Nurses and midwives are the largest group of health providers in Australia (60%), and with increasing remoteness, this proportion increases substantially.1 The recruitment and retention of nurses, and more specifically midwives in rural health services, is at crisis point. Sustainable birthing services will be reliant on a stable, regenerative workforce. Key to this goal is the education of nurses, midwives and doctors, all of whom have stringent pre-service professional placement quotas in order to meet required competencies to practice. The rural workforce crisis in maternity care has been a driving force in health care reform.2 Rural innovation has involved negotiating the space between increased medical risk and the need for a healthy pregnant woman to have the option of staying within her local community to have her baby.3,4 Rural nurses and midwives together with rural doctors agree that continuity of care, irrespective of how it is achieved, is associated with the best outcomes for women and their families in rural locations.4–6 Continuity of care can be achieved using a shared-care medical model involving obstetricians and general practitioners, or midwifery-led primary maternity care services. In the process of securing maternity services that provide continuity of care, the influence of specialist obstetricians, a limited resource in rural locations, has been moderated, and unique solutions to local problems have resulted in the formation of collaborative relationships involving rural nurses, midwives and general practitioners. This polemic makes an argument for a review of the current regulatory requirements for both the education of undergraduate rural nurses and midwives, and the continuing registration of rural midwives who work predominantly in nursing roles. In doing so, the authors provide an overview of the dilemmas facing policymakers, educators, health services managers and clinicians in the provision of sustainable maternity services in rural and remote Australia.
Summary Background Clinical placements form a large and integral part of midwifery education. While much has been written about nursing students' clinical placements, less is known about clinical experiences of undergraduate midwifery students. In nursing, belongingness has been demonstrated to be a key factor in clinical learning but little is known about this in midwifery education. Objectives This study sought to examine undergraduate midwifery students' sense of belongingness in their clinical practice. Design A quantitative design using an online questionnaire was employed. A tool adapted by Levett-Jones (2009a), and previously used with nursing students, was utilised to examine sense of belonging in undergraduate midwifery students. Participants Sixty undergraduate midwifery students from two campuses at one Australian university participated in the study. Students were drawn from a single Bachelor of Midwifery degree and a double Bachelor of Nursing/Bachelor of Midwifery degree. Methods On completion of a scheduled lecture, students were invited by one of the researchers to participate in the study by completing the online questionnaire and the link provided. Data were analysed using descriptive statistics. Results Midwifery students generally reported similar perceptions of belongingness with previous studies on nursing students. However, a few differences were noted that require further exploration to fully understand. Conclusions Midwifery students experienced a sense of belonging in their clinical placements. The findings contribute to understandings of the experiences for midwifery students and provide a foundation on which to develop future clinical placement experiences.