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dc.contributor.authorHarris, Fiona Margaret-
dc.contributor.authorvan, Teijlingen Edwin-
dc.contributor.authorHundley, Vanora-
dc.contributor.authorFarmer, Jane-
dc.contributor.authorBryers, Helen-
dc.contributor.authorCaldow, Jan-
dc.contributor.authorIreland, Jillian M-
dc.contributor.authorKiger, Alice-
dc.contributor.authorTucker, Janet-
dc.description.abstractObjective: to explore and understand what it means to provide midwifery care in remote and rural Scotland. Design: qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach. Setting: remote and rural areas of Scotland. Participants: predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs. Findings: remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without on site specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Where as most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence. Conclusions: this study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations. Implications for practice: it is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be required in considering issues of transfer.en_UK
dc.relationHarris FM, van Teijlingen E, Hundley V, Farmer J, Bryers H, Caldow J, Ireland JM, Kiger A & Tucker J (2011) The buck stops here: Midwives and maternity care in rural Scotland, Midwifery, 27 (3), pp. 301-307.-
dc.rightsThe publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author; you can only request a copy if you wish to use this work for your own research or private study.-
dc.subjectRural maternity careen_UK
dc.subjectConstructing ruralityen_UK
dc.subjectEmbodied midwifery practiceen_UK
dc.subject.lcshRural health services Scotland-
dc.subject.lcshMaternal health services Scotland-
dc.titleThe buck stops here: Midwives and maternity care in rural Scotlanden_UK
dc.typeJournal Articleen_UK
dc.rights.embargoreasonThe publisher does not allow this work to be made publicly available in this Repository therefore there is an embargo on the full text of the work.-
dc.type.statusPublisher version (final published refereed version)-
dc.contributor.affiliationNMAHP Research-
dc.contributor.affiliationUniversity of Aberdeen-
dc.contributor.affiliationUniversity of Stirling-
dc.contributor.affiliationUHI Millennium Institute-
dc.contributor.affiliationNHS Highland-
dc.contributor.affiliationUniversity of Aberdeen-
dc.contributor.affiliationBournemouth University-
dc.contributor.affiliationUniversity of Aberdeen-
dc.contributor.affiliationUniversity of Aberdeen-
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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