Linking midwifery practice to outcomes

Holly Powell Kennedy, University of Rhode Island


How is excellence in the profession of midwifery defined? Does excellence result in improved outcomes for the recipient(s) of midwifery care. These are the questions that the profession of midwifery grapples with today within the context of a changing health care arena. The purpose of this research was to (a) describe exemplary midwifery practice, (b) link specific aspects of the process of exemplary practice to specific outcomes, and (c) initiate the development of an exemplary midwifery model of care. ^ A Delphi study was conducted in 1998 using the perspectives of “exemplary midwives” identified by leadership circles in the midwifery profession. Women who had received care from these midwives were invited to participate in a parallel investigation. By using a variety of knowledgeable experts in the profession, and those with first hand knowledge of their care, the method allowed for consensus to emerge about the issues the research questions posed. ^ A model of exemplary midwifery care emerged from the responses of the midwives in the study that was well supported by the recipients of care. Three dimensions of care were identified, each with key processes which were supported by qualities and traits of the midwife. The first dimension of therapeutics reflected the philosophy supporting the choice and use of therapies by the exemplary midwife. The second dimension of caring reflected the philosophy of care by the exemplary midwife. The final dimension was the profession of midwifery, which is supported by the exemplary practice of midwives. ^ There is little research that links specific processes of care used by midwives to specific outcomes for the woman, her newborn, or her family. This is a critical deficit; therefore research is essential to gain knowledge about how those processes of care are linked to outcomes. This study attempted to bridge that gap. Further research is crucial to test the model in actual practice settings to support the midwifery model as a national standard of care. ^

Subject Area

Anthropology, Cultural|Health Sciences, Obstetrics and Gynecology|Health Sciences, Nursing|Health Sciences, Public Health

Recommended Citation

Holly Powell Kennedy, "Linking midwifery practice to outcomes" (1999). Dissertations and Master's Theses (Campus Access). Paper AAI9945209.