Recent Question/Assignment

Verbal Assessment guide:
Key
(1) Citation- include this in your group’s bibliography in alphabetical order.
(2) Introduction- briefly describe the research area and the researchers.
(3) Aims & Research methods- state if the research is qualitative or quantitative, mixed methods or Kaupapa Maori, and briefly outline the methods.
(4) Scope- where was the research caried out and for how long?
(5) Usefulness - Link the research to the narrative and your particular topic.
(6) Limitations- every article states their limitations near the end, for a higher mark you may add some of your own that relate to Cultural Safety or Continuity of Care so you can tie it to (8) your reflection.
(7) Conclusions- this should be brief; the abstract is useful for this.
(8) Reflection- This is the main component and should be about 250 words. Comment on how this research considers Continuity of Care as a strategy to uphold quality and safety and integrates Cultural Safety. The research may do this well, or not do this at all. If the article does not do this, you may want to briefly explain why Continuity of Care is important to quality and safety and now Cultural Safety could have been considered more fully.
NB 1-7 should be between 250 words. 8 should be about 250 words.
EXAMPLE TEXT FOR THE VERBAL ASSESSMENT (APPROX 500 words depending on your delivery)
(1) Sweet, L., Wynter, K., O'Driscoll, K., Blums, T., Nenke, A., Sommeling, M., Kolar, R. and Teale, G. (2022), Ten years of a publicly funded homebirth service in Victoria: Maternal and neonatal outcomes. Aust N Z J Obstet Gynaecol, 62: 664-673. https://doi.org/10.1111/ajo.13518
(2) This is an article by an Australian midwife Linda Sweet and seven other researchers considering homebirth outcomes for low-risk women. Homebirths are less than 0.3% of all births in Australia.
(3) This is quantitative research. The authors report on six maternal and six neonatal outcomes and compare them to hospital birth outcomes. ?2 tests were conducted to compare categorical outcomes; non-parametric tests (Mann-Whitney U or Kruskal Wallis) were used to compare continuous outcomes. Statistical significance was set at P 0.001.23
(4) This research examines ten years of a publicly funded homebirth service, 2009–2019 at Western Health
(5) Jonelle’s narrative made me curious about the comparative safety of homebirth compared to hospital birth and this article gives some information about this question. This article found the homebirth group were significantly more likely to have a normal vaginal birth and an intact perineum, less likely to require suturing and less likely to have blood loss of more than 500mL. Infants born at home were significantly less likely to require resuscitation, more likely to be of normal birthweight and exclusively receive breastmilk on discharge. There were no maternal deaths and one neonatal death of a baby born at home in water before the arrival of a midwife.
(6) This article is from Australia, so it is not necessarily transferrable to New Zealand homebirth context. This article also reports there was a significant amount of missing data. The research only included 1.3% Indigenous homebirth whanau and the remaining 98.7% were not considered by ethnicity.
(7) The findings suggest that the right people are being supported to labour and birth at home and that a publicly funded homebirth program, with appropriate governance and clinical guidelines, appears to be a safe option for women experiencing low-risk pregnancies.
(8) This research acknowledges that the midwifery-led Continuity of Care (CoC) model provides a high level of job control, flexible working arrangements, supportive work partnerships and one-to-one care with women and their support people, greater job satisfaction and lower burnout rates than standard midwifery care. The homebirth service is embedded in a CoC model. This model of care probably may have improved the quality and safety of the service because when women become ineligible, due to a risk factor, they can discuss and change their plan of care in a timely manner. They may leave the homebirth service, but still receive CoC. This also allowed the researchers to track outcomes for not only those who birthed at home, but those women seeking homebirth and not achieving it without CoC becoming a confounding factor.
Despite the large sample size, only 1.3% of the participants identified as Aboriginal and/or Torres Strait Islander. The remaining sample (98.7%) were simply reported as Non-Aboriginal and/or Torres Strait Islander. There was no discussion about Cultural Safety in relation to the number of Indigenous people eligible compared to the number of Indigenous people choosing homebirth. There was no discussion about accessibility or barriers to Indigenous people or the availability of Indigenous midwifery services and there was no comparison of homebirth rates by other ethnicities. More thorough data collection would allow for more practice reasoning to inform ways CoC could be provided equitably. (529 words)

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