Wednesday, April 30, 2008

Collecting names and stories of inspiring midwives for International Day of the Midwife

Who is the midwife who inspires you?

Collecting names and stories
As a response to a post I wrote about the midwives who have inspired me over the years, I am collecting names and stories that will be published in the journal of the International Confederation of Midwives to celebrate International Midwives Day.

Contact me
So please feel free to leave me the name of the midwife who inspires you and why, either on this blog or by email: sarahstewart(at)

Image: 'Amy in Labor'

Tuesday, April 29, 2008

Twitter for beginners

Thanks to Alex Miller who reminded me about this Common Craft video that explains what Twitter is all about.

Monday, April 28, 2008

Story telling in Second Life

If you would like to get a taste for Second Life or if you are interested in seeing what New Zealand Educators are up to, or if you like to hear/tell stories then please read on:

International Storytelling Day is being celebrated on Koru Island. Participants are invited to meet and join a storytelling circle on Friday May 16th 8pm NZ (May16th 1am - SL time) - International Time Zones.

Further details from Arwenna Stardust (Clare Atkins) at her blog: Arwenna Stardust's Second Life Blog.

Saturday, April 26, 2008

Who is the midwife who inspires you?

Image: Salisbury Hospital (Florence Nightingale once worked here) where I did my nurse training - is now a block of luxury flats.

One of the things we are doing to celebrate International Day of the Midwife on 5th May is to have an Otago Polytechnic School of Midwifery lunch. The theme for the lunch is: which midwifery character, figure or personality inspires you?

Who inspires me?
I have a long list of midwives who inspire me including the wonderful team of midwifery lecturers I work with. But I have whittled my list down to five midwives, although I been inspired by many wonderful midwives over the years, and to them - thank you.

Sister Butcher: love and compassion
When I left school I went and did my nurse training at Salisbury Hospital in Salisbury, UK in 1980. During my training I did a short four week placement on the maternity unit at Odstock Hospital, which is now the Salisbury District Hospital. During that placement I spent some shifts working on a post natal ward managed by Sister Butcher. Those were the 'good old days' when first time mums stayed in hospital for eight days after giving birth and babies were kept in the nursery at night. So the post natal wards had a much stronger community feel than they have now, but that is another story.

Sister Butcher would probably be considered 'old school' now with her crisp navy blue uniform, cap and bright red lip stick. She could be quite fierce and she had a reputation for taking no nonsense. And some of the students were a little frightened by her. So I was rather daunted at the thought of doing an evening shift with her, all by myself. We were not very busy and I had the job of feeding a baby in the nursery. Sister Butcher came and talked to me as I was cuddling the baby for what felt like hours, and we had the most amazing discussion about life, midwifery, babies, pregnancy, women and midwives. I was so deeply moved not only by what she said, but the love with which she said it that I cried (and am crying now as I remember this). And it was at that moment that I knew I wanted to be a midwife. If I could be half as strong, thoughtful and loving as a midwife as Sister Butcher was, I knew I would be a great midwife. As soon as I completed my nurse training in 1984 I went on to train as a midwife at Odstock/Salisbury where I stayed until 1996 when I moved to a job as community midwifery sister in Basingstoke.

Sister Newland: midwifery assessment and actions
Sister Newland was one of the lead midwives on the labour ward (sorry about the terminology, but that is what we used to call it) at Odstock Hospital - I think she is retired now. She was incredibly knowledgeable, skilled and experienced. I had the privilege of working with her throughout my time at Salisbury from 1984 until 1996 when I moved to another job.

Sister does the saying go... had forgotten more about childbirth than I have had hot dinners. She was the one you would go to for tips and advice. She would know exactly what to do in any emergency. She was a true mentor. In particular, I remember her as the one who taught me the vital importance of assessment - if you do not thoroughly assess what is happening, then you cannot make an accurate judgment about your midwifery actions. And it was her skill of using her hands, heart and brain that made her such a brilliant midwife - she didn't need to rely on machines or doctors. Now I am not saying that I agreed with everything she did or said, but even after all these years I always think of her whenever I am with a woman in labour. I try to emulate her ability to assess, act and document, and also pass on my knowledge to students as she did to me when I was a junior midwife.

Glynis: questioning practice
Glynis was a student midwife I worked with in the early 1990s - I cannot remember her surname. My particular memory of Glynis was when I was working with her on the labour ward and she was 'conducting' a birth - don't even ask me about the terrible terminology, it is too embarrassing! In other words, she was making the decisions and I was supporting her. The woman was birthing the baby but instead of the mantra I used (because that was how I was trained) of 'take a deep breathe, push for as long as you can and do it three times with each contraction', Glynis was quietly supporting the woman without saying much. The room was quiet and calm - it didn't feel like the finishing post at a racetrack. And the woman was doing her own thing and very happily birthed her baby without any interference from us.

I was gobsmacked to say the least. And when I talked to Glynis about this afterwards she told me about what she was learning and that there was no evidence to support directed pushing and time limits in the second stage of labour. So it was Glynis who inspired me to think about my practice, what I do and why I do it. Do I do something because that was what I was taught and is the routine or is it based on the evidence of research and my own personal investigations - in other other words, do I have an evidence based practice? Glynis started me on my academic studies and when I start to fall into bad habits, I think of Glynis and the vital importance of questioning my practice and why I do things.

Lesley Page: total midwifery caseload practice
Lesley Page is a very well known midwifery researcher and writer. My midwifery claim to fame is that I have had a curry in Manchester with Lesley before a conference a few years ago. She has written a very influential midwifery textbook called 'The New Midwifery: Science and Sensitivity in Practice'. But the reason I cite Lesley as an inspiration is because of the work she did investigating caseload midwifery back in the early 1990s. The result of this work was an editied book called 'Effective Group Practice in Midwifery: Working with Women'.

At the time I read Lesley's book I was working in a hospital rotating around the wards, staying on a ward several months at a time. I enjoyed my work and loved working with women. But it felt quite unsatisfactory. I only knew the women for a short time and the whole process felt very disjointed. I wanted more from my job as a midwife. Once I read Lesley's work and the experiences of the midwives and women in her research, I knew that I wanted to work in a way that allowed me to provide continuity of midwifery care to women throughout their birthing experience, not just for a few days in hospital.

I campaigned with others for caseload midwifery in the area where I worked but it never came to being. And then we moved to New Zealand. It was when I landed in Gisborne I realized the whole maternity system in New Zealand is based on caseload midwifery and I started my job as an LMC. It was thanks to Lesley that I knew how I wanted to practice as a midwife and have been committed to caseload midwifery ever since.

Sheila Hunt: communication and research
Professor Sheila Hunt is also a midwifery academic who truly inspired me as a result of her book 'The social meaning of midwifery' which she wrote in 1994. This book was the result of ethnographic research that Sheila carried out watching midwives interact with women when they were in labour. Some of the results were distressing because it showed that midwives can be thoughtless and denigrating in the way they interact with women, which can be devastating to the women and their families.

There was nothing in this book that was rocket science, but it did make me sit up and reflect on how I am with women and how I communicate with them and my midwifery colleagues. This was definitely an important part of the development of my midwifery philosophy in which I feel it is vital to work in a respectful relationship with women.

This was also one of the first pieces of qualitative midwifery research that I had read and it opened my eyes to the potential of research in midwifery practice - I could see the relevance and application of research. And I think that it was this book that hooked me into research
compared to the dry, statistical randomized-controlled trials that I usually tried to wade through, and it started my interest in being a researcher.

Image: Some of my colleagues who inspire me on a daily basis

What will the students say?
I am really looking to our lunch and can't wait to hear about the midwives who inspire our students.

If you are a midwife, what would be your answer to this question? And if you are not a midwife, who inspires you?

International Day of the Midwife 2008: meeting student midwives in Nashville

Last year I went to Nashville, USA and amongst other things I met Professor Mavis Schorn and her team of midwifery educators at Vanderbilt University.

I am extremely thrilled that Mavis has agreed to join with me and run a combined Elluminate seminar for our senior midwifery students to celebrate International Day of the Midwife on May 5th.

My personal aims for the meeting
  • Encourage my students to consider the international context of midwifery
  • Increase my skills of facilitating online meetings
  • Introduce my students to Elluminate and web 2.0, which hopefully will lead to ongoing online meetings
  • Explore opportunities for collaborative research and teaching
Plan for meeting
This is a bit of an experiment as neither of us have done anything like this before, so we plan to keep things low key. What I thought we would do is to give a short joint presentation about midwifery in our respective countries and then open things up for questions and discussions.

Technology concerns
The meeting is going to be have about 40 people and we're going to have the students in computer labs. So at least we'll have technicians on hand to sort out problems that our students have.

My main concern is that the technology lets us down although generally I have found Elluminate to be very reliable. I have spoken to the Nashville technical team via Skype and they are going to download the software onto the computers the students are going to use this week. And we'll have a practice run this week as well. So hopefully we'll be as prepared as we can be.

I just have to have a back-up plan in case everything does turn to custard. Any suggestions for what Plan B could be?

Image: 'Nashville Sporting Goods'

Pregnant women are having too many ultrasound scans

The evidence has been around for some time that ultrasound scans have no effect on outcomes of pregnancy and birth for low risk pregnant women. This has been confirmed by Associate Professor Janet Vaughan, an obstetrician from the University of Sydney. Dr Vaughan says that healthy women should have only one scan when they are about 12 weeks pregnant, to confirm dates.

Friday, April 25, 2008

Starting to feel the Twitter love

I think I am starting to feel the Twitter love.

For those of you who do not know what Twitter is, here is a post 'Getting my head around Twitter' that explains what it is and here are a few thoughts about how I see Twitter working for midwives.

Party time
I have lurking on Twitter for a few months now, but didn't really find it of any value until recently. I thought it was useful to have a Twitter presence in the same way that I have in Facebook - available to anyone that uses that media, but I do not participate - I tried to post an 'informative' message once a day. But other than that, I didn't engage with Twitter.

Twitter has been described by Nina Simon as being at a cocktail party, where people meet and spontaneously and synchronously interact. The snag with going to parties is that sometimes you do not know anyone, or you are not part of the 'in' crowd which makes you feel very uncomfortable. This has been discussed in length by people such as Vicki Davis in relation to blogging and social networking.

Whilst I did not feel excluded because people like Sue Waters introduced me around, I have felt like I have been on the edges of the party. The parties I have been going to are those of educators who are interested in web 2.0 where I feel I have little to contribute because I am at the stage of of learning about web 2.0. There does not appear to be a midwifery twitter party. If there was, I am sure I would feel I have more to contribute because midwifery is my primary field of expertise and knowledge.

Rules to using Twitter
The main reason for this lurking was that I didn't want to open my mouth and offend anyone, or waste people's time with trivialities. I needed to find out what the Twitter 'rules' were. Martin Weller opened a discussion about Twitter etiquette which was related to the ins and outs of following people on Twitter, but the sense I got from the comments to this post was that there are no rules to using Twitter - you do what suits you and your learning needs. Nevertheless, I try to minimize my personal and social comments and keep my messages to professional topics.

At the same time, I am loving the personal glimpses into people's lives that Twitter is giving me that I would not see in other mediums like blogs. For example, I laughed when Howard Rheingold (the midwifery equivalent of Ina May Gaskin) tweeted that he'd nearly choked to death on a bite of a banana. Now I know that is not a laughing matter, but it is the equivalent of hearing from 'The Queen' about her shopping trip to Tesco - how cool is that?!

Stage of Twitter cycle
So what stage am I in the Twitter cycle? Well, it was a couple of weekends ago that I started to move from the 'I still don't get it' stage to the 'Wow, just found a great link from Vicki' stage - check out CogDog's wiki for more information about the Twitter Cycle.

What happened was I spent the whole weekend interacting with people in a very concentrated way ie I put my party frock on and partied on down. One thing led to another as it often does at parties, and I ended up in several live seminars and meetings, and even got as far as Second Life listening to Leigh Blackall talk about his latest Second Life teaching/learning project.

As a result I have seen an increase in the visits to this blog and my Twitter network has grown. Whilst this has not led to offers of 'all expenses paid' speaking tours or such like, I do know that there is a support/learning network available to me that wasn't there before I joined Twitter.

A passionate affair?
Now I have started to feel the Twitter love, is it likely to blossom into a passionate affair?

No, I do not think so. Like Michele Martin I see the advantages of being able to connect with people and get instant responses. I love the spontaneity of Twitter but I rarely use it to follow asynchronous links ie I do not use it to follow blog posts - I prefer to use Google Reader so that I can read blogs in my own time. I am mainly using Twitter for synchronous activities such as giving and receiving feedback and advice, and spontaneously attending online events. And of course, how much I get involved with depends on my other time commitments.

But I do agree with Darren Draper that you get out of Twitter what you put into it but then...doesn't that apply to everything you do?

How are you using Twitter? What do you see as the advantages and disadvantages?

Thursday, April 24, 2008

Online international midwifery collaboration

I had a very interesting online conversation on Elluminate last night with midwifery educators in Pakistan. This time the Internet did not let me down. As I explained in a previous post, Rafat and her colleagues are looking at midwifery curriculum from other countries in order to give them ideas for the curriculum they are developing.

Online meetings
I found it truly mind-blowing that I was able to sit in my living room with a cuppa and talk to midwives in Pakistan. We all agreed that being able to meet online is amazing for communication and collaboration, especially as none of us can afford to go to the ICM conference - the major international midwifery conference of the year in Glasgow, UK. And even though as midwifery educators we live and work in very different contexts, we face the same issues and challenges; juggling the demands of academia and clinical practice, and accessing research funding.

International midwifery collaboration
Rafat and her team are women after my own heart. They are very keen to explore opportunities for collaboration, and in particular are interested in developing free, open access midwifery resources. They have agreed to become involved with the online midwifery seminar program and present a session on midwifery in Pakistan.

Image: 'Karachi, Pakistan'

Tuesday, April 22, 2008

Getting midwives to adopt web 2.0

I read the blog of Navelgazing Midwife the other day and she has written about how she has discovered Skype. She is very keen to set up a conference call with other midwives to discuss midwifery. So needless to say, I quickly got in touch with her and gave her my contact details and the information about the online seminars I am organising. It will be interesting to see if anything comes of this connection.

Telling the horse about the water
What interested me about Navelgazing Midwife is that she is not new to the Internet - she has been blogging since 2004. Yet it is only recently that she has become aware of Skype, although it has been around for some years. I love Skype. I find it easy to use and I love the fact that I can call anyone in the world (who has a computer) and have a free conversation. And since I have been given a web cam, I use that all the time and find it overcomes the criticisms people have of not being able to see who you are talking to.

In my last couple of posts I have been discussing the advantages of more sophisticated software like Elluminate compared Skype, which I think of as a commonly used tool. But is it as commonly used as I think it is, especially amongst the general population?

Leading the horse to water
People will not use a technology unless they see value to it - what's in it for them? I was told about Skype years ago by my brother-in-law who used it to make business calls. But I never considered it for my own use. But it wasn't until I was going through a stage where I had to look at making financial savings to the family budget that I considered Skype for free international calls to family and friends. (I might add though, that broadband was going to be the last thing to go!) The other event that increased my uptake of Skype was when my best friend moved to Australia and I wanted to keep in close contact with her. Once I saw the personal value of Skype, that is when I started to utilize it fully.

In the context of trying to 'sell' online tools to students and midwives, it is clear that it has to be done in a way that captures people's attention, and shows them that there is value in these tools.

Getting that darn horse to drink
Another frustration I have is actually getting people to engage with web 2.0. My family in the UK have all the bells and whistles. They have computers, broadband, web cams and still they do not use Skype. They have digital cameras but they will not upload their photos onto Flickr for me to see, despite the fact I have talked to them about it and showed them my photos on Flickr.

So if I cannot encourage my family to use tools like Skype with the motivation of keeping in touch, how can I encourage midwives, who are strangers with no relationship to me, to engage with web 2.0?

The horse has gone to another trough
My daughter has just bought a lap top and I have been trying to encourage her to register with Skype. But she has chosen to use MSN which has similar functions as Skype. Yet another frustration. Its great that she is using the Internet to communicate but I want her to use the tools I use! I do not want to have to register with yet another program or web site!

What is this post about? I'm still not quite sure! I think I'm trying to get my head around the challenges of introducing newbies to online communication tools. I guess the message to myself is not to make assumptions about what people know and how they use the Internet. And whilst I want to leap ahead, I must remember that even simple barriers like a lack of awareness of online tools exist.

What would be your strategies to get people interested in online communication and collaboration?

Image: 'Pastoral'

Politician slams midwives

You can tell it is election year in New Zealand. The politicians are getting into stride and of course, the health service is always a target for their pontificating.

Midwives are the cause of all evils
Stephen Franks (National party) believes that midwives are responsible for obstetricians and GPs leaving the health service as well as a rise in mortality rates, staff shortages and decrease in breastfeeding rates. I'm surprised he didn't suggest we were also responsible for global warming.

Women's choice
Grant Robertson (Labour) had a far more balanced post on his blog written by a guest, who is the mother of two babies. She pointed out that the current maternity set up came about because women lobbied for more choice and control over their birthing experiences which they believed they would get from midwives. However, the post ends with the complaint that midwives put too much pressure on women to labour without pharmacological pain relief.

The facts
The reality is that GPs and obstetricians were leaving the maternity service before midwives gained parity of autonomy. And the situation in New Zealand is following a global trend, as with the shortages of all health staff. Mortality rates have stayed stable for years and midwifery outcomes are better when there is continuity of care, which is why countries like Australia are looking at midwifery-led care schemes like that in New Zealand. The drop in breastfeeding rates must also be seen in a global context. Women in New Zealand probably get the best post natal care in the world. They are supported by midwives up to six weeks after they have had their babies. In many other developed countries, women get little or no post natal care at all.

No pain, no gain?
As for pressuring women to go without pharmacological pain relief, I feel sure that the majority of midwives encourage choice and informed consent. What worries me about the liberal use of measures such as epidurals is that women are not supported to explore other non-medical alternatives first. Pharmacological pain relief such as pethidine and epidural have side-effects and potential for harm. They can also start a slide into a cascade of intervention that cannot be reversed.

My stance would be that women should have access to all means of preventing pain, including water pools and the opportunity to labour at home with the support of a midwife for as long as they wish before they go to hospital. It is the trend for making epidurals a routine part of care in labour which midwives have grave concerns about.

How much notice do you take of politicians in election year?

Image: 'The beehive' - Parliament, New Zealand

Sunday, April 20, 2008

Enjoying the 19th hole

I took my new digital camera out for a test drive today.

Learning to play golf
My husband is trying to teach the family to play golf. I have decided my favorite part of the game is the 19th hole.

Personal interests
This video clip will go into my ePortfolio in the biography section where I talk about my personal interests.

Friday, April 18, 2008

Midwifery education in Pakistan

Today I briefly met Rafat Jan Rukanuddin via web conference using Elluminate. Rafat is developing a midwifery education program at the Aga Khan University School of Nursing, Karachi, Pakistan and she is very interested in how we have developed our program in New Zealand.

Rafat has been following my blog and is interested in the online seminar project.

The frustrations of technology
Unfortunately, within 10 minutes of our meeting, my Internet connection crashed so we didn't get to finish our discussions. I was cross about this because I never usually have problems with my connection and I had been really looking forward to talking to Rafat.

From the short time we managed to talk I got a sense that midwives in Pakistan are faced with a number of complex problems that I can only imagine. Maternal and neonatal mortality rates remain high. Mothers die because of a lack of resources and skilled health care providers.

Midwifery in Pakistan
My understanding is that maternity care is provided by nurses and midwives who have basic obstetric education, but they are not skilled midwifery practitioners. Maternity services are dominated by male medical doctors who have made little difference to poor maternity outcomes, and cannot deal effectively with underlying problems that face women in Pakistani society such as family violence. Midwives support the doctors as opposed to being autonomous midwifery practitioners.

Looking at midwifery education
Rafat is convinced that midwifery education is the key to improving maternity outcomes in Pakistan. Midwives need to be educated to be autonomous practitioners practicing across the full midwifery scope of practice including complete mother and baby assessment and 'catching' of babies. At the moment Rafat is looking at models of midwifery education all over the world, so I am keen to support her as much as possible.

If you are interested to knowing more about midwifery and midwifery education in Pakistan, Rafat recently had a paper published:
  • Midwifery education and maternal and neonatal health issues: challenges in Pakistan. Rafat Jan Rukanuddin, Tazeen Saeed Ali, Beth McManis. J Midwifery Womens Health (Vol. 52, Issue 4, Pages 398-405)
This scenario supports the argument for open access midwifery education.

Image: 'Northern Pakistan'

How to be attractive to men

The annual Regent Theatre 24 hour second hand book sale, Dunedin, is one of my favorite events of the year. It is one of the biggest second hand book sales in Australasia. It is being held 12 noon Friday 23 May to 12 noon Saturday 24 May this year, 2008.

My annual ritual
Every year at this time I sort out my old books that I do not need and donate them to the sale - usually the ones I bought last year and have never read! Then when the sales starts, I drag the family down to the theatre and spend hours sifting though the books. I usually go down two or three times during the 24 hour period because more books are always being brought out on display.

I love it - it is noisy, crowded and brutal at times. But the atmosphere is fantastic. Everyone is having fun and it is a great social occasion as you often meet up with people you haven't seen for ages. The best time to go is in the middle of the night. There's still a large number of people around, but there is a sense of camaraderie as you battle to keep sharp and alert, and able to spot that rare book before anyone else does!

I specifically look for old midwifery textbooks and anything related to pregnancy and childbirth. This year I will be on the hunt for the first three editions of the Myles Midwifery textbooks.

Sorting though my old books
This brings me to what this post is actually about. The other day when I was sorting out the books I wanted to donate to the sale this year, I came across a book I bought a couple of years ago at the 24 Hour sale. It is called 'How to be attractive', written by Joan Bennett and was published in 1952 by Nicholas Kaye, London. It is packed with good advice for young women, so here is my top five favorite pieces of advice from Joan.

Advice for today's young woman
  1. Taking care of your appearance is just plain housekeeping. It's more important than polishing the silver or dusting the furniture.
  2. Remember your neck. Creaming is a bore, but it is absolutely necessary.
  3. When carrying out your cleaning routine and putting on your makeup, it is advisable to wear a washable make-up smock for this important job. You can then be a lot more thorough than in a dress.
  4. A bulging tummy is a horrid thing...To try to make a girdle take up the slack is to be down-right lazy...
  5. Men like pretty hats, big ones preferred... They like to be blissfully unaware of slips, girdles and brassieres. They do not like a wrinkled stocking or twisted seam.
So there you have it, girls. Cover up those bra straps and g-strings. Put away your body shaper that you just bought for hundreds of dollars, and go and do some exercise. And finally, forget Internet dating - start wearing a big, floppy hat!

Image: 'IMG_8256.jpg'

Thursday, April 17, 2008

Developing an online survey with SurveyMonkey

As part of my ongoing project of developing a program of online seminars for midwives I have needed to develop an evaluation tool, so a 'short and sweet' online survey should do the trick.

I was advised to try SurveyMonkey, which I found extremely easy to use. The free version allows you to develop a survey of up to ten questions. There is a choice of a number of question formats from open text to multiple choice. The program hosts the survey and also analyzes the results. I would say that even a person who had basic computer skills would be able to use this program.

Developing the questions
I based the questions on the evaluation survey that MIDIRS uses for its webinars. What I am going to be really interested in knowing is:
  • the effectiveness of my advertising;
  • the effectiveness of the information I provide;
  • the effectiveness of the technology;
  • people's experience of the seminars;
  • suggestions for any change.
Validity of the survey
The survey is what I call 'cheap and cheerful'. In other words, it will never pass a validity test. For example, because it is freely accessible anyone can come along and make up false answers.
But havinf said that, hopefully it will give me an idea of how people feel about the seminars. This survey will go alongside the verbal feedback I will receive

If this project ever becomes an research project, I will have to be a lot more stringent about the project's evaluation and survey questions.

To find out more about developing online surveys, read any work of Don Dillman.

Stewart, S. 2006. Practical considerations for Internet research.
British Journal of Midwifery, 14 (9): 527-529.

Stewart, S. 2003. Casting the net: using the Internet for survey research. British Journal of Midwifery, 11(9): 543-546.

Wickham, S., & Stewart, S. 2001.
Web research . . . the final frontier? MIDIRS Midwifery Digest, March, 11 (1): 28-31

Image: 'Clowning around'

Free online PD for midwives

One of my aims for this year is to try to encourage more midwives to use social networking tools and engage in free, open web conferences for professional development.

Why online seminars?
I have chosen to concentrate on developing online seminars for midwives because I am fed up with hearing about exciting things going on in the UK, but missing them because of where I live. So this is an attempt to redress this problem for those of us living in the Southern hemisphere.

I also believe that this is one way of supporting each other and forming communities of practice, which in turn will help in a small way in sustaining midwifery, and hopefully increase recruitment and retention. I am not unrealistic - I know this isn't going to change the midwifery world over night, but if it supports communication between a few people and helps start collaborative thinking in a small way then I will be pleased.

Seminar program
Using the MIDIRS webinar series as a model, I have started to develop the program for 2008. I have no funding for this so I am relying on midwives, researchers and teachers to volunteer their services as speakers for free. I am hoping that these speakers will see their reward as being able to contribute to global communication and collaboration.

I think the '10 minute lecture' followed by discussion used so successfully by Leigh Blackall and Bronwyn Hegerty is a good format to follow. As speakers will be donating their time free of charge, I am not wanting to create too much of a burden for them. If people feel that this is too big of a time commitment, they are much less likely to volunteer their services as speakers.

I hope to get enough volunteers so that I can run a seminar at least once a month from May until November. Because MIDIRS has a series of seminars that serves midwives in the UK and Europe, I am planning these seminars to mainly serve Australasian time zones.

PD for midwives wiki
Initially, I thought I would manage it all through this blog, but I changed my mind and decided to develop a wiki called PD for midwives. This is for several reasons:
  • speakers can add their details to the wiki without going through me;
  • midwives can write their own ideas for topics;
  • people can edit and improve the information that I have started to develop, especially the information on how to use the wiki and Elluminate;
  • I will develop my wiki skills.
I chose wikispaces as the wiki platform because I thought it think it is reasonably user-friendly for people inexperienced with wikis.

Incorporation with my ePortfolio
I am really enjoying working in an electronic environment because I am finding it so much easier to manage this project, chart its development, reflect and incorporate it into my ePortfolio. I have the additional advantage of being able to get feedback from a much wider audience then I would have by managing and documenting this project in a traditional way.

Would you like to be a speaker?
I would love to hear from people who would like to be a speaker. You do not have to be a midwife, but obviously your topic should be of interest/relevance to midwives. It is preferable that you live in a time zone that suits people in Australasia. Feel free to drop me a message if you'd like to discuss this further.

I have just dropped a clanger!

I have just made a big mistake.

Advertising the first online midwifery seminar for 2008
I have been sending emails and posting information about the first online midwifery seminar for this year. I have cut and pasted the information about the meeting from the PD for midwives wiki.

Where I have sent the information
I have posted information to midwifery research email discussion list, OzMidwifery email list, The New Zealand College of Midwives and Australian College of Midwives, midwifery blogs such as Sage Femme and midwifemuse, and 'Bein a Midwife is the best job in the world!!!!' Facebook group (nearly 2000 members).

I have not included the wiki address/URL. This means that people do not know how to access the information about how to use Elluminate.

I wonder if this will have a negative effect on the uptake of this seminar?

Image: 'A clanger in the library'

Online seminar for midwives: What does professional activity have to do with midwifery competence?

International Day of the Midwife: What does professional activity have to do with midwifery competence? A review of the recertification program (annual practice) requirements for New Zealand midwives and changes for 2008-2011.

Dr Sally Pairman, Chair of NZ Midwifery Council

NZ midwives: This is your chance to get a preview of the Midwifery Council's recent review of the Recertification Program; find out what you have to do over the next 3 years to keep an annual practicing certificate and to ask questions.

Overseas midwives: This is a rare opportunity to speak directly to one of the main architects of modern midwifery in New Zealand. Will be particularly useful for midwives wishing to move to NZ, as well as those interested in the professionalization and regulation of midwifery.

Meeting name:
Professional activity and midwifery competence

Monday 5th May 16:00 - 17.00 NZST

Attendee(s) may join by using the following link:

Meeting password: This is an open meeting. Attendee(s) don't require a password to join.

Click here to find the time of the meeting if you are in a different time zone from New Zealand.

Online professional development seminars for midwives
Go to PD for Midwives for more information about this meeting or other meetings planned this year as well as how to use Elluminate.

Any questions about this or if you need help with accessing Elluminate, please feel free to contact me.

Image: 'Sunny Side Up'

Wednesday, April 16, 2008

Excluding midwives from learning

I have been questioned about my use of Elluminate as a platform for facilitating a program of online seminars for midwives. Whilst there is no cost to midwives, they can only access Elluminate through me, which I can use because I am an employee of Otago Polytechnic. So if midwives want to organise a web conference without my 'say so', they are excluded from doing so via Elluminate.

Why do I use Elluminate?
I suppose the answer to this is... because I can. It doesn't cost me anything or the midwives who attend the meetings, but obviously because it is a commercial product it does cost Otago Polytechnic. I use Elluminate because I like it and am now familiar with it. It is tidy: it offers a number of functions such as the ability to show presentations, video, whiteboard, instant text, audio and breakout rooms all in one package.

Excluding midwives
But as Leigh Blackall has pointed out to me, there are a number of programs that are completely freely accessible that do this such as Skype,, Flash Meeting, DimDim and Yugma. So why waste my time developing resources for the use of Elluminate? Would I not be better off working with online tools that people are familiar with? For example, I could use Skype for a conference call and present my images on Flickr and incorporate a video clip via YouTube.

Where to from now?
Leigh is absolutely right to question me and I do not think I have a very good answer. Nevertheless, I am not convinced that there is a great familiarity with Skype, Flickr etc amongst the general midwifery population. So at the moment I am teaching midwives to use one tool as opposed to teaching them to use half a dozen. And considering that I am doing this in my own time, this is an important issue for me.

However, I think it is important that I keep exploring the free web conference tools that are available so that I can incorporate them into the online midwifery seminars as well as into my 'proper' teaching. I have started a page on the 'PD for midwives' wiki as a collection point for information and resources about free web conferencing.

I would be very interested to hear about people's experiences with web conferencing. What tools have you found easiest and most effective to use, especially when you are working with people who are unfamiliar with using the Internet?

Image: 'First Flight'

Monday, April 14, 2008

Learning how to use Elluminate to have a web meeting or conference

Here is an opportunity to learn more about using Elluminate for having web meetings, conferences or seminars.

This session is designed to give people a chance to 'play' and experiment, so it will be a very relaxed and spontaneous session. Experienced facilitators from Otago Polytechnic will be available to answer questions on how to use Eluminate.

18th April 12.30-14.30 New Zealand Time. Check here to find the time of the meeting if you are in a different time zone from New Zealand.

Attendee(s) may join this meeting up until this time. The meeting will remain in session until the last person leaves.

Attendee(s) may join by using the following link: .nz:80/join_meeting.html ?meetingId=1208121642285

How to log in to Elluminate
Instructions on how to log into Elluminate can be found here.

Meeting password
This is an open meeting. Attendee(s) don't require a password to join.

Why I am joining this session
I am planning on joining this session because I want to find out more about what Elluminate offers. I know how to use it on a basic level ie I know how to add Powerpoint slides, get the web cam working and use the white board.

But I would like to know more about the screen-share facilities, breakout room and quiz.

I also am hoping that we can use this session to critique the instructions for using Elluminate that I have just developed.

What to do if you have any questions

Any questions about this session, please feel to email me or leave a comment.

Image: Tulip

Sunday, April 13, 2008

Building my digital library of images

Have spent the day playing with my new camera in an attempt to build up my own digital library of images to save me having to rely on FlickrCC.

Angel, my dog

Blackie, the cat

Anderson's Bay, Dunedin

Saturday, April 12, 2008

What I have learned from... odd jobs

This month's 'what I have learned from' writing project from Middle Zone Musings is about learning from doing odd jobs. Odd jobs is also the theme on The high calling of our daily work.

This story I am about to tell isn't so much about an odd job, but an interesting one that made me realize the power of jealousy and envy. And what makes people plot to do away with elderly relations for their fortune!

Being an agency nurse
Many moons ago, to augment my wages, I would work occasionally as an agency nurse. This was when I lived in Salisbury in the UK. I would put myself on call and do whatever job the agency had that could utilize my skills, which as a new graduate nurse was basic nursing care.

One night I had to go and spend the night with an old lady who was elderly and frail. I had to get her ready for bed, watch over her to make sure she didn't fall out of bed and help her to the toilet in the night. And in the morning, I had to give her her breakfast.

How the other half live
She lived in a lovely old cottage in the same area where Madonna and Sting live, in Wiltshire. When I put her to bed, she told me that the bed used to belong to Josephine, ex-wife of Napoleon Bonaparte. She was quite a grumpy old lady. She got very cross with me because I was rocking the chair I was sitting on - she didn't want me to damage a very valuable antique chair, thank you very much!

When I went to the kitchen to make her breakfast, I found a file of clothing on the table including a crown. They initially looked like dressing-up clothes but they turned out to be the ceremonial regalia worn by a member of the House of Lords, in the British Parliament. Apparently, her uncle had been a peer of the realm.

Making dastardly plans
When the day nurse turned up, she confirmed that the old lady was extremely wealthy and had no one to leave her money to, apart from a nephew who was a monk, of all things. So I started to plot and scheme - after all, what would a monk want with all that money? If I made myself indispensable to her, she might leave me a few thousand pounds, or I could flog off one of her precious antique chairs! One chair would probably pay off my whole mortgage!

It just didn't seem fair that one grumpy old lady had so much whilst I, who had my whole life ahead of me, was working all the hours under the sun just to keep a roof over my head.

Needless to say, I must have upset her so much by my hooligan chair-rocking behavior that I was never asked to go back again.

If I had my time again?
If I had my time again, I would have talked to her properly to find out about her past and her family, to learn how she had Josephine's bed in her possession and ask her about her memories. I bet she must have had some amazing stories to tell.

Image: 'Stonehenge' (which is in Wiltshire)

Friday, April 11, 2008

Family violence screening education for health professionals

I have just been told about a free online open access education course about family violence screening for health professionals. It has been developed by Jane Kozial-Mclean at the Auckland University of Technology.

Aim of program
The course Intimate Partner Violence Screening: Healthcare Worker On-line Learning Programme aims to:

to efficiently educate healthcare workers to screen and intervene in the case of intimate partner violence in order to interrupt the cycle of violence that involves abuse, injuries, illness and - all to often - death.

The program consists of four chapters and two case studies. The content covers
  • introduction and background
  • screening
  • intervention
  • documentation
In the grand scheme of things, this course is short and sweet. It works by providing information to read and then you have simple quiz questions to answer. Only basic computer skills are required to register and work your way through this.

You could complain about its lack of sophistication but I think it is a wonderful little tool for reinforcing information about family violence screening and intervention. I would certainly recommend it to my students and any other health professionals.

My only 'complaints' were:
  • that the only date attached to the web site was 2004 so I do not know when this course was last updated, and consequently I do not know how current the information is other than by looking at the dates of the references;
  • the references came right at the end of the course and I had to hunt for them. I would have preferred to have had access to the references at the end of each chapter;
  • there was no other way to contact the author/s other than the ability to email for 'help'.
I think this course is an excellent resource but if something like this is going to be made freely available, I feel it is really important to ensure that the readers know it is current and hasn't been abandoned years ago like old satellites in space.

Image: 'Silhouette series # 2'

Thursday, April 10, 2008

My great Web 2.0 day!

A great day!
I have just had a great Web 2.0 day!

OpenPD seminar
It started about 9am when I saw a Twitter message from Sue Waters - I was still lounging about in bed. She had sent out an invitation to join an open access seminar facilitated by the OpenPD team. OpenPD is a free open access program that aims to educate teachers and anyone interested in the use of Web 2.0 tools such as blogs and wikis.

I joined in because I wanted to know more about OpenPD and because they were using UStream as their web conference program, which is a technology I want to look at in more detail. It was great fun to try out a new technology and 'meet' people from countries like USA, South Africa, UK and Australia who are learning about blogging. Made me realize how much I have learned in the last few months. I think I was able to contribute a few helpful ideas. The tip I picked up was to put headings in a post, which will make reading it a lot easier.

Online seminars wiki
I spent the rest of the morning thinking about the program of online professional development seminars that I am planning for midwives and health professionals. These seminars will be free, open access seminars, headed by key midwives and researchers in Australasia. They will follow a similar format introduced to me by Leigh Blackall, using a 10 minute formal 'lecture' followed by discussion and questions. The plan is to replicate the model of free professional development seminars provided by MIDIRS in the UK, which will be better suited, time wise, to the southern hemisphere. I threw around a few ideas with my best mate who lives in Sydney, Australia using Skype.

The result of my thoughts and Skype discussion has led to me starting a wiki. The wiki will act as a tool for developing the program and providing information for people who want to attend the seminars or be a presenter.

Digital literacy meeting
The afternoon was spent at a meeting about digital literacy where I work at Otago Polytechnic. The meeting was attended by staff from all over the Polytechnic who are working to incorporate Web 2.0, flexible delivery and social networking into their programs.

It was hugely exciting to see what others are doing in a diversity of programs from cooking to art and vet nursing. The outcome of the meeting was that we all agreed on the value of institutional collaboration, 'globalising' our digital literacy resources instead of us reinventing the wheel over and over. It feels very positive to part of this institutional movement and collaboration.

Image: 'ekuverikamakee, gadha fadha baareh'

Midwives in the news again

The national shortage of midwives has hit the news again.

I wonder what's going to be done about it?

Wednesday, April 9, 2008

My third video option

This is my third option of video, courtesy of my new 'point and shot' camera that I was given for my birthday: the two previous choices were my web cam and my 'posh' camera.

Of the three options, I think this is the best quality - you can see quite clearly that I've just got out of bed! But the sound isn't so good - I sound as if I have a lisp.

On reflection, I think this will suffice for short videos I make for my ePortfolio reflections. I would agree with Claire Thompson, who wrote in her post 'Look Ma, I'm on TV' that there is a limited appeal for very long video presentations. So it is important to consider how I am going to use video and how it will engage my audience.

Tuesday, April 8, 2008

Working as a midwife in Gisborne, New Zealand

Here is my account of my experiences of working as a midwife in Gisborne, when I emigrated to New Zealand from England. This slidecast was developed to put in the employment section of my ePortfolio.

I tried to keep this to under ten minutes but just couldn't do it!

My ePortfolio: recording sensitive professional midwifery material

Those of you who have been following this blog recently will know that I have been building my ePortfolio. As I have said before, one of the reasons for this is because I am required to have a portfolio as a midwife in New Zealand. So I want to model ePortfolios for my students and midwives who are interested in the concept.

The area that is causing me the most concern is how I present the information that pertains to clients and my professional practice in a way that is meaningful for my reflection, but keeps both my clients and myself safe, and observes all professional and legal standards that regulates my practice.

So where I have got to now is that I have almost completed the Midwifery Review section of my ePortfolio. This is the part of the portfolio that is most likely to have sensitive professional information in it. I have taken the material from all my previous reviews and put them into this portfolio. There are a couple of things I have omitted and I have made a few changes, but otherwise, what you see is what I have presented in the past to the Review Committees.

I am conscious that there is a lot of written text which could be very boring for readers, although that is how Review material is currently presented to the Reviewers.

Here are the questions I would really appreciate feedback on because these will be issues that face the profession as midwives explore the option of ePortfolios.
  • What do you think about the clinical stories I have presented? Is it acceptable for them to be in the public eye or are they breaching confidentiality and should be kept in a private space?
  • What material should stay in text form and what could be presented effectively in video or audio?
  • How 'honest' can I be about my personal clinical practice in an open forum?
  • How much background information should be given to accommodate non-midwifery readers - are non-midwives likely to be interested?
Any feedback about these issues would be gratefully received.

What I am loving about the electronic format for my portfolio is that I can link and add material into my writing that I would not otherwise would not be able to do in a paper portfolio. I am also finding that the links between my ePortfolio and the reflections in my blog are increasing. I am getting to the point of saying that the two are dependent on each other.

Midwifery Sustainability Wiki

Lorna Davies has just started a wiki on midwifery sustainability. I have joined up and will be very interested to see how this wiki develops in the midwifery community.

Lorna is using Wetpaint which is a wiki platform that I have never heard of before. So I am looking forward to comparing its attributes to platforms such as wikispaces and wikeducator.

The thing that 'bugs', or 'concerns' or 'niggles' at me is that 'we' (in this case, I mean midwives but it applies to 'everyone') are doing bits and pieces all over the place and it is difficult to track where and what people are doing. I wonder if it would be much better... easier... logical...time saving... consistent...if we all agreed to work in just one or two places.

But how we agree on what platform to use is another issue. I guess the first step is to make sure we are all talking the same language and communicating with each other regularly.

Any thoughts on this?

Image: 'Waterfall'

Monday, April 7, 2008

Planning for International Day of the Midwife 2008

International Day of the Midwife is on Monday 5th May. I have been thinking about how midwives can really make it 'international' by organizing some sort of virtual activity like an online seminar via Elluminate or Second Life.

Do you have any thoughts about what would be useful or even, fun? If a virtual seminar was organised, how would you like to attend - web conference, email discussion, Second Life or do you have a different idea?

What topic would you like to explore?

Any ideas at all?

Sunday, April 6, 2008

Saturday, April 5, 2008

Thomas Beatie, pregnant man on Oprah

Here is the interview that Oprah had with Thomas Beatie, who is a transgendered man having a baby.

Friday, April 4, 2008

Placements for overseas student midwives in New Zealand

Another question I get asked frequently is from student midwives who live overseas and who want to come to New Zealand for short placements.

On the whole I am fairly unhelpful, mostly for selfish reasons. One of my jobs is to organize placements for students here in New Zealand and I find it a challenge at the best of times. We only have a small population of midwives here and it can be very difficult to find quality placements with midwives who provide excellent support and teaching, as well as the numbers of births that the students require. So having foreign students here contesting these placements only adds to the pressure I face.

But my selfish motivations aside, here is the advice I normally give students from overseas.
  1. Contact the New Zealand College of Midwives and ask for their advice about how to organize a placement.
  2. Plan to come in December/January when midwifery and medical students are generally on holiday. Having said that, the academic year for student midwives is about to become longer so that will reduce the window of opportunity for overseas students.
  3. Contact the big general hospitals in places like Auckland, Wellington and Christchurch who may be more likely to be able to place students in hospital wards. But be mindful that that will not give you an all-round feel for midwifery practice in New Zealand compared to hospital practice in countries like the UK.
If you have any other advice for overseas students, please feel free to drop me a comment. I am also happy to hear from you if you think I am being rude and unhelpful!

Image: 'New Zealand / Beach near Dunedin'

Tuesday, April 1, 2008

Video using my digital photo camera

Here is a short video clip using my digital photo camera.

What do you think is better - the video here or the one using my web cam? What was the better quality picture and sound, and which one was easier to download?

Using video to connect with my readers

A number of comments have been made over the last couple of days that has made me think about how I can get generate a sense of who I am online, especially when I am talking about things like my midwifery philosophy and how I practice as a midwife. I am very comfortable using text and photos, but this media only allows the reader to see one or two dimensions of who I am.

Initially, this came about from discussions I have been having with Michele Martin, particularly in connection with how I am creating my online identity in my ePortfolio and how I am trying to present more personal reflections about who I am and so on. In response to Michele's comments about connecting with the audience in a more effective way, I posted a slidecast (Powerpoint and audio) in my ePortfolio explaining how I practice as a midwife. The audio alongside the various images seems to work well, although I do tend to drone on at times.

Then I read a blog post by Sue Waters who also talks about how to develop your online identity and connect with readers. I have been communicating with Sue for some months via a number different communication modes such as Twitter, email and blogs. I have seen various photos of her and I have got a sense of who she is through her writing. But when I watched the video she made of herself talking, I caught a completely different glimpse of who she is and that has really reinforced the power of video to me. So I think I will use it a lot more in my ePortfolio and also in my online teaching. I guess the only thing I must be mindful of is the people whose Internet connections are not strong enough to download the videos, and reinforce what I say with some sort of text summary.

I do not have a digital video so I am going to experiment with my web cam (pretty basic) and camera to find out which makes the best quality video and is easiest to embed into my blog and ePortfolio. Here's my first attempt using my web cam.