Newly-graduated midwives transcending barriers: Mechanisms for putting plans into action

Objective: the aim of this qualitative study was to develop theory regarding how newly-graduated midwives deal with applying a midwifery philosophy of care in their first six months of practice. Design: the research aim signifies the study of social processes. Hence Grounded Theory methodology was employed. Data were generated from semi-structured interviews and participant and interviewer journals. Setting: the study was conducted in Perth, Western Australia, with graduate midwives working in private and public, secondary and tertiary maternity hospital settings. Participants: 11 female midwives who were previously nurses and had recently graduated from a 12month post graduate university-based midwifery course participated. Theory generated: the substantive theory of transcending barriers was generated. It has three stages: ‘Addressing personal attributes’, ‘Understanding the ‘bigger picture’’, and ‘Evaluating, planning and acting’ to provide woman-centred care. An overview of the theory was presented in a previous paper. The mechanisms where ‘plans are moved into action’ which form the final sub-stage of the stage ‘Evaluating, planning and acting’ are presented in this paper. Key conclusion: the theory of transcending barriers provides a new perspective on how newly-graduated midwives ‘deal with’ applying the philosophy of midwifery in their first six months of practice. The final sub-stage of the theoretical model highlights four mechanisms that newly-graduated midwives implement in their endeavours to provide woman-centred care, increase autonomy and develop their personal philosophy of midwifery. Implication for practice: understanding the four mechanisms can assist health care providers to facilitate the transition of newly-graduated midwives into clinical practice