethnic and cultural diversity.
2. Midwifery practice promotes and advocates for non-intervention in normal childbirth.
3. Midwifery practice builds women's self confidence in handling childbirth.
4. Midwives use technology appropriately and effect referral in a timely manner when problems arise.
5. Midwives offer anticipatory and flexible care.
6. Midwives provide some with appropriate information and advice in a way that promotes participation and facilitates informed decision making.
7. Midwifery care maintains trust and mutual respect between the midwife and the woman.
8. Midwifery care actively promotes and protects women's wellness and enhances the health status of the baby.

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ACM Philosophy

- Midwifery is founded on respect for women and on a strong belief in the value of women's work of bearing and rearing each generation.
- Midwifery considers women in pregnancy, during childbirth and early parenting to be undertaking healthy processes that are profound and and precious events in each woman's life. These events are also seen as inherently important to society as a whole.
- Midwifery is emancipatory because it protects and enhances the health and social status of women, which in turn protects and enhances the health and wellbeing of society.
- Midwifery is a woman centred, political, primary health care discipline founded on the relationships between women and their midwives.

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Midwifery Partnership

A relationship of 'sharing' between the woman and the midwife. Involving trust, shared control and responsibility and shared meaning through mutual understanding.

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Midwifery Partnership Requirements

- Relationship where power imbalances are recognised and addressed.
- Commitment to cultural safety.
- Respect for and recognition for the individuality of each partner.
- Midwife's initiation
- Active participation and communication by both partners
- Understanding of the social context.

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Philosophical Underpinnings of Midwifery

- Midwifery is woman centred
- Midwifery provides continuity of carer
- Midwifery is an independent profession
- Pregnancy & Childbirth are normal life events

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Midwifery is Woman-Centred

- Midwife's primary relationship is with the woman
- Midwifery exists to 'facilitate the optimal birth experience for the women and their families'
- Acknowledges the vital role of and connection with family and community

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Midwifery provides Continuity of Carer

- Allows midwives to work in their full scope of practice
- Facilitates the building of trust and partnership
- Time for information sharing, thinking and decision making
- One midwife providing care throughout pregnancy, labour and beyond

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Midwifery is an Independent Profession

- Involves autonomous practice
- Informed by evidence
- Assuming responsibility for judgements and actions
- Pertains to the way the midwife sees his/her role
- Does NOT mean working in isolation

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Pregnancy & Childbirth are normal Life Events

- Foundation of midwifery knowledge
- Midwife's role to protect and trust the physiological process
- Main difference between midwifery and medical model of care

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Reflective Practice

Throwing back of thoughts and memories, in cognitive acts such as thinking, contemplation, mediation and any other form of attentive consideration, in order to make sense of them, and to make contextually appropriate changes if they are required.

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Why Reflect?

- Source of Midwifery knowledge
- Self-development and awareness
- Allows you to 'make sense' of experiences
- Facilitates ability to develop strategies for practice improvement
- Allows you to identify what you do well
- Develops critical thinking skills
- Enhances decision making
- Provides fresh insights
- The ANMC expects all professional midwives practice reflectively and ethically
- All midwives face daily issues in their practice which can be helped using effective reflective practice
~ Daily habits and routine
~ Ideal vs. Real practice
~ Self-blaming
~ Wanting to be perfect
~ Struggling to be assertive
~ Struggling to be an advocate
~ Relationships with colleagues
~ Relationships with women and families
~ Organisational issues

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Reflection in Practice

- Not introspective
- About adapting to change and enhancing practice

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Methods of Reflecting

- Writing
- Audiotaping
- Creative
- Talking to a 'critical friend'