Midwifery leadership in maternity emergencies: a video analysis

ABSTRACT

Maternity emergencies require effective leadership due to their time-critical high stakes nature, and like many emergency teams are recommended to have a singular leader. Midwives possess many of the skills required for leadership, but the extent to which they contribute to leadership in emergencies is unknown. In this video analysis study of 16 interprofessional teams responding to a simulated post-partum hemorrhage, a functional view of leadership was applied to determine midwifery contribution to leadership. The number and type of leadership utterances by team members during an emergency response was assessed, and midwifery and doctor leadership utterances compared. Midwives contributed just over 40% of all leadership utterances, indicating the occurrence of interprofessional shared leadership, despite the recommendation for a singular leadership. While the number of leadership utterances per scenario was similar for midwives and doctors, midwives contributed less to utterances of a clinical nature compared to doctors but a similar amount of non-clinical leadership. Further exploration of the factors which influence midwifery leadership in emergencies and the impact it may have on patient care is warranted.

KEYWORDS:

• Leadership
• emergencies
• obstetrics
• midwifery

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

Dr Janssens is supported by a Betty McGrath Health Practitioner Fellowship (Mater Foundation). A/Prof Marshall is supported by an Australian National Health and Medical Research Council (NHMRC) ECR fellowship grant [1130929].

Notes on contributors

Sarah Janssens

Dr Sarah Janssens  is the Clinical Simulation Director for Mater Group,  and a Staff Specialist Obstetrician and Gynaecologist at the Mater Mothers' Hospital.

Robert Simon

Dr Robert Simon is an educator with nearly 50 years experience who, until his recent semi-retirement, served as a faculty member of the Harvard Medical School and as Senior Director for Educational Leadership & International Programs at the Center for Medical Simulation, Boston.

Stephanie Barwick

Ms Stephanie Barwick is a registered midwife and critical care nurse, and currently holds the position of Head of Partnerships, Programs and Innovation at Mater Education.

Sharon Clipperton

Ms Sharon Clipperton is the Simulation Manager for Mater Education, and also program lead for Maternity Programs at Mater, complimenting her background as an experienced registered midwife

Michael Beckmann

A/Prof Michael Beckmann is the Director of Mothers' Babies and Womens' Health Services at Mater Group and a Senior Staff Specialist in Obstetrics and Gynaecology.

Stuart Marshall

A/Prof Stuart Marshall is an Anaesthetist, Human Factors Specialist and NHMRC Senior Research Fellow with a research interest in patient safety.