The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women.
Courage has remained an elusive concept to define despite having been in the English lexicon for hundreds of years. The Canterbury earthquake sequence that began in 2010 provided a unique context in which to undertake research that would contribute to further conceptualisation of courage. This qualitative study was undertaken in Christchurch, New Zealand, with adults over the age of 70 who experienced the Canterbury earthquakes and continued to live in the Canterbury region. The population group was chosen because it is an under researched group in post-disaster environments, and one that offers valuable insights because of members' length and breadth of life experiences, and likely reminiscent and reflective life stage. A constructivist grounded theory approach was utilised, with data collected through semi-structured focus groups and individual key informant interviews. The common adverse experience of the participants initially discussed was the earthquakes, which was followed by exploration of courage in their other lived experiences. Through an inductive process of data analysis, conceptual categories were identified, which when further analysed and integrated, contributed to a definition of courage. The definition was subsequently discussed with social work professionals who had remained working in the Canterbury region after experiencing the earthquakes. From the examples and the actions described within these, a process model was developed to support the application of courage. The model includes five steps: recognising an adverse situation, making a conscious decision to act, accessing sources of motivation, mastering emotion and taking action. Defining and utilising courage can help people to face adversity associated with everyday life and ultimately supports self-actualisation and self-development. Recommendations from the study include teaching about courage within social work education, utilising the process model within supervision, intentionally involving older adults in emergency management planning and developing specific social work tasks in hospital settings following a disaster.
