gms | German Medical Science

Clinical midwives are expert in giving care, and academic midwives are expert in research. The best research will be done when clinicians and researchers collaborate in planning, conducting and disseminating practical research, based on what women want. In 2006, a direct-entry BSc in Midwifery was introduced in Ireland, and all students, and staff, were expected to be able to read, understand and use research findings to ensure care provided was evidence-based. To prepare them for this, all newly-appointed lecturers had to develop their research skills to doctoral level. A strategic plan was instituted over a ten-year period, resulting in 80% of academics progressing to doctoral level. Newly-graduated students are also offered the opportunity to continue on to post-graduate study, where they learn research skills.

The next challenge is to encourage collaborative research between women, clinicians and research staff. Ideas for research can be gathered from focus groups with women, who are, after all, the experts in what care they want. Research can take the form of researchers assisting clinicians to audit their practice, helping with data analysis and writing a paper for publication. Other examples include: researchers interviewing clinicians who have demonstrated excellence in practice, and analysing their statements to find out the best way of giving aspects of care, or clinicians or researchers leading a retrospective study, analysing routine data from a hospital’s database.

Four examples of interesting and useful studies will be presented. The first is a retrospective study that examined episiotomy rates and showed how, with very little educational input, the rates were reduced. The second examines the topic of preserving the perineum intact, presenting data from an interview study of 21 expert midwives, whose average episiotomy rate for primigravid women was 3.9%, with severe tear rates of less than 1.1%. The third example is similar, presenting data from an interview study of 28 expert midwives demonstrating how to conduct a physiological third stage of labour, correctly, resulting in low rates of postpartum haemorrhage without using routine oxytocic drugs. Lastly, ways of auditing practice are explained, which are useful in showing whether changes in services or ways of giving care have been effective.

The methods used are all easy to learn, easy to do, and will serve as a template for clinicians who would like to become involved in research, but are not confident in how to do it. In this way, by using women’s ideas to prioritise research topics, and then by merging researcher knowledge with clinician expertise, useful, practice-based research can be done so that maternity care in local, national and international arenas will be improved.