WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

midwife, representing “working the system”, “being a professional” and “working with
complexity” (p. 260). She observes in her study the uniqueness of the New Zealand
midwifery system whereby women who have risk factors are not excluded from LMC
care. Continuity of care prevails and the LMC usually travels the woman’s journey with
her.
Notably, Skinner proposes altering her birth stool to fit New Zealand secondary DHB
midwives midwifery practice. Her research suggests midwives working in shift situations
in hospital settings “might have ‘the demands of the institution’ as the seat for their birth
stools” (p.261). This suggestion reveals the potential dilemma for DHB midwives who
aspire to their professional standards of partnership, continuity of care and promoting
normal birthing, but in reality, organizational factors hinder them from achieving this.
Skinner questions whether midwives who work within the secondary system can be ‘with
women’ and identifies this as an area of research which requires addressing.
Organizational factors which impinge on ‘midwifery work’ are highlighted by Walsh
(2007). He identifies the pressure of time, institutional constraints, regulations and
bureaucratic power differentials both within professional groups and between
professionals and women being of relevance, which concurs with Skinner’s research.
In the absence of research relating to coordinator midwives, research on nurses in charge
of shifts was accessed. Goldblatt, Granot, Admi and Drach-Zahavy (2008) studied the
experiences of nurses being shift leaders in a hospital ward. Coordinator midwives often
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