A critical ethnographic approach to facilitating cultural shift in midwifery

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

“…36,39 It is imperative that organisations review postnatal protocols and that more midwives are included in developing strategies to assist them to provide optimal care. 40,46 There is a need to actively generate a midwifery culture that is supportive, acknowledges the difficulties and is willing to find solutions together. 39,40 It would be beneficial to more fully explore this concept of grief associated with organisational change, and the ongoing implication for midwifery practice in Australia.…”

“…38,39 The words 'grief' and 'disappointment' have been used to describe the emotional response of midwives to organisational change. 35,39,40 In this study, the midwives were described as 'angry' and 'resentful'. Interestingly, these emotions are often identified as part of the continuum experienced by individuals encountering loss and grief.…”

“…42 Similar responses have been noted from midwives to institutional changes, particularly regarding the model of early discharge. 35,39,40,44 Midwives have responded with frustration and anger towards reduced time available to provide postnatal care. There has been chaos as midwives have tried to fit previous routines and methods into condensed timeframes.…”

Professionalism and person-centredness: developing a practice-based approach to leadership within NHS maternity services in the UK

“…Previous research experiences have shown that critical ethnography can provide useful insights into the cultural phenomena within a maternity setting, where power, hegemony and organisational operation play such important roles (Dykes, 2005;Hughes, Deery & Lovatt, 2002;Rayment, 2011). Thus, critical ethnography can be understood as studying a culture in order to find an alternative and therefore seeks to identify how oppressive situations are (re)produced and reified within a research setting (Hammersley & Atkinson, 2007).…”

“…At the time the study was undertaken the well-established midwife-led unit was located alongside the obstetric unit. A number of practice developments had been implemented at Site A, largely to promote midwife-led care, which had resulted in a diversification of care and the options available to childbearing women (Hughes et al 2002;Deery and Hughes 2004). Site B had a newly established unit for midwife-led care that operated alongside the obstetric unit.…”