MIDW351 - Global Perspectives on Midwifery

Year

Credit points

Campus offering

Prerequisites

MIDW200 Clinical Midwifery Practice 2 OR MIDW213 Midwifery Professional Practice 3

Unit rationale, description and aim

Midwifery is a recognised global profession, aligned with principles of primary health care and public health. To fulfill their role effectively and inclusively, midwives need to be able to establish culturally safe partnerships with women and families from various backgrounds and contexts, and recognise relevant maternal health priorities. [ANMAC 3.5b; 3.9a]

To prepare you so that you may successfully do this once you graduate, you need to develop insights and knowledge into diverse cultural, social, political and international contexts and influences on maternal health, including respect for other ways of knowing.

Building upon earlier learnings from previous units, in this unit you will further develop your knowledge about the midwife’s role in primary health care and the provision of culturally safe midwifery care both in local and global contexts. As well, you will further describe the ACU community engagement principles as they relate to midwifery care.

You will identify common causes of global maternal mortality and morbidity, analyse social and cultural influences on maternal health outcomes locally and globally, and gain insight into the different ways of knowing that may impact maternal health. You will reflect critically on your 20-hour community engagement experience, analysing this for alignment with ACU community engagement principles and identifying examples of personal transformational learning.

The aim of this unit is to expand your knowledge of the midwife’s global role in relation to primary health care, public health principles and culturally safe midwifery care, through the exploration of cultural, political and social influences on maternal health, as well as participation in community engagement experiences aimed at capacity building and partnership. 

We recognise that people who access maternity care may have diverse gender identities, that those who do can experience marginalisation and oppression, and that using appropriate terminology can help with these community members’ recognition and visibility, acknowledge the variety of pregnancy and birth experiences people may have, and respect individuals’ preferences. To reflect this, terms such as ‘pregnant person’, ‘birthing person’, ‘childbearing people’, ‘parent’ and ‘chestfeeding’ may be used in the midwifery courses at ACU in addition to ‘woman’, ‘mother’, ‘maternity’, ‘maternal’ and ‘breastfeeding’, which are used not to exclude those who do not identify as a woman, but in recognition that women continue to be marginalised and oppressed in many places around the world and to respect their own individual preferences.  

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Examine the midwife’s role in advocating for the rights of women, families and communities in relation to primary health care, public health and culturally safe care in both local and global contexts (GA4, GA5, GA6)

LO2 - Analyse the impact of cultural beliefs and practices upon childbearing and midwifery practice (GA4, GA5)

LO3 - Identify the common causes and impacts of maternal morbidity and mortality and the social, cultural and political influences on these, as well as the associated challenges in measuring maternal mortality (GA4, GA6)

LO4 - Examine different ways of knowing, including Indigenous perspectives, and how these may impact upon childbearing and midwifery practice (GA4, GA7)

LO5 - Reflect critically on how your experience of community engagement aligns with the ACU community engagement principles and has contributed to your transformational learning (GA1, GA2, GA3, GA4, GA7)

Graduate attributes

Each unit in your course contributes in some way to the development of the ACU Graduate Attributes which you should demonstrate by the time you complete your course. All Australian universities have their expected graduate attributes. ACU’s Graduate Attributes have a greater emphasis on ethical behaviour and community responsibility than those of many other universities. All of your units will enable you to develop some attributes.

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

NMBA Midwife Standards for Practice

NMBA (2018) Midwife Standards for Practice developed in this unit are: 

Content

Topics will include: 

Legal and professional practice 

• Global Standards from professional bodies (ICM, WHO, UNICEF, United Nations, World Bank, Caritas) 
• Capacity building 
• Legal issues 
• Risk management 
• Preparation of student 
• Development of learning contract 
• Assertive communication skills

Midwifery knowledge and practice 

• Global models of care   
• Rural, regional, remote,  
• Urban, tertiary 
• Partnership with women  
• Birthing on Country

Midwifery as primary health care 

• Global maternity services 
• Social 
• Economic 
• Cultural and political issues 
• Working in partnership with other key providers in the maternity workforce 
• Traditional Birth Attendants   
• Aboriginal Health Workers   
• Strong Women Workers   
• Health inequalities for childbearing women in minority groups  
• Epidemiological evidence of inequalities in health outcomes 
• Refugee, migrant and asylum seekers 
• Rural and remote communities  
• Indigenous women 
• Midwifery as a public health strategy 
• Reproductive health 
• Current outbreaks and emergencies 
• Indigenous communities  
• International communities  
• Maternal mortality and morbidity globally 
• Principles of community engagement 
• Respect for human dignity 
• Mutuality and reciprocity 
• Partnerships for transformation 
• Working with, not doing for 
• Nurturing hope for a better tomorrow 
• Focus of community engagement 
• Local 
• Regional 
• International 
• Processes for identifying needs and working with communities to plan and implement strategies  

Reflective and ethical practice 

• Midwifery as a sustainable health care practice 
• Ethics of international recruitment of midwives 
• Ethical issues 
• Transformation of self 

Learning and teaching strategy and rationale

This unit is offered by flexible mode using the online learning management system. Students in this unit will also undertake community engagement. They will actively participate in 20 hours of community engagement, identifying and accessing an appropriate experience that aligns with the ACU community engagement criteria.

Consistent with adult learning principles, teaching and learning strategies will provide students with foundational knowledge and skills relevant to professional midwifery practice. Development of knowledge, skills and understanding will also be supported using 'hands on' methods, story sharing, community linking and other Aboriginal ways of learning. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers. Scenario-based learning, case-based learning, problem-based learning and inquiry-based learning are all used to support the development of students' independent learning ability. 

Students exiting university need significant life-long learning skills to deliver sound, ongoing, evidence-based graduate practice as a member of the professional workforce. To embed life-long learning skills students must demonstrate increasing reflective capacity to identify what is being done well and what requires additional work in progressing toward required learning outcomes. Located in the third year of the programme, this theory/community engagement unit offers online components of learning. Students will extend their capability as a member of the community of learners, and increase their self-reliance, critical reflection and debate. Online materials provide students with the opportunity to undertake directed, self-motivated study and continue to transition to  independent study and life-long learning. 

Assessment strategy and rationale

A range of assessment procedures consistent with University assessment requirements will be used to meet the unit learning outcomes and develop graduate attributes.

The community engagement assignment provides scaffolding for the student’s experience. First, students will develop a learning contract in which they articulate their goals for collaborative work within the community group/organisation. Second, students will maintain a reflective journal throughout the 20 hour placement in the chosen community group/organisation. Third, students will write a report on their collaboration with the chosen community group/organisation and the manner in which they contributed to it’s mission, aims and objectives. Online group and individual classroom activities will enable students to showcase sound written communication skills and understanding of the key issues in primary health care and community engagement. 

Online group and individual classroom activities will enable students to showcase sound written communication skills and understanding of the key issues in primary health care, culturally safe care and public health as they relate to midwifery care.

The community engagement portfolio enables students to present their learnings and reflections pertaining to their community engagement experience, offering the opportunity to demonstrate knowledge and application of the ACU community engagement principles and evidence of transformational learning.

Overview of assessments

Representative texts and references

Alkema, L., Chou, D., Hogan, D., Zhang, S., Moller, A-B., Gemmill, A., Fat, D.M., Boerma, T., Temmerman, M., Mathers, C. & Say, L. (2016). Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency group. The Lancet 387, 462-474. https://doi.org/10.1016/S0140-6736(15)00838-7

Clendon, J., & Munns, A. (2018). Community Health and Wellness (6th ed). Elsevier.

International Confederation of Midwives [ICM]. (2019). ICM Advocacy Toolkit for Midwives. International Confederation of Midwives.

Khosla, R., Zampas, C., Vogel, J., Bohren, M., Roseman, M. & Erdman, J. (2016). International Human Rights and the Mistreatment of Women during Childbirth. Health and Human Rights Journal 18(2), 131-143.

Multiple Authors. (2019). 'Birthing on Country in Australia' edition. Women and Birth 32(5), 381-476.

Starrs, A., Ezeh, A., Barker, G., Basu, A., Bertrand, J., Blum, R., Coll-Seck, A., Grover, A., Laski, L., Roa, M., Sathar, Z., Say, L., Serour, G., Singh, S., Stenberg, K., Temmerman, M., Biddlecom, A., Popinchalk, A., Summers, C. & Ashford, L. (2018). Accelerate progress – sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission. The Lancet 391(10140), 2642-2692. https://doi.org/10.1016/S0140-6736(18)30293-9.

ten Hoope-Bender, P., de Bernis, L., Campbell, J., Downe, S., Fauveau, V., Fogstad, H., Homer, C., Kennedy, H., Matthews, Z., McFadden, A., Renfrew, M. & Van Lerberghe, W. (2014). Improvement of maternal and newborn health through midwifery. The Lancet 384(9949), 1226-1235. https://doi.org/10.1016/S0140-6736(14)60930-2

United Nations Fund for Population Activities. (2021). The State of the World’s Midwifery 2021. United Nations Fund for Population Activities 

World Health Organization. (2015). Strategies toward ending preventable maternal mortality (EPMM). World Health Organization. 

World Health Organization. (2015). WHO recommendations on health promotion interventions for maternal and newborn health 2015. World Health Organization.