Speaker: Carolyn McIntosh Master in Midwifery thesis presentation Currently: Rural midwife Midwifery Lecturer Otago New Zealand. Diversity and desires of rural midwifery practice in te Waipounamu
Funding support from Otago Polytechnic research grants
Ethical approval from Otago Polytechnic ethics committee
Qualitative descriptive study
Four focus groups from around the South Island of New Zealand
Outline of presentation
Aims of my study
Diversity of rural practice in NZ
Common experiences of rural midwifery
Some of my study finding related to social learning theory
Communities of practice
Rural networks and what is happening elsewhere
What if anything do we want to do?
Aim of study
To identify how particular groups of rural midwives from around the South Island of New Zealand informed their practice
to discover if they had any issues with informing practice
what they would like to see in the future
Reality of rural midwifery practice in New Zealand
Diverse - no real ‘norm’- evolved and evolving
Local service meets needs of the local community and developed around the service providers in the area.
Local practice groups
Individual midwives or midwives working in pairs
Limited opportunities to meet with other midwives or other health professionals
Commonality in rural practice
Part of a rural community
Always seen in that community as the midwife
Geographically distant from specialist services and learning resources
Need skills to support women birthing at a distance from specialist services
Working with normal
Early recognition of problems
Stabilisation and transfer
Working with women in the community requiring specialist care
(Baird, 2006; Patterson, 2007; Tucker et al, 2005)
Formal study / workshops
Sharing with collegues
On study days
“ The greatest benefit of it for me was sharing things with, other midwives, midwives in a room, partly through not having that, was one of the inspirations for starting to convene these meetings here, I was not really meeting many other midwives otherwise, which is the best way of getting information”
On connecting with colleagues
“ I have to say personally I gain most of my knowledge from my colleagues, from working with more experienced, or highly experienced, other midwives ”
“ Even from team to team we often learn different things from each other, which is good, it’s all knowledge sharing ”
Social learning theory
Social interaction plays a fundamental role in learning.
We learn through modeling others behaviour, attitudes and outcomes of this behaviour.
Learning is embedded within activity, context and culture.
Communities of practice
Lave and Wenger (1991);
understanding the technology of practice is more than learning to use tools; it is a way to connect with the history of the practice and to participate more directly in its cultural life (p.101).
participation in the cultural practice in which any knowledge exists is an epistemological principle of learning. The social structure of this practice, its power relations, and its conditions for legitimacy define possibilities for learning (p.98).
Communities of practice
Communities of practice are groups of people who share a concern or passion for something they do and learn how to do it better as they interact regularly.
Wenger, E. (2008). Communities of practice: a brief introduction. Retrieved May 14 , 2008, from
Researched what was required to maintain confidence and competence in rural maternity.
Established a rural network providing local training and networking for rural midwives. (Tucker et al, 2005)
Rural and remote nurses and midwives forum
Do we need or want something like this?
Contact Carolyn McIntosh [email_address]
Rural midwives inform practice in a variety of ways but prefer to share and acquire new information through communities of practice
Rural midwives have limited opportunities to engage with or develop communities of practice
Online networking may provide new and exciting opportunities to facilitate networks for rural midwives
Links can be forged nationally and internationally
Do we want to establish a rural midwives network in New Zealand?
Bandura, A. (1977). Social learning theory. New Jersey: Prentice Hall
Baird. M. ( 2005). Sustaining rural midwifery practice: New Zealand midwives' experiences. A qualitative descriptive study. Masters of midwifery thesis, Otago Polytchnic, Dunedin.
Lave, J. Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge: Cambridge University Press
Patterson, J. (2007). Rural midwifery and the sense of difference. NZCOM journal . (37) 15-19.
McIntosh, C. (2007). Wise women’s Web: Rural midwives communities of practice. Master of midwifery thesis, Otago Polytechnic, Dunedin.
Tucker, J., Hundley, V., Kiger, A., Bryers, H., Caldow, J., Farmer, J., Harris, F., Ireland, J., Van Teijlingen, E. (2005). Sustainable maternity services in remote and rural Scotland? A qualitative survey of staff views on required skills, competencies and training. Quality and safety in health care . (14) 34-40.
Vgotsky, L., S. (1978). Mind in society (ed. M. Cole, V. John-Steiner, S. Scribner and E. Souberman). Cambridge, MA: Harvard University Press.