Abstract:
In 1990 New Zealand midwives regained the legal right to practice autonomously
Large numbers of midwives exited the hospital system to provide continuity of care
both in the community and in the hospital. These midwives practise independently and
are funded by the state to do so. The New Zealand College of Midwives has
developed and promoted a midwifery model of partnership, incorporating this model
into its Code of Ethics and Standards for Practice. In its commitment both to
professional development and to accountability, and in partnership with consumers of
maternity care, the College developed the Midwifery Standards Review Process. This
process involves the midwife in an annual review of her practice. The midwife gathers
and collates her statistics, and measures her practice against the NZCOM Standards for
Practice. Consumer feedback forms are sent directly to the review co-ordinator. All
this information is presented to a panel consisting of two midwifery peers and two
consumer representatives. Together with the midwife they discuss her year's work and
develop goals for the coming year. The purpose of the review is to provide the
midwife with a supportive, educative environment in which to reflect on her practice
while at the same time providing an avenue for professional accountability.
This study describes the Midwives Standards Review Process in detail using a case
study approach. It finds that the process is a unique and innovative addition to the
ways peer review and reflective practice can be provided. It identifies the issues of quality assurance, reflective practice, supervision and competence as being of most
relevance. In particular it develops the ideas of how reflective practice can be
enhanced within a quality assurance model. It recommends that further research is
undertaken to ascertain whether midwives using the process find it useful, in particular
how it has assisted them in their professional development. Further research may also
increase the body of knowledge on the nature of reflective practice and how it is best
facilitated.
