Integration of Examination of The Newborn Into Holistic Midwifery Practice: A Grounded Theory Study.

Background & Objectives: The Examination of the newborn (EONB), previously the remit of medical doctors, has been undertaken by midwives once they have completed a programme of Continuing Professional Development for over a decade. This study examined what motivated midwives to undertake the examination of the newborn post registration midwifery course and then to utilise their skills or not. It also investigated the expectations of the Heads of Midwifery (HOM) when facilitating and supporting midwives to undertake the post registration training and their views of how midwives with the skills to undertake EONB had influenced service provision. The study examined what influences midwives’ ability to integrate examination of the newborn into holistic midwifery practice and how best to bring about this change in midwifery practice. Method: Using a grounded theory approach, 12 midwives and 5 Heads of Midwifery were interviewed. Data were collected through interviews and analysed using Strauss and Corbin mode of grounded theory analysis. Findings: The substantive theory of ‘Integration of the examination of the newborn into holistic midwifery practice’ was generated from the data encompassing four key categories; 1) knowledge & training acquisition, 2) change in culture: perception and practice, 3) philosophy of midwifery and 4) political and financial drivers. The majority of participants believed they were delivering holistic care to mothers and babies. The participants believed that you did not have to be an experienced midwife to undertake the examination of the newborn and that the training should be integral to the pre- registration midwifery curriculum. Their views indicate a belief that midwives do not need to be specialist or advanced practitioners to undertake EONB. Conclusion: The researcher argues that this theory contributes to a greater understanding of midwives’ roles and responsibilities in EONB. It provides insight and understanding into why midwives are motivated to undertaken additional training to facilitate them in providing holistic care for mothers and their newborn baby and disputes the notion of having to be an advanced or specialist practitioner to undertake this aspect of midwifery care. Wider implications are for nursing and other professional groups with technical skills which enhance care