Generativity: transforming and transmitting midwifery practice

Objective. To explore midwives’ perceptions of developing their practice knowledge and skills, concerning maternal postnatal genital tract assessment (GTA); and to highlight how midwives pass on their practice knowledge and skills to student midwives. Design. A constructionist grounded theory methodology was employed to guide the design and processes. Ethical approval was gained from the regional research ethics committee and the research and development committee at the data collection site. Sampling was purposeful and data were collected using narrative style in-depth interviews involving 14 midwives. Setting. A small maternity unit providing midwifery care to childbearing women in both the hospital and community setting in the north east of England. Findings. The findings of this study suggest midwives engage in two processes: transforming practice and transmitting practice. Transforming practice involved the midwives progressively changing their practice over time. The principal factor that affected the midwives transforming their practice was engaging in diverse practice experiences, which facilitated competence and confidence with a range of assessment methods. Transmitting practice involved the midwives creating learning opportunities for student midwives and articulating their clinical reasoning. However, the midwives voiced concerns that changes to maternity services provision limited the contact midwives and student midwives had with women postnatally. They believed this impacted upon the ability to develop and pass on their practice knowledge and skills concerning maternal postnatal GTA. The findings suggest midwives engage in generativity, a process in which adults attempt to develop a future legacy by initiating change in the thoughts and actions of themselves and others. Conclusions. This study provides a rich understanding, from the midwives’ perspectives, of how and why their midwifery practice knowledge and skills concerning maternal postnatal GTA has changed. The significance of opportunities to engage in diverse experiences and opportunities for discourse and reflection to transform experience into learning is highlighted.