How do midwives and obstetricians communicate at the primary/secondary interface?
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Other Title
Authors
Cassie, Rachel
Author ORCID Profiles (clickable)
Degree
Master of Midwifery
Grantor
Otago Polytechnic | Te Pūkenga
Date
2019
Supervisors
Griffiths, Christine
Patterson, Jean
Parker, George
Patterson, Jean
Parker, George
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
midwives
obstetricians
interprofessional communication
safe maternity care
midwifery philosophy
primary-secondary care
obstetricians
interprofessional communication
safe maternity care
midwifery philosophy
primary-secondary care
ANZSRC Field of Research Code (2020)
Citation
Cassie, R. (2019). How do midwives and obstetricians communicate at the primary/secondary interface? [Master's thesis, Otago Polytechnic]. Research Bank. https://doi.org/10.34074/thes.6812
Abstract
Interprofessional communication is a critical component of safe maternity care. The literature reports circumstances in New Zealand and overseas when interprofessional collaboration works well between midwives and obstetricians as well as descriptions of unsatisfactory communication between the two professions. This qualitative research focused on communication between community based LMC (lead maternity carer) midwives and public hospital obstetricians/registrars at a New Zealand District Health Board. The objectives were to define effective collaboration from research participants’ perspective, to identify barriers and challenges to good communication, to generate proposals to foster positive collaboration, and to explore participants’ understanding and use of the Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines). Eight primary care midwives, three obstetricians and two obstetric registrars were interviewed about their interactions at the primary secondary interface and their understanding of and use of the Referral Guidelines. The theoretical perspective was Appreciative Inquiry and data was analysed using thematic analysis. Results indicated usually positive interprofessional interactions. Participants valued the Referral Guidelines but also reported some limitations to their applicability. Dominant themes that emerged were the need to negotiate differing philosophies, to clarify blurred boundaries that sometimes led to lack of clear lines of responsibility, and the importance of three-way conversations. When three-way communication between midwife, obstetrician/registrar and woman occurred effectively, communication was usually optimal. Three-way communication was pivotal in negotiating philosophical difference and clarifying blurred boundaries. The research findings lead to recommendations on promotion of optimal communication.
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CC BY-NC-ND Attribution-NonCommercial-NoDerivs 4.0 International