This assignment will aim to discuss the implementation of water births as an area of change within the midwifery profession. The subject of water births as been chosen for this assignment, following discussion within local practice and the controversial views of birthing pools that midwives seem to have. The Lewin (1951) change theory model has been used as a framework to build this assignment on, discussing areas of change within each of the stages suggested by Lewin (1951). Driving forces and restraining forces have been analyzed and areas for change suggested. Professional responsibilities of the midwife have been addressed and analyzed along with Government and local trust policies and procedures. Ethical issues have been discussed relating back to the midwives responsibilities when implementing an area of change such as water births.
[...] (1994) Water births the legal implications for midwives Modern Midwife January Page 13 English National Board (1999) Advice and Guidance to local supervising authorities and supervisors of midwives ENB London Garland D. and Jones K. (2000) Water births: Supporting practice and clinical audit Midirs Midwifery Digest 10 page 333-6 Hein E (1994) Contemporary Leadership Behaviors (5th Edition) Philadelphia Lippincott Raven Publishers Kirkham M. (2000) Development of the Supervision of Midwives Manchester Midwives Press Kitzinger S. (1980) Pregnancy and Childbirth Harmondsworth Penguin Press La Monica E.L. [...]
[...] These articles alone would give midwives an insight into the patient's perspective of water births and how birthing pools could be implemented considering professional and organizational requirements. According to Lewin (1951) the phase known as ‘unfreezing' occurs when driving forces exceed restraining forces and an individual perceives the need for change. Diseqilibrium can occur within this system. In order for driving forces to be stronger than restraining forces then Change Agent' the person who wishes to implement the change needs to consider many factors. [...]
[...] If a midwife does not feel competent in the area of water births she needs to say so before she assumes the task. If this area is left undressed by the change agent, then problem could arise once water births have been implemented, for example not having enough knowledgeable, competent staff to care for the laboring mother in a birthing pool and having to decline the woman the choice of using the birthing pool, which could prove to be both unprofessional and embarrassing. [...]
[...] Looking at strengths for water births could include the maternal benefits as discussed earlier, providing a service that woman can have access to if required, giving the woman freedom of choice and control. Some of the weaknesses may include issues focused upon by the change subjects such as media coverage on neonatal inhalation of water and death, Laurance (1993), staff back injuries, the cost involved in purchasing and locating a birthing pool. Opportunities may include locating a birthing pool in a midwifery led care unit enabling staff to extend their midwifery skills and promote normality. [...]
[...] Some areas relating to water births that need to be considered could be: - professional expertise, this may include looking at the education and training needs of staff. This could be through midwifery supervision, with the assistance of the Local Supervisors Authority (LSA). The ENB (1999) states that the duties of the LSA Officer are to ensure that there are ‘comprehensive education and training opportunities available for all midwives and supervisors of midwives'. Other areas to consider could be equipment, Health and Safety Regulations, i.e. [...]
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