‘Living the rural experience-preparation for practice’: The future proofing of sustainable rural midwifery practice through midwifery education

Abstract

Rural practice presents unique challenges and skill requirements for midwives. New Zealand and Scotland face similar challenges in sustaining a rural midwifery workforce. This paper draws from an international multi-centre study exploring rural midwifery to focus on the education needs of student midwives within pre-registration midwifery programmes in order to determine appropriate preparation for rural practice. The mixed-methods study was conducted with 222 midwives working in rural areas in New Zealand (n = 145) and Scotland (n = 77). Midwives' views were gathered through an anonymous online survey and online discussion forums. Descriptive analysis was used for quantitative data and thematic analysis was conducted with qualitative data. 'Future proofing rural midwifery practice' using education was identified as the overarching central theme in ensuring the sustainability of rural midwives, with two associated principle themes emerging (i) 'preparation for rural practice' and (ii) 'living the experience and seeing the reality'. The majority of participants agreed that pre-registration midwifery programmes should include a rural placement for students and rural-specific education with educational input from rural midwives. This study provides insight into how best to prepare midwives for rural practice within pre-registration midwifery education, in order to meet the needs of midwives and families in the rural context.

Addressing a need. Holistic midwifery in the Netherlands: A qualitative analysis

“…This is in accordance with the findings of Jefford and Jomeen [44], who report that independent midwives in the UK spoke of feeling ‘out on a limb’ and of ‘being blamed’ for women’s refusals, and of Symon et al [40], who found that hospitals did not respect holistic midwives’ expertise. This theme of difficulty working with other providers in the chain of maternity care can also be found in the work of Kensington et al [45] and Crowther and Smythe [46] among midwives in rural practices in New Zealand and Scotland. In addition, as Crowther et al found, in case of a bad outcome, midwives can fear the notoriety that may accompany being identified as the midwife who ‘was responsible for’ a dead baby [47].…”

Investigating first‐year graduate paramedics’ reason for current work location: A cross‐sectional, data linkage study

“…Studies from other health professions have outlined the influence of various factors on graduate work location, [9][10][11][12][13][14][15] whilst this study additionally focuses on the subjective influences on workplace choice. To the authors' best knowledge, this is the first study to examine these factors concerning paramedicine in Australia and seeks to illustrate the juxtaposition of factors between paramedicine and other health professions.…”

“…Studies from health professions other than paramedicine have outlined the influence of various factors on graduate work location. The literature reports strong evidence for the positive impact of rural background, 9,10 rural education, 11,12 rural placements 11,13,14 and mentorship 9,15 towards promoting rural practice amongst medical, nursing and allied health graduates. In one Australian study, allied health graduates of rural origin were 2.4 times more likely to be practising in a rural location one year after graduating than those of a metropolitan background 10 .…”

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“…The research team reached a consensus on the final template of themes following three faceto-face meetings and regular virtual meetings. These themes have been reported on elsewhere (Crowther et al, 2019;Kensington et al, 2018). Subsequently, two regional focused articles have been written, the first specifically focusing on the Scottish rural midwives' data (Crowther et al, 2020) and this article, which focuses specifically on the New Zealand rural midwives' data.…”